Pattern Recognition Receptor-reactivity Screening of Liver Transplant Patients: Potential for Personalized and Precise Organ Matching to Reduce Risks of Ischemia-reperfusion Injury

Rebecca A. Sosa, Maura Rossetti, Bita V. Naini, Victoria M. Groysberg, Fady M. Kaldas, Ronald W. Busuttil, Yu Ling Chang, David W. Gjertson, Jerzy W. Kupiec-Weglinski, Elaine F. Reed

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Objective and Background:Pattern recognition receptors (PRRs) on immune and parenchymal cells can detect danger-associated molecular patterns (DAMPs) released from cells damaged during ischemia-reperfusion injury (IRI), in heart attack or stroke settings, but also as an unavoidable consequence of solid organ transplantation. Despite IRI being a significant clinical problem across all solid organ transplants, there are limited therapeutics and patient-specific diagnostics currently available.Methods:We screened portal blood samples obtained from 67 human liver transplant recipients both pre-[portal vein (PV) sample] and post-(liver flush; LF) reperfusion for their ability to activate a panel of PRRs, and analyzed this reactivity in relation to biopsy-proven IRI.Results:PV samples from IRI+ orthotopic liver transplantation (OLT) patients (n = 35) decreased activation of hTLR4-and hTLR9-transfected cells, whereas PV from IRI-patients (n = 32) primarily increased hTLR7 and hNOD2 activation. LF samples from OLT-IRI patients significantly increased activation of hTLR4 and hTLR9 over IRI-LF. In addition, the change from baseline reactivity to hTLR4/9/NOD2 was significantly higher in IRI+ than IRI-OLT patients.Conclusions:These results demonstrate that TLR4/7/9 and NOD2 are involved in either promoting or attenuating hepatic IRI, and suggest a diagnostic screening of portal blood for reactivity to these PRRs might prove useful for prediction and/or therapeutic intervention in OLT patients before transplantation.

Original languageEnglish (US)
Pages (from-to)922-931
Number of pages10
JournalAnnals of surgery
Volume271
Issue number5
DOIs
StatePublished - May 1 2020

Keywords

  • damage-associated molecular patterns
  • innate immunity
  • ischemia-reperfusion injury
  • liver transplantation
  • pattern recognition receptors
  • risk score
  • sterile inflammation

ASJC Scopus subject areas

  • Surgery

Fingerprint

Dive into the research topics of 'Pattern Recognition Receptor-reactivity Screening of Liver Transplant Patients: Potential for Personalized and Precise Organ Matching to Reduce Risks of Ischemia-reperfusion Injury'. Together they form a unique fingerprint.

Cite this