A better understanding of the immunobiological processes and predictors of graft rejection holds promise for the development of potential therapeutic strategies.
It will also aid individualization of immunosuppression.
Professor Mehra and colleagues from India analyzed the clinical relevance of immune parameters on live-related donor renal transplant graft outcomes.
The research team assessed immune parameters such as antidonor antihuman leukocyte antigen antibodies, and monitored cytokines and their receptors.
The team used flow cytometry-based methods to detect antidonor antibodies and intracellular cytokines.
|Grafts survived in 60% with T- and B-cell antidonor antibodies vs 80% in the antibody-negative group|
Enzyme-linked immunosorbent assay methods were employed to detect antidonor antihuman leukocyte antigen class I and class II antibodies.
This method also detected quantitative serum-soluble interleukin-2 receptor levels.
Patients with antidonor antihuman leukocyte antigen class I-specific immunoglobin G-antibody had an 82% rejection at 1 year vs 56% in the antibody negative group.
On the contrary, the research team found that donor-specific class II antibodies did not have any influence on the graft survival.
However, 15 recipients having both T- and B-cell antidonor antibodies had a significantly poor graft survival of 60% vs 80% in the antibody-negative group.
The team noted that patients with non-donor but antidonor antihuman leukocyte antigen-specific antibodies had a 64% graft survival.
In comparison, graft survival in the antibody-negative group was 88%.
Patients undergoing acute rejection episodes had significantly higher expression of interferon-γ-producing T cells, of 19% vs their pre-transplant levels of 6%.
The team observed that interleuken-2 was increased in rejection episodes during the first month of transplantation vs those with well-functioning grafts and healthy controls.
Dr concludes, “Evaluation of antidonor antibodies by flow cytometry is found to be relatively more sensitive and a better predictor of graft outcome.”
“Further monitoring of cytokine expression profile of primed peripheral T-helper cells and quantitative analysis of interleukin-2 offer additional valuable diagnostic and prognostic tools for follow-up of transplant subjects and a better alternative for functional assessment of immunosuppression.”