Focal B cell infiltrates in chronically rejecting kidneys are not recognizing anti-donor MHC antigens.
This result does not support the current thinking that chronic rejection is simply an antibody-mediated disease.
Infiltrates are clonal and the antibodies expressed recognize E. Coli LPS.
This result suggests that one driver of chronic kidney transplant injury is LPS derived from the genito-urinary microbiome.
What can be learned at the nexus of the microbiome and transplantation immunology?
We will review what is already known about the influence of the microbiome and LPS on immune-mediated diseases to consider unifying mechanisms.
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