Pathophysiological role of B cells and the therapeutic potential of anti-CD20 in chronic renal allograft rejection

50%接受肾移植（或“移植”）的患者将不得不在10年内返回透析。一个高风险的群体是那些产生抗体的人。为了帮助延长这些患者的移植物，该项目旨在明确抗体如何与移植物损伤相关。将从300名移植受者中确定大约60名具有抗体的患者。进一步的分析将取决于他们的移植物是否恶化。如果是这样，将检查血液和活检标本，以确定抗体是否（以及如何）参与恶化过程。所有这些患者都将接受治疗，以阻止他们的“B”淋巴细胞（产生抗体的细胞）发挥作用，看看这是否会影响移植物退化的速度。这种疗法在其他抗体相关疾病中效果良好，通常使用安全。一小部分有抗体的患者预计移植物工作良好。这些患者将被研究，试图了解为什么抗体或T细胞不会损害他们的移植物。预计这项工作将有助于理解移植物丢失的机制，并改善移植失败患者的预后。

50% of the patients who receive a kidney transplant (or ‘graft‘) will have to return dialysis within 10 years. One group at high risk are those who develop antibodies. To help prolong the grafts in these patients, this project aims to clarify precisely how antibodies are associated with graft damage. Approximately 60 patients with antibodies from within 300 transplant recipients will be identified. Further analysis will depend on whether their grafts are deteriorating. If so, blood and biopsy specimens will be examined to try and identify whether (and how) antibody is involved in the process of deterioration. All these patients will be offered treatment to stop their ‘B‘ lymphocytes (the cells that makes antibodies) from working, to see if this it affects the rate of graft deterioration. This therapy works well in other antibody-associated conditions and is generally safe to use. A small number of patients with antibodies are expected to have grafts that are working well. These patients will be studied to try and understand why antibodies or T cells do not damage their grafts. It is expected that this work will help understanding of the mechanisms of graft loss and should improve the prognosis of patients with failing transplants.