Acute kidney graft allorejection affects primarily the renal cortex. The present study by Chessa et al. offers an explanation for this phenomenon. The authors employ microarray-based gene expression analysis to provide evidence that the hyperosmolarity of the renal medulla induces a transcriptional fingerprint associated with anti-inflammatory functionality in medullary dendritic cells, which may attenuate local alloreactivity. This novel immunoregulatory mechanism hints at a new opportunity to prevent allorejection.
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