[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-618585-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-618585-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","serum-proteomic-profiles-of-microvascular-inflammation-in-donor-specific-antibodynegative-and-c4d-negative-in-kidney-transplantation","Serum Proteomic Profiles of Microvascular Inflammation in Donor-specific Antibodynegative and C4d-negative in Kidney Transplantation","","Serum proteomic profiling was used to characterize isolated microvascular inflammation (iMVI) defined by MVI+/donor-specific antibody (DSA)−/C4d− in kidney transplant recipients. Patients undergoing allograft biopsy from 2013–2024 were grouped into iMVI, antibody-mediated rejection (AMR; MVI+/DSA+/C4d+), and acute tubular injury (ATI; MVI−/DSA−/C4d−), followed by propensity score matching. After proximity extension assay analysis, iMVI showed innate and cytotoxic immune activation protein enrichment, whereas AMR favored adaptive and humoral mediators. Protein risk scores discriminated iMVI and AMR in both main and validation cohorts and selected iMVI proteins associated with higher death-censored graft loss risk.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & Report",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/serum-proteomic-profiles-of-microvascular-inflammation-in-donor-specific-antibodynegative-and-c4d-negative-in-kidney-transplantation/618585/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/serum-proteomic-profiles-of-microvascular-inflammation-in-donor-specific-antibodynegative-and-c4d-negative-in-kidney-transplantation/618585.png","ImageObject",300,407,{"name":42,"@type":43},"Muffet","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-20","2026-10-19",true,{"@type":52,"interactionType":53,"userInteractionCount":22},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What distinguishes isolated MVI (iMVI) in the study?","Question",{"text":62,"@type":63},"iMVI is defined as MVI+/donor-specific antibody (DSA)−/C4d− under the 2022 Banff classification. It is treated as a distinct phenotype from AMR and acute tubular injury.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How were patient groups and cohorts constructed?",{"text":67,"@type":63},"Recipients were classified into iMVI, AMR, or ATI based on MVI, DSA, and C4d status using biopsies from 2013–2024. The main cohort was obtained after propensity score matching, and an independent validation cohort was assembled for additional testing.",{"name":69,"@type":60,"acceptedAnswer":70},"What proteomic patterns were associated with iMVI versus AMR?",{"text":71,"@type":63},"iMVI showed enrichment of innate and cytotoxic immune activation proteins and pathways related to natural killer differentiation and leukocyte migration. AMR showed higher expression of adaptive and humoral immune mediators and interferon-γ–related adaptive pathways.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},618585,1792490070,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":107,"show_sort_weight":108,"slug":109},7,"Healthcare",40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":112,"slug":113},8,30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":111,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":22,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":139,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145},962090768927,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Original Clinical Science—General  \nSerum Proteomic Profiles of Microvascular Inflammation in Donor-specific Antibodynegative and C4d-negative in Kidney Transplantation  \nHee Byung Koh, MD,1 Hyo Jeong Kim, MD,2 Hyung Woo Kim, MD,1 Byounghwi Ko, MD,1 Minyu Kang, MD,3 Hyun Jeong Kim, MD,3 Juhan Lee, MD, PhD,3 Myung Soo Kim, MD, PhD,3 Beom Seok Kim, MD, PhD,1 Kyu Ha Huh, MD, PhD,3 and Jaeseok Yang, MD, PhD1  \nBackground. Microvascular inflammation (MVI) has long been considered a hallmark of antibody-mediated rejection (AMR) . However, the 2022 Banff classification introduced isolated MVI (iMVI; MVI+/donor-specific antibody [DSA]−/C4d−) as a distinct phenotype. The biological characteristics and clinical significance of iMVI remain incompletely understood. Methods. Kidney transplant recipients who underwent allograft biopsy between 