Assessing the role of phosphorylated S6 ribosomal protein in the pathological diagnosis of pulmonary antibody-mediated rejection
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Assessing the role of phosphorylated S6 ribosomal protein in the pathological diagnosis of pulmonary antibody-mediated rejection. / Lunardi, Francesca; Vedovelli, Luca; Pezzuto, Federica; Le Pavec, Jerome; Dorfmuller, Peter; Ivanovic, Marina; Pena, Tahuanty; Wassilew, Katharina; Perch, Michael; Hirschi, Sandrine; Chenard, Marie Pierre; Sosa, Rebecca A.; Goddard, Martin; Neil, Desley; Montero-Fernandez, Angeles; Rice, Alexandra; Cozzi, Emanuele; Rea, Federico; Levine, Deborah J.; Roux, Antoine; Fishbein, Gregory A.; Calabrese, Fiorella.
I: Journal of Heart and Lung Transplantation, Bind 43, Nr. 3, 2024, s. 403-413.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Assessing the role of phosphorylated S6 ribosomal protein in the pathological diagnosis of pulmonary antibody-mediated rejection
AU - Lunardi, Francesca
AU - Vedovelli, Luca
AU - Pezzuto, Federica
AU - Le Pavec, Jerome
AU - Dorfmuller, Peter
AU - Ivanovic, Marina
AU - Pena, Tahuanty
AU - Wassilew, Katharina
AU - Perch, Michael
AU - Hirschi, Sandrine
AU - Chenard, Marie Pierre
AU - Sosa, Rebecca A.
AU - Goddard, Martin
AU - Neil, Desley
AU - Montero-Fernandez, Angeles
AU - Rice, Alexandra
AU - Cozzi, Emanuele
AU - Rea, Federico
AU - Levine, Deborah J.
AU - Roux, Antoine
AU - Fishbein, Gregory A.
AU - Calabrese, Fiorella
N1 - Publisher Copyright: © 2023 The Authors
PY - 2024
Y1 - 2024
N2 - Background: Pulmonary antibody-mediated rejection is still a challenging diagnosis as C4d immunostaining has poor sensitivity. Previous studies have indicated that the phosphorylated S6 ribosomal protein, a component of the mammalian target of rapamycin (mTOR) pathway, is correlated with de novo donor-specific antibodies in lung transplantation. The objective of this study was to evaluate the phosphorylation of S6 ribosomal protein as a surrogate for antibody-mediated rejection diagnosis in lung transplant patients. Methods: This multicentre retrospective study analyzed transbronchial biopsies from 216 lung transplanted patients, 114 with antibody-mediated rejection and 102 without (19 with acute cellular rejection, 17 with ischemia/reperfusion injury, 18 with infection, and 48 without post-transplant complications). Immunohistochemistry was used to quantify phosphorylated S6 ribosomal protein expression in macrophages, endothelium, epithelium, and inter-pathologist agreement was assessed. Results: Median phosphorylated S6 ribosomal protein expression values were higher in antibody-mediated rejection cases than in controls for all cell components, with the highest sensitivity in macrophages (0.9) and the highest specificity in endothelial expression (0.8). The difference was mainly significant in macrophages compared to other post-lung transplantation complications. Inter-pathologist agreement was moderate for macrophages and endothelium, with higher agreement when phosphorylated S6 ribosomal protein expression was dichotomized into positive/negative. The inclusion of phosphorylated S6 ribosomal protein in the diagnostic algorithm could have increased antibody-mediated rejection certainty levels by 25%. Conclusions: The study supports the role of the mTOR pathway in antibody-mediated rejection-related graft injury and suggests that tissue phosphorylation of S6 ribosomal protein could be a useful surrogate for a more accurate pathological diagnosis of lung antibody-mediated rejection.
AB - Background: Pulmonary antibody-mediated rejection is still a challenging diagnosis as C4d immunostaining has poor sensitivity. Previous studies have indicated that the phosphorylated S6 ribosomal protein, a component of the mammalian target of rapamycin (mTOR) pathway, is correlated with de novo donor-specific antibodies in lung transplantation. The objective of this study was to evaluate the phosphorylation of S6 ribosomal protein as a surrogate for antibody-mediated rejection diagnosis in lung transplant patients. Methods: This multicentre retrospective study analyzed transbronchial biopsies from 216 lung transplanted patients, 114 with antibody-mediated rejection and 102 without (19 with acute cellular rejection, 17 with ischemia/reperfusion injury, 18 with infection, and 48 without post-transplant complications). Immunohistochemistry was used to quantify phosphorylated S6 ribosomal protein expression in macrophages, endothelium, epithelium, and inter-pathologist agreement was assessed. Results: Median phosphorylated S6 ribosomal protein expression values were higher in antibody-mediated rejection cases than in controls for all cell components, with the highest sensitivity in macrophages (0.9) and the highest specificity in endothelial expression (0.8). The difference was mainly significant in macrophages compared to other post-lung transplantation complications. Inter-pathologist agreement was moderate for macrophages and endothelium, with higher agreement when phosphorylated S6 ribosomal protein expression was dichotomized into positive/negative. The inclusion of phosphorylated S6 ribosomal protein in the diagnostic algorithm could have increased antibody-mediated rejection certainty levels by 25%. Conclusions: The study supports the role of the mTOR pathway in antibody-mediated rejection-related graft injury and suggests that tissue phosphorylation of S6 ribosomal protein could be a useful surrogate for a more accurate pathological diagnosis of lung antibody-mediated rejection.
KW - antibody-mediated rejection
KW - antibody-mediated rejection (AMR)
KW - lung transplantation
KW - mammalian target of rapamycin (mTOR) pathway
KW - phosphorylated s6 ribosomal protein (p-S6RP)
U2 - 10.1016/j.healun.2023.10.002
DO - 10.1016/j.healun.2023.10.002
M3 - Journal article
C2 - 37806601
AN - SCOPUS:85179721082
VL - 43
SP - 403
EP - 413
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
SN - 1053-2498
IS - 3
ER -
ID: 384878323