Korean J Transplant.  2020 Dec;34(Supple 1):S46. 10.4285/ATW2020.OP-1096.

Changes of T lymphocyte subsets after kidney transplantation according to induction immunosuppressants

Affiliations
  • 1Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 2Department of Biomedical Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 3Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Background
The aim of this study is to investigate the change of T cell subsets during early post-transplant period according to the type of induction therapy (anti-thymocyte globulin [ATG] vs. basiliximab).
Methods
We conducted prospective observational study for 174 patients who underwent kidney transplantation and in Seoul St.Mary's Hospital from May 2018 to January 2020. A baseline blood sample was collected within 5 days before the kidney transplant, and additional blood samples were collected and analyzed at 4 weeks and 12 weeks after the kidney transplant. Flow cytometric study of peripheral blood mononuclear cells was performed using anti-CD3, -CD4, -CD57, -CD127, -CD161, -CD45RA, and -CCR7 in order to analyze T cell subsets. We compared the change of each T cell subsets between patients who took ATG (n=61) and basiliximab (n=113).
Results
At baseline, all of the CD4+ and CD8+ T cell subsets did not show significant differences. However, changing pattern of T cell subsets showed significant difference according to the type of induction therapy at 4 weeks and 12 weeks after kidney transplantation. In the ATG group, at 4 weeks, the expression of CD4+CD161+, CD4+CD25+CD127low, and CD8+CD45RA+CCR7- T cells increased, and CD8+CD28nullCD57+ T cells decreased. At week 12, CD4+CD161+, CD4+CD25+CD127low, CD8+CD45RA+CCR7-, CD8+CD45RA-CCR7- T cells significantly increased and CD8+CCR7+ T cells decreased. In basiliximab group, CD8+CCR7+ T cell expression decreased and CD8+CD45RA-CCR7- T cell increased at 12 weeks compared to baseline.
Conclusions
In this study, we observed CD4+CD161+ and CD4+CD25+CD127low T cells activation and increase of CD8+CD45RA+CCR7- T cells in patients with ATG induction in comparison with basiliximab. The correlation between T cell subset changes and clinical outcome could not be confirmed in our study. Further long-term study is required to determine the effect of T cell subsets changes on clinical outcomes.

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