2013 and 2024 were classified into iMVI, AMR (MVI+/DSA+/C4d+), and acute tubular injury (ATI; MVI−/DSA−/C4d− ) . After propensity score matching, 80 patients (30 iMVI, 30 AMR, and 20 ATI) compromised the main cohort. An independent validation cohort (n = 88; 26 iMVI, 26 AMR, 26 T-cell–mediated rejection, 10 ATI) was additionally assembled. Serum proteomic profiling was performed using a proximity extension assay. Results. iMVI exhibited a distinct proteomic profile enriched for innate and cytotoxic immune activation proteins, including tumor necrosis factor receptor superfamily member 9, programmed death-ligand 1, interleukin-15 receptor subunit alpha, fibroblast growth factor 19, C-X3-C motif chemokine ligand 1, C-C motif chemokine ligand 23, signaling lymphocytic activation molecule family member 1, and interleukin-10 receptor subunit beta with enrichment of natural killer cell differentiation and leukocyte migration pathway. In contrast, AMR showed higher expression of adaptive and humoral immune mediators, including interleukin-33, interleukin-2, TNF-related apoptosis-inducing ligand, and interleukin-2 receptor subunit beta with enrichment of immunoglobulin production and interferon-γ–related adaptive immune pathways. Protein risk scores showed strong discriminative performance in the main cohort (area under the curve, 0.856 for iMVI; 0.879 for AMR) and retained significant ability in the validation cohort (area under the curve, 0.708 and 0.689, respectively) . Several iMVI-enriched proteins were significantly associated with increased risk of death-censored graft loss. Conclusions. iMVI is characterized by dominant innate and cytotoxic immune activation distinct from AMR and is associated with adverse graft outcomes, supporting its recognition as a clinically meaningful phenotype beyond conventional AMR.  \n(Transplantation 2026;00: 00–00) .  \nINTRODUCTION  \nMicrovascular inflammation (MVI) is characterized by the accumulation of immune cells within glomerular and peritubular capillaries and has long been regarded as a  \npathological hallmark of antibody-mediated rejection (AMR) . In earlier Banff classifications, AMR was diagnosed based on 3 major criteria—the presence of donorspecific antibodies (DSAs), C4d deposition, and evidence  \nReceived 26 December 2025. Revision received 11 June 2026. Accepted 15 June 2026.  \n1 Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.  \n2 Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.  \n3 Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.  \nThis study was supported by a research grant of the Department of Internal Medicine, Yonsei University College of Medicine (2025-2) and the Ministry of Health & Welfare (RS-2023-KH135842).  \nThe authors declare no conflicts of interest.  \nH.B.K., H.Y.K., B.K., H.W.K., M.K., H.J.K., J.L., M.S.K., B.S.K., K.H.H., and  \nJ.Y. participated in conception and design. H.B.K., H.Y.K., B.K., and H.W.K. participated in analysis and interpretation of the data. H.B.K., H.Y.K., B.K., and  \nH.W.K.","cbCails7GAlYnkfd","https://ap.wps.com/l/cbCails7GAlYnkfd","pdf",2144674,13,"English","# Background\n# Methods\n# Results\n# Conclusions\n# Introduction","[{\"question\":\"What distinguishes isolated MVI (iMVI) in the study?\",\"answer\":\"iMVI is defined as MVI+/donor-specific antibody (DSA)−/C4d− under the 2022 Banff classification. It is treated as a distinct phenotype from AMR and acute tubular injury.\"},{\"question\":\"How were patient groups and cohorts constructed?\",\"answer\":\"Recipients were classified into iMVI, AMR, or ATI based on MVI, DSA, and C4d status using biopsies from 2013–2024. The main cohort was obtained after propensity score matching, and an independent validation cohort was assembled for additional testing.\"},{\"question\":\"What proteomic patterns were associated with iMVI versus AMR?\",\"answer\":\"iMVI showed enrichment of innate and cytotoxic immune activation proteins and pathways related to natural killer differentiation and leukocyte migration. AMR showed higher expression of adaptive and humoral immune mediators and interferon-γ–related adaptive pathways.\"}]","Serum Proteomic Profiles of Microvascular Inflammation in Donor-specific Antibodynegative and C4d-negative in Kidney Transplantation | PDF",1792449087,33]