Open AccessSuperior 3‐year kidney graft function in patients with impaired pretransplant Th2 responses
Author(s) -
Weimer R.,
Zipperle S.,
Daniel V.,
Carl S.,
Staehler G.,
Opelz G.
Publication year - 1998
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.1998.tb01154.x
Subject(s) - medicine , monocyte , renal function , immunology , creatinine , pokeweed mitogen , cytokine , kidney , t cell , kidney transplantation , gastroenterology , immune system , in vitro , peripheral blood mononuclear cell , biochemistry , chemistry
In a prospective study of 80 patients, we investigated the association of kidney graft rejection with pretransplant CD4 helpersuppressor function, B cell responses, and in vitro cytokine secretion. A pokeweed mitogen‐driven allogeneic coculture system was used to assess CD4 helper/suppressor function and T cell‐dependent B cell responses. SAC I was used for T celland monocyte‐independent stimulation of B cell cultures. B cell differentiation was assessed in a reverse hemolytic plaque assay. ELISAs were used to determine in vitro cytokine secretion. None of the 12 patients with pretransplant CD4 helper defects (<10% helper activity) had acute rejection episodes in contrast to 32 of 68 (47%) patients with normal pretransplant CD4 helper function ( P = 0.001). Patients with pretransplant CD4 helper defects exhibited better 3‐year graft function than patients without CD4 helper defects (serum creatinine of functioning grafts: 1.2 ± 0.1 mg/dl compared to 1.7 ± 0.1 mg/dl, P < 0.05). Low pretransplant IL‐10 responses (<100 pg/ml; 14/80 patients) were significantly associated with a low incidence of acute rejection episodes ( P < 0.01) and good 3‐ year graft function ( P < 0.05). These data show that impaired pretransplant Th2 responses‐CD4 help and IL‐10 responses‐predict a low risk of kidney graft rejection and good 3‐year graft function, whereas Th1 (IL‐2, IFN‐γ) and B cell/monocyte responses are not of predictive value.