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Regulatory T cells in kidney transplant recipients: the effect of induction immunosuppression therapy
- Source :
- Nephrology Dialysis Transplantation. 27:2576-2582
- Publication Year :
- 2011
- Publisher :
- Oxford University Press (OUP), 2011.
-
Abstract
- BACKGROUND Regulatory T cells have been suggested to down-regulate the alloimmune response. The aim of this prospective open study was to evaluate the effects of different inductive agents on peripheral blood regulatory T cells in kidney transplant patients and to analyse their association with short-term graft outcome. METHODS Regulatory and effector T cell numbers in peripheral blood were determined by flow cytometry in 71 prospectively followed kidney transplant recipients at postoperative day 0, 7, 14, 21, 28, 60 and 90. Patients were treated with a calcineurin inhibitor-based triple immunosuppression with polyclonal rabbit anti-thymocyte globulin (rATG, n = 28), basiliximab, the anti-CD25 monoclonal antibody (n = 18) or without induction (controls, n = 25). Flow cytometry data were correlated to rejection incidence. RESULTS Compared to controls, CD4(+)CD25(+)FoxP3(+) regulatory T-cell expansion among CD4(+) T cells was noticed in the rATG group at all post-transplant time-points by Day 14 (P < 0.001). A significant decrease in Treg frequency (P < 0.001) and concurrently a transient increase of CD4(+)CD25(low/-)FoxP3(+) population were observed in basiliximab-treated patients 7-60 days post-transplantation. Biopsy-proven acute rejection occurred in 16.7% of controls, 10.7% of the rATG group and in 11.1% of the basiliximab group. Higher CD4(+)FoxP3(+)/CD8(+)CD45RA(+)CD62L(-) ratios were observed repeatedly in those patients after basiliximab induction who were rejection free (P < 0.01). CONCLUSIONS In this study, the rATG induction therapy was associated with an expansion of regulatory cells. Sustained high CD4(+)FoxP3(+)/Teff ratios were associated with the absence of rejection after basiliximab induction.
- Subjects :
- Adult
Graft Rejection
Male
medicine.medical_specialty
Adolescent
Basiliximab
Recombinant Fusion Proteins
medicine.medical_treatment
T cell
Population
T-Lymphocytes, Regulatory
Gastroenterology
Young Adult
Internal medicine
Immune Tolerance
medicine
Humans
Prospective Studies
IL-2 receptor
education
Aged
Antilymphocyte Serum
Immunosuppression Therapy
Transplantation
education.field_of_study
business.industry
Interleukin-2 Receptor alpha Subunit
Antibodies, Monoclonal
FOXP3
Immunosuppression
Middle Aged
Flow Cytometry
Prognosis
Kidney Transplantation
Calcineurin
medicine.anatomical_structure
Nephrology
Immunology
Female
business
Immunosuppressive Agents
Follow-Up Studies
medicine.drug
Subjects
Details
- ISSN :
- 14602385 and 09310509
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- Nephrology Dialysis Transplantation
- Accession number :
- edsair.doi.dedup.....281bfbb515a4d8362b4b0a5a5ecef551