TIM3 and TIGIT-expressing CD4 T cells are impacted by kidney transplantation and associated with risk of infection

IntroductionOlder kidney transplant patients experience higher rates of infection compared with younger transplant patients suggesting the impact of age-associated immune dysfunction. However, little is known about the impact of immunosuppression including antithymocyte globulin (ATG) induction, as...

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Main Authors: Harry Pickering, Subha Sen, Monica Cappelletti, Erik L. Lum, Suphamai Bunnapradist, Elaine F. Reed, Joanna M. Schaenman
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1550154/full
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author Harry Pickering
Subha Sen
Monica Cappelletti
Erik L. Lum
Suphamai Bunnapradist
Elaine F. Reed
Joanna M. Schaenman
author_facet Harry Pickering
Subha Sen
Monica Cappelletti
Erik L. Lum
Suphamai Bunnapradist
Elaine F. Reed
Joanna M. Schaenman
author_sort Harry Pickering
collection DOAJ
description IntroductionOlder kidney transplant patients experience higher rates of infection compared with younger transplant patients suggesting the impact of age-associated immune dysfunction. However, little is known about the impact of immunosuppression including antithymocyte globulin (ATG) induction, as well as whether T cell subtypes can predict risk for infection.MethodsWe collected blood from 91 patients before and then 3 months after kidney transplantation and analyzed CD4 and CD8 T cell phenotypes to determine the impact of immunosuppression on immune maturation, senescence, and infection.ResultsAfter transplantation the number of naïve T cells decreased overall, while TIM3-expressing naïve and central memory (CM) CD4 T cell frequency increased, with more striking change in patients receiving ATG compared with basiliximab induction. Transplantation also led to increased frequency of TIGIT-expressing effector memory (EM) CD4 T cells and senescent TIGIT and KLRG1-expressing CD8 T cells. Decreased frequencies of naïve CD4 and CD8 T cells (p=0.016 and p=0.038, respectively) and increased frequency of CD4 CM and EM TIGIT+ T cells (p=0.022) were associated with development of infection. A model incorporating increased frequency CD4 EM TIGIT+ T cells and ATG induction was predictive of development of infection after kidney transplantation (HR 3.73, CI 1.08-12.9).DiscussionIncreased frequency of TIM3 and TIGIT markers associated with T cell experience and senescence was a notable phenotypic change associated with transplantation and induction and maintenance immunosuppression. Incorporation of TIGIT expression and induction type into an infection prediction model holds promise for risk stratification and individualization of immunosuppression to decrease risk of adverse outcomes, especially for older patients.
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spelling doaj-art-9b68d64a0685409d99d24d9100b2aa122025-08-20T02:25:41ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-05-011610.3389/fimmu.2025.15501541550154TIM3 and TIGIT-expressing CD4 T cells are impacted by kidney transplantation and associated with risk of infectionHarry Pickering0Subha Sen1Monica Cappelletti2Erik L. Lum3Suphamai Bunnapradist4Elaine F. Reed5Joanna M. Schaenman6Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United StatesDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United StatesDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United StatesDivision of Nephrology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United StatesDivision of Nephrology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United StatesDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United StatesDivision of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United StatesIntroductionOlder kidney transplant patients experience higher rates of infection compared with younger transplant patients suggesting the impact of age-associated immune dysfunction. However, little is known about the impact of immunosuppression including antithymocyte globulin (ATG) induction, as well as whether T cell subtypes can predict risk for infection.MethodsWe collected blood from 91 patients before and then 3 months after kidney transplantation and analyzed CD4 and CD8 T cell phenotypes to determine the impact of immunosuppression on immune maturation, senescence, and infection.ResultsAfter transplantation the number of naïve T cells decreased overall, while TIM3-expressing naïve and central memory (CM) CD4 T cell frequency increased, with more striking change in patients receiving ATG compared with basiliximab induction. Transplantation also led to increased frequency of TIGIT-expressing effector memory (EM) CD4 T cells and senescent TIGIT and KLRG1-expressing CD8 T cells. Decreased frequencies of naïve CD4 and CD8 T cells (p=0.016 and p=0.038, respectively) and increased frequency of CD4 CM and EM TIGIT+ T cells (p=0.022) were associated with development of infection. A model incorporating increased frequency CD4 EM TIGIT+ T cells and ATG induction was predictive of development of infection after kidney transplantation (HR 3.73, CI 1.08-12.9).DiscussionIncreased frequency of TIM3 and TIGIT markers associated with T cell experience and senescence was a notable phenotypic change associated with transplantation and induction and maintenance immunosuppression. Incorporation of TIGIT expression and induction type into an infection prediction model holds promise for risk stratification and individualization of immunosuppression to decrease risk of adverse outcomes, especially for older patients.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1550154/fullT cellimmunosuppressionantithymocyte globulinkidney transplantationinfection
spellingShingle Harry Pickering
Subha Sen
Monica Cappelletti
Erik L. Lum
Suphamai Bunnapradist
Elaine F. Reed
Joanna M. Schaenman
TIM3 and TIGIT-expressing CD4 T cells are impacted by kidney transplantation and associated with risk of infection
Frontiers in Immunology
T cell
immunosuppression
antithymocyte globulin
kidney transplantation
infection
title TIM3 and TIGIT-expressing CD4 T cells are impacted by kidney transplantation and associated with risk of infection
title_full TIM3 and TIGIT-expressing CD4 T cells are impacted by kidney transplantation and associated with risk of infection
title_fullStr TIM3 and TIGIT-expressing CD4 T cells are impacted by kidney transplantation and associated with risk of infection
title_full_unstemmed TIM3 and TIGIT-expressing CD4 T cells are impacted by kidney transplantation and associated with risk of infection
title_short TIM3 and TIGIT-expressing CD4 T cells are impacted by kidney transplantation and associated with risk of infection
title_sort tim3 and tigit expressing cd4 t cells are impacted by kidney transplantation and associated with risk of infection
topic T cell
immunosuppression
antithymocyte globulin
kidney transplantation
infection
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1550154/full
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