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Injured epithelial cell states impact kidney allograft survival after T-cell-mediated rejection

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Item Type:Article
Title:Injured epithelial cell states impact kidney allograft survival after T-cell-mediated rejection
Creators Name:Pfefferkorn, Anna Maria, Jahn, Lorenz, Gauthier, Patrick T., Kulow, Vera Anna, Roeles, Johannes, Müller-Bötticher, Niklas, Gerhardt, Louisa M.S., Leiz, Janna, Sarfraz, Sadia, Plumbom, Izabela, Greite, Robert, Lovric, Svjetlana, Gamrekelashvili, Jaba, Limbourg, Florian, Schmitz, Jessica, Bräsen, Jan Hinrich, Scheffner, Irina, Sauer, Igor M., Aigner, Felix, Altmüller, Janine, Conrad, Thomas, Gwinner, Wilfried, Ishaque, Naveed, Fähling, Michael, Schmidt-Ott, Kai M., Halloran, Philip F., Ashraf, Muhammad Imtiaz and Hinze, Christian
Abstract:T-cell-mediated rejection (TCMR) remains a major cause of kidney transplant failure, despite being considered treatable. Its impact reflects a limited understanding of the underlying molecular mechanisms and their clinical consequences. To address this, we induced acute TCMR in mouse kidney transplants and profiled molecular changes using single-nucleus RNA sequencing (snRNA-seq), spatial transcriptomics and immunofluorescence. Results were compared with human snRNA-seq data from TCMR and stable allografts, as well as single-cell deconvolution analysis of bulk transcriptomic data from kidney transplant biopsies. Here we show that TCMR induces injured epithelial cell states in mouse kidney allografts, particularly in proximal tubules and thick ascending limbs. Spatial transcriptomics of these injured epithelial states demonstrated heterogeneous localization, interactions with immune cells and cellular microenvironments. Cross-species analysis confirmed similar severely injured epithelial states in human samples, whose abundances correlated with transplant survival and persisted despite TCMR resolution. Collectively, our results identify epithelial injury cell states as a determinant of outcome after TCMR.
Keywords:Allografts, Epithelial Cells, Graft Rejection, Graft Survival, Inbred C57BL Mice, Kidney, Kidney Transplantation, Single-Cell Analysis, T-Lymphocytes, Transcriptome, Animals, Mice
Source:Nature Communications
ISSN:2041-1723
Publisher:Nature Publishing Group
Volume:17
Number:1
Page Range:1060
Date:28 January 2026
Official Publication:https://doi.org/10.1038/s41467-026-68397-1
PubMed:View item in PubMed
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