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Calcineurin and mTOR inhibitors have opposing effects on regulatory T cells while reducing regulatory B cell populations in kidney transplant recipients
Affiliation:1. Infection Biology Laboratory, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain;2. Department of Nephrology, Hospital del Mar. Institute Hospital del Mar for Medical Research (IMIM), Barcelona, Spain;3. Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain;1. Etablissement Français du Sang, Laboratoire d''Histocompatibilité, Lyon, France;2. Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, Lyon, France;3. Hospices civils de Lyon, Hôpital Edouard Herriot, Service d''Immunologie et Transplantation, Lyon, France;4. Université Claude Bernard Lyon 1, Lyon, France;5. Hospices civils de Lyon, Hôpital Edouard Herriot, Service d''Anatomie Pathologique, Lyon, France;6. Hospices Civils de Lyon, Centre de Biologie et Pathologie Est, Laboratoire de Virologie, Lyon, France;1. Division of Immunology Allergy and Infectious Diseases (DIAID), Department of Dermatology, Medical University of Vienna, Vienna, Austria, A-1090;2. Department of Dermatology, Medical University of Graz, Austria, A-8036;3. Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland, 4410;1. Nephrology Department, IDIBELL, Hospital Universitari de Bellvitge, Barcelona, Spain;2. Biochemistry Department, IDIBELL, Hospital Universitari de Bellvitge, Barcelona, Spain
Abstract:BackgroundRegulatory B (Breg) and T (Treg) cells represent a biomarker for tolerance in transplant patients. Despite the importance of Treg and Breg in transplantation and the suggested crosstalk between both suppressive cell populations, little is known on how they are influenced by long-term immunosuppressive treatment. The aim of the present study was to investigate the effect of different immunosuppressive drugs used in routine clinical practice on Treg and Breg cell numbers.MethodsThirty-six kidney transplant recipients with stable graft function were recruited and classified according to their concomitant therapy: 22 patients received calcineurin inhibitors (CNI) and 14 patients received mammalian target of rapamycin (mTOR) inhibitors. A group of 8 healthy untreated subjects was included as control. Absolute numbers of peripheral blood-derived IL10-producing B cells (CD19+IL10+), CD19+CD24hiCD38hi transitional B cells and Treg cells (CD4+CD25+FOXP3+) were quantified in all KT patients and controls by flow cytometry.ResultsCD19+CD24hiCD38hi transitional B cells increased over time and seem to be related with long-term therapeutic graft survival irrespective of the treatment regimen. CNI and mTOR inhibitors significantly reduced numbers of Breg cells when compared with healthy individuals, whereas mTOR inhibitors expanded Treg cells in comparison with CNI drugs.ConclusionsBridging the drug-mediated reduction of Breg cell numbers in vivo with the requirements of Breg cells for long-term transplant success remains an as yet unresolved task for therapeutic intervention. Further larger cohort studies that evaluate the effect of different treatment regimen on defined lymphocyte subpopulations are warranted.
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