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Evaluation of quantitative changes in regulatory T cells in peripheral blood of kidney transplant recipients with skin cancer after conversion to mTOR inhibitors.

Evaluation of quantitative changes in regulatory T cells in peripheral blood of kidney transplant recipients with skin cancer after conversion to mTOR inhibitors.

Authors :
Cegielska A
Lisowska KA
Dębska-Ślizień A
Imko-Walczuk B
Okuniewska A
Rutkowski B
Source :
Postepy dermatologii i alergologii [Postepy Dermatol Alergol] 2018 Oct; Vol. 35 (5), pp. 474-480. Date of Electronic Publication: 2018 Jul 19.
Publication Year :
2018

Abstract

Introduction: Immunosuppressive therapy, necessary for graft survival, has its clinical consequences with an increased risk of developing malignancies being one of them. It seems that the maintenance of a proper balance between cytotoxic and regulatory activity of the immune system may prevent graft rejection, and with a lower risk of cancer.<br />Aim: To assess the quantitative changes in regulatory T cells (Tregs) in peripheral blood of kidney transplant recipients with post-transplantation skin neoplasm after conversion to mTOR inhibitors (mTORi) and to assess the incidence of secondary skin cancer in that group of patients.<br />Material and Methods: Fourteen patients with post-transplant cutaneous malignancies converted to mTORi were included into the study. The control group consisted of eighteen patients maintained on immunosuppressive regimens without mTORi. The level of Tregs with a phenotype defined as CD4lowCD25high was measured before, and 6 months after, mTORi introduction.<br />Results: In all cases, 6 months after conversion, a significant decrease in the ratio of CD4 <superscript>+</superscript> CD25 <superscript>+</superscript> to CD4 <superscript>low</superscript> CD25 <superscript>high</superscript> from 6.52 to 4.29 was detected ( p = 0.035). One patient converted to mTORi developed subsequent skin cancer, while in the control group, subsequent skin cancer was recognized in eight patients. Moreover, introducing mTORi significantly improved progression-free survival in this group of patients ( p = 0.016).<br />Conclusions: Introducing mTORi to the immunosuppressive regimen resulted in an increase in the number of regulatory cells without increasing the incidence of secondary skin cancer in the investigated group of patients.<br />Competing Interests: The authors declare no conflict of interest.

Details

Language :
English
ISSN :
1642-395X
Volume :
35
Issue :
5
Database :
MEDLINE
Journal :
Postepy dermatologii i alergologii
Publication Type :
Academic Journal
Accession number :
30429704
Full Text :
https://doi.org/10.5114/ada.2018.77237