Document Detail


Elevation of CD4+ differentiated memory T cells is associated with acute cellular and antibody-mediated rejection after liver transplantation.
MedLine Citation:
PMID:  23619734     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is now well known that the outcome after allogeneic transplantation, such as incidence of acute rejections, very much depends on the individual's immune reactivity status. There is also increasing evidence that the presence of preexisting memory T cells can affect antigraft immune responses.
METHODS: In a prospective study, we monitored peripheral CD4 and CD8 central memory, effector memory, and terminal differentiated effector memory (TEMRA) T cells in 55 patients who underwent deceased liver transplantation and received conventional immunosuppressive treatment with or without basiliximab induction. The primary endpoint of the study was acute allograft rejection during a 1-year follow-up period.
RESULTS: We observed significantly increased proportions of CD4 and CD8 TEMRA cells in patients before transplantation compared with healthy controls (P=0.006 and 0.009, respectively). This characteristic was independent of the underlying disease. In patients with no signs of acute rejection, we observed an immediate reduction of CD4 TEMRA cells. In contrast, patients who experienced acute cellular rejection, and especially antibody-mediated rejection, displayed persistent elevated TEMRA cells (P=0.017 and 0.027, respectively). Basiliximab induction therapy did not influence CD4 and CD8 TEMRA numbers.
CONCLUSIONS: Conventional immunosuppressive or basiliximab treatment cannot control the persistence of TEMRA T cells, which may contribute to acute cellular rejection and antibody-mediated rejection after liver transplantation. In the future, specific targeting of TEMRA cells in selected patients may prevent the occurrence of difficult to treat steroid-resistant rejections, thereby leading to improved patient outcome.
Authors:
Undine A Gerlach; Katrin Vogt; Stephan Schlickeiser; Christian Meisel; Mathias Streitz; Desiree Kunkel; Christine Appelt; Stefanie Ahrlich; Nils Lachmann; Peter Neuhaus; Andreas Pascher; Birgit Sawitzki
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transplantation     Volume:  95     ISSN:  1534-6080     ISO Abbreviation:  Transplantation     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-06-18     Completed Date:  2013-08-28     Revised Date:  2013-10-27    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1512-20     Citation Subset:  IM    
Affiliation:
Department of Visceral- and Transplant Surgery, Charite Universitätsmedizin, Augustenburger Platz 1, Berlin, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antibodies, Monoclonal / therapeutic use
CD4-Positive T-Lymphocytes / cytology*
CD8-Positive T-Lymphocytes / cytology
Cell Differentiation
Female
Graft Rejection / immunology*
Humans
Immunologic Memory / immunology*
Immunosuppressive Agents / therapeutic use
Liver Failure / immunology,  therapy*
Liver Transplantation / immunology*
Male
Middle Aged
Prospective Studies
Recombinant Fusion Proteins / therapeutic use
Reverse Transcriptase Polymerase Chain Reaction
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunosuppressive Agents; 0/Recombinant Fusion Proteins; 0/basiliximab
Comments/Corrections
Erratum In:
Transplantation. 2013 Aug 27;96(4):e33

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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