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T cell Activation Marker HLA-DR Reflects Tacrolimus-Associated Immunosuppressive Burden and BK Viremia Risk After Kidney Transplantation – An Observational Cohort Study

2025/07/17 by Simon Aberger, Max Schüller, Agnes A. Mooslechner +7 · 1 voice
Medicine · #Polyomavirus and related diseases #Renal Transplantation Outcomes and Treatments #Organ and Tissue Transplantation Research

paper · pdf · doi:10.3389/ti.2025.14443

openalex publication_date 2025/07/17 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/31

Abstract

Kidney transplantation (KT) is the current treatment of choice in patients with end-stage kidney disease. Immunosuppression is required to prevent acute rejection but is associated with a high incidence of adverse events. The immunosuppressive burden substantially differs between individuals, necessitating new immune monitoring strategies to achieve personalization of immunosuppression. To compare the evolution of T cell profiles in correlation with immunosuppression and clinical outcomes, 87 kidney transplant recipients were followed for 12 months after KT. Flow cytometry along with assessment of T cell activation markers and clinical data was performed before KT and during study visits 10 days, 2 months and 12 months after KT. Longitudinal T cell phenotyping revealed a significant decrease of T cell activation markers HLA-DR, FCRL3, and CD147 in CD4 + effector T cells after KT. The most pronounced reduction (75%) was found for the activation-proliferation marker HLA-DR, which persisted throughout the observational period. The decrease in HLA-DR expression reflected immunosuppressive burden through strong associations with tacrolimus trough-level exposure (coeff = −0.39, p < 0.01) and BK viremia incidence (coeff = −0.40, p < 0.01) in multivariable regression analysis. T cell activation marker HLA-DR emerges as a potential biomarker for tacrolimus-related immunosuppressive burden in association with BK viremia risk following KT.

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