Journalartikel

Jahr der Veröffentlichung: 2011

Seiten: 596-609

Zeitschrift: Transplant International

Bandnummer: 24

Heftnummer: 6

ISSN: 0934-0874

DOI Link: https://doi.org/10.1111/j.1432-2277.2011.01241.x

Verlag: Frontiers Media

Abstract: 

P>The Symphony study showed superior 1-year kidney graft outcome in patients on immunosuppression with tacrolimus/mycophenolate mofetil (Tacr/MMF). To analyze whether differences in clinical outcome between maintenance regimens may be explained by their impact on clinically relevant immune parameters, we assessed CD4 helper activity, immunoglobulin-secreting cell (ISC) formation, neopterin, sCD30, and intracellular cytokine production in a prospective study in 77 renal transplant recipients treated with cyclosporine A/azathioprine (CsA/Aza), CsA/MMF, Tacr/Aza or Tacr/MMF at 2 years post-transplant. Tacr- compared with CsA-based immunosuppression was independently associated with increased IL-2 (P < 0.0001, CD4 cells; P = 0.014, CD8 cells) and CD4 cell IL-4 responses (P = 0.046; stepwise logistic regression) resulting in physiological responses in Tacr/Aza patients as compared with 25 healthy controls. MMF versus Aza treatment was proven to be an independent variable associated with suppression of CD4 cell IL-10 responses (P = 0.008), B-cell IL-6R expression (P < 0.0001) and ISC formation [P = 0.020, staphylococcus cowan strain I (SAC I); P = 0.021, pokeweed mitogen (PWM)]. Our data suggest that Tacr/MMF had the most effective impact on graft protective Th2 responses (enhanced CD4 cell IL-4 by Tacr, decreased CD4 cell IL-10 responses by MMF) and suppression of B-cell functions (MMF), whereas Tacr/Aza was associated with physiological IL-2 and IL-4 and stronger humoral responses which may reduce the risk of infectious disease complications.

(ClinicalTrials.gov number: NCT00150891).

Harvard-Zitierstil: Weimer, R., Deisz, S., Dietrich, H., Renner, F., Boedeker, R., Daniel, V., et al. (2011) Impact of maintenance immunosuppressive regimens - balance between graft protective suppression of immune functions and a near physiological immune response, Transplant International, 24(6), pp. 596-609. https://doi.org/10.1111/j.1432-2277.2011.01241.x

APA-Zitierstil: Weimer, R., Deisz, S., Dietrich, H., Renner, F., Boedeker, R., Daniel, V., Kamali-Ernst, S., Ernst, W., Padberg, W., & Opelz, G. (2011). Impact of maintenance immunosuppressive regimens - balance between graft protective suppression of immune functions and a near physiological immune response. Transplant International. 24(6), 596-609. https://doi.org/10.1111/j.1432-2277.2011.01241.x