Transplantation-Induced Ischemia-Reperfusion Injury Modulates Antigen Presentation by Donor Renal CD11c+F4/80+ Macrophages through IL-1R8 Regulation

J Am Soc Nephrol. 2020 Mar;31(3):517-531. doi: 10.1681/ASN.2019080778. Epub 2020 Jan 27.


Background: In donor kidneys subjected to ischemia-reperfusion injury during kidney transplant, phagocytes coexpressing the F4/80 and CD11c molecules mediate proinflammatory responses and trigger adaptive immunity in transplantation through antigen presentation. After injury, however, resident renal macrophages coexpressing these surface markers acquire a proreparative phenotype, which is pivotal in controlling inflammation and fibrosis. No data are currently available regarding the effects of transplant-induced ischemia-reperfusion injury on the ability of donor-derived resident renal macrophages to act as professional antigen-presenting cells.

Methods: We evaluated the phenotype and function of intragraft CD11c+F4/80+ renal macrophages after cold ischemia. We also assessed the modifications of donor renal macrophages after reversible ischemia-reperfusion injury in a mouse model of congeneic renal transplantation. To investigate the role played by IL-1R8, we conducted in vitro and in vivo studies comparing cells and grafts from wild-type and IL-R8-deficient donors.

Results: Cold ischemia and reversible ischemia-reperfusion injury dampened antigen presentation by renal macrophages, skewed their polarization toward the M2 phenotype, and increased surface expression of IL-1R8, diminishing activation mediated by toll-like receptor 4. Ischemic IL-1R8-deficient donor renal macrophages acquired an M1 phenotype, effectively induced IFNγ and IL-17 responses, and failed to orchestrate tissue repair, resulting in severe graft fibrosis and aberrant humoral immune responses.

Conclusions: IL-1R8 is a key regulator of donor renal macrophage functions after ischemia-reperfusion injury, crucial to guiding the phenotype and antigen-presenting role of these cells. It may therefore represent an intriguing pathway to explore with respect to modulating responses against autoantigens and alloantigens after kidney transplant.

Keywords: ischemia/reperfusion injury; macrophages; transplantation.

MeSH terms

  • Adaptive Immunity / genetics*
  • Animals
  • Antigen Presentation
  • CD11c Antigen / immunology*
  • CD11c Antigen / metabolism
  • Cells, Cultured
  • Cold Ischemia / methods
  • Disease Models, Animal
  • Gene Expression Regulation / genetics
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / methods
  • Macrophages / immunology
  • Macrophages / metabolism
  • Male
  • Mice
  • Receptors, Interleukin-1 / genetics*
  • Receptors, Interleukin-1 / immunology
  • Reperfusion Injury / genetics*
  • Reperfusion Injury / prevention & control
  • Sensitivity and Specificity
  • Signal Transduction / genetics


  • CD11c Antigen
  • Receptors, Interleukin-1
  • SIGIRR protein, human