Mieux comprendre les mécanismes immunologiques du rejet chronique chez le greffé rénal afin d'améliorer le diagnostic et la prise en charge thérapeutique


Sacha De Serres

Centre hospitalier universitaire de Québec [CHUQ]


Domaine : nutrition et métabolisme

Programme Chercheurs-boursiers cliniciens - Junior 2

Concours 2018-2019

The main objective of my research program is to improve the diagnostic and therapeutic management of rejection in kidney transplant recipients. In the last twenty years, considerable progress has been achieved in the short-term survival of kidney transplants. Unfortunately, despite these gains the life expectancy of transplanted kidneys has not increased adequately. Still today, a young transplant recipient will need 2 or maybe even more grafts during his or her life. One reason for this failure is chronic rejection, which is difficult to detect and treat. Moreover, the immunosuppressants used are associated with serious side effects, such as life-threatening infection and cancer. To better fight kidney rejection and reduce drug toxicity, we need to explore new ways to depress the immune system.

As part of my research program, one of my objectives is to study a population of immune cells that has received little attention so far in transplantation: the follicular helper T lymphocytes. They seem to be key players in the production of antibodies against the graft; we are currently characterizing how they develop following transplantation. In parallel, my team works at better understanding how the anti-donor antibodies damage endothelial cells in the graft. Finally, I work in collaboration with other researchers across Canada and elsewhere, to develop a tool to detect the patients that are too highly immunosuppressed by their antirejection therapy, putting them at risk of life-threatening infections and cancer. With this new knowledge, we hope to better target immunosuppressive therapy and to reduce the side effects of immunosuppressants.

This will increase the life expectancy of the kidney recipients and prevent their return to dialysis. These tools will be instrumental to adjust immunotherapy not only for kidney recipients, but for recipients of other organs, as well as patients that are immunosuppressed for autoimmune diseases.