TY - JOUR
T1 - Prolonged lymphocyte depletion by single-dose rabbit anti-thymocyte globulin and alemtuzumab in kidney transplantation
AU - Sageshima, Junichiro
AU - Ciancio, Gaetano
AU - Guerra, Giselle
AU - Gaynor, Jeffrey J.
AU - Cova, Deborah
AU - Zarak, Alberto
AU - Chen, Linda
AU - Mattiazzi, Adela
AU - Kupin, Warren
AU - Roth, David
AU - Hanson, Lois
AU - Livingstone, Alan S.
AU - Ruiz, Phillip
AU - Burke, George W.
PY - 2011/9/1
Y1 - 2011/9/1
N2 - Although antibody induction has gained in popularity, two agents are rarely combined. We retrospectively analyzed peripheral lymphocyte phenotypes of renal transplant recipients who received induction therapy with a different antibody/combination: alemtuzumab(C1H), Thymoglobulin(rATG), daclizumab(Dac), rATG. +. C1H, and rATG. +. Dac. CD4+ T-cells were suppressed by C1H and rATG. +. C1H, as well as by rATG and rATG. +. Dac but to a lesser extent. The effect lasted for 3. years at around 40% of baseline values. CD8+ T-cells showed a similar trend but had a more rapid recovery to baseline. CD19+ B-cells were effectively suppressed for 2. months by C1H and rATG. +. C1H, and abruptly returned to baseline afterwards; suppression by rATG(7 doses) was modest but lasted longer. A higher proportion of CD56. +. CD16+ Natural Killer cells in C1H treated patients suggested a relatively spared effect of C1H on this cell type. Low CD25+ T-cells by 5-dose Dac returned to baseline around 6. months, whereas rATG. +. C1H and rATG. +. Dac showed persistent effect. CD4. +. CD25hi T-cells were suppressed by both rATG. +. C1H and rATG. +. Dac, but the initial proportion of CD4. +. CD25hi T-cells among CD4+ T-cells and CD4. +. CD25hi/CD4. +. CD25lo ratio were significantly higher in rATG. +. C1H. Overall, with extensive and persistent lymphocyte suppression by a simple administration of agents, single-dose rATG. +. C1H induction can be an alternative in renal transplantation.
AB - Although antibody induction has gained in popularity, two agents are rarely combined. We retrospectively analyzed peripheral lymphocyte phenotypes of renal transplant recipients who received induction therapy with a different antibody/combination: alemtuzumab(C1H), Thymoglobulin(rATG), daclizumab(Dac), rATG. +. C1H, and rATG. +. Dac. CD4+ T-cells were suppressed by C1H and rATG. +. C1H, as well as by rATG and rATG. +. Dac but to a lesser extent. The effect lasted for 3. years at around 40% of baseline values. CD8+ T-cells showed a similar trend but had a more rapid recovery to baseline. CD19+ B-cells were effectively suppressed for 2. months by C1H and rATG. +. C1H, and abruptly returned to baseline afterwards; suppression by rATG(7 doses) was modest but lasted longer. A higher proportion of CD56. +. CD16+ Natural Killer cells in C1H treated patients suggested a relatively spared effect of C1H on this cell type. Low CD25+ T-cells by 5-dose Dac returned to baseline around 6. months, whereas rATG. +. C1H and rATG. +. Dac showed persistent effect. CD4. +. CD25hi T-cells were suppressed by both rATG. +. C1H and rATG. +. Dac, but the initial proportion of CD4. +. CD25hi T-cells among CD4+ T-cells and CD4. +. CD25hi/CD4. +. CD25lo ratio were significantly higher in rATG. +. C1H. Overall, with extensive and persistent lymphocyte suppression by a simple administration of agents, single-dose rATG. +. C1H induction can be an alternative in renal transplantation.
KW - Alemtuzumab
KW - Anti-thymocyte globulin
KW - Induction therapy
KW - Kidney transplantation
KW - Monoclonal antibody
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U2 - 10.1016/j.trim.2011.07.002
DO - 10.1016/j.trim.2011.07.002
M3 - Article
C2 - 21784152
AN - SCOPUS:80052338014
VL - 25
SP - 104
EP - 111
JO - Transplant Immunology
JF - Transplant Immunology
SN - 0966-3274
IS - 2-3
ER -