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Successful resolution of inflammation and increased regulatory T cells in sirolimus-treated post-transplant allograft hepatitis.
MedLine Citation:
PMID:  22360400     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Ekong UD, Mathew J, Melin-Aldana H, Wang D, Alonso EM. Successful resolution of inflammation and increased regulatory T cells in sirolimus-treated post-transplant allograft hepatitis. Pediatr Transplantation 2012: 16: 165-175. © 2012 John Wiley & Sons A/S. Abstract:  This retrospective case series reviews our center's experience with sirolimus and a CNI as alternative therapy for the treatment of PTAH. It also characterizes regulatory T cells (Tregs) in PTAH. LT recipients with PTAH who had received or were receiving treatment with sirolimus were retrospectively identified (n = 12). Liver enzymes, immunohistochemistry, and histology were compared in all 12 patients. Immunophenotyping for Tregs in peripheral blood mononuclear cells was performed on LT recipients with PTAH on conventional therapy with CNI, azathioprine ± prednisone (CT) (n = 11), recipients with PTAH on sirolimus, CNI ± prednisone (n = 8), recipients without PTAH (n = 25), and pre-transplant patients (n = 5). Severity of necro-inflammatory changes markedly improved with sirolimus. Treg frequency and number were significantly lower in recipients with PTAH on CT compared to (i) those on sirolimus (p = 0.002 and p = 0.01, respectively), and (ii) recipients without PTAH (p = 0.07 and p = 0.009, respectively). Treg frequency was significantly higher in recipients with PTAH on sirolimus compared to recipients without PTAH under CNI therapy (p = 0.027). Sirolimus in addition to a CNI is successful in reversing inflammation in LT recipients with PTAH. This is associated with significantly higher circulating Tregs.
Authors:
Udeme D Ekong; James Mathew; Hector Melin-Aldana; Deli Wang; Estella M Alonso
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric transplantation     Volume:  16     ISSN:  1399-3046     ISO Abbreviation:  Pediatr Transplant     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9802574     Medline TA:  Pediatr Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  165-75     Citation Subset:  IM    
Copyright Information:
© 2012 John Wiley & Sons A/S.
Affiliation:
Siragusa Transplant Center, Children's Memorial Hospital Comprehensive Transplant Center, Department of Surgery, Northwestern University Department of Microbiology-Immunology, Northwestern University Department of Pathology, Children's Memorial Hospital Children's Memorial Research Center, Chicago, IL, USA.
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