Figure 9.

Histologic analysis of protocol kidney graft biopsy, profile of circulating B and T cell subsets, and immunologic functional assays of memory T cell response in patient #5, who received pretransplant infusion of mesenchymal stromal cell (MSC) in the setting of induction therapy with basiliximab/low-dose rabbit anti-thymocyte globulin (RATG). Patient #5, a 42-year-old woman with end-stage renal disease secondary to tubular interstitial nephropathy, received a kidney transplant from her sister, mismatched for two HLA alleles. She was given MSC before surgery (day −1) and induction therapy with the combination of basiliximab and low-dose RATG. A representative image of Gomori’s trichrome staining on 1-year protocol kidney graft biopsy (original magnification 100×) of MSC-treated patient #5 is shown (A). Percentages of circulating CD45RO⁺RA⁻ memory CD8⁺ T cells (on CD3⁺CD8⁺ T cells) (B), percentages of circulating regulatory T cells (Tregs) (Foxp3⁺CD127⁻ on CD4⁺CD25^high T cells) (C), and ratio of the percentages of Tregs to CD45RO⁺RA⁻ memory CD8⁺ T cells (D) in patient #5 (yellow circles) and in control kidney transplant recipients given basiliximab/low-dose RATG induction therapy but not MSC (white histograms) from baseline (pretransplant) to 1-year posttransplant. Number of circulating naïve IgD⁺CD27⁻ B cells (E) and CD24^highCD38^high transitional B cells (F) in patient #5 (yellow circles) and in control kidney transplant recipients given basiliximab/low-dose RATG induction therapy (white histograms) from baseline to 1-year posttransplant. ELISpot for IFNγ (G) and CD8⁺ T cell function by T cell-mediated lympholysis [as percentage of specific lysis at 50:1 effector-target ratio (H)] toward donor or third-party antigens in patient #5 (yellow circles) and in control kidney transplant recipients given basiliximab/low-dose RATG induction therapy (white histograms) on peripheral blood mononuclear cells collected pretransplant and at 1 year after transplantation. Data are mean ± SEM.