PUBLICAÇÕES científicas

Immune monitoring of immunosuppression withdrawal of liver transplant recipients

García de la Garza R (1), Sarobe P (2), Merino J [ES] (3), Lasarte JJ (2), D'Avola D [ES] (4), Belsue V (5), Delgado JA (6), Silva L (5), Iñarrairaegui M [ES] (4), Sangro B (4), Sola I (7), Pardo F (8), Quiroga J [ES] (4), Ignacio Herrero J (9).
(1) Liver Unit, Clínica Universidad de Navarra, Pamplona, Spain.
(2) Division of Hepatology and Gene Therapy, Centro de Investigación Médica Aplicada, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain.
(3) Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain; Department of Immunology, Clínica Universidad de Navarra, Pamplona, Spain.
(4) Liver Unit, Clínica Universidad de Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain; Centro de Investigación Biomédica en Red de enfermedades hepaticas y digestivas (CIBERehd), Spain.
(5) Division of Hepatology and Gene Therapy, Centro de Investigación Médica Aplicada, Pamplona, Spain.
(6) Department of Immunology, Clínica Universidad de Navarra, Pamplona, Spain.
(7) Department of Pathology, Clínica Universidad de Navarra, Pamplona, Spain.
(8) Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain; Department of Surgery, Clínica Universidad de Navarra, Pamplona, Spain.
(9) Liver Unit, Clínica Universidad de Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Spain; Centro de Investigación Biomédica en Red de enfermedades hepaticas y digestivas (CIBERehd), Spain.

Revisão:Transplant Immunology

Data: 1/Out/2015

Hepatologia Área de Tumores de Fígado e Pâncreas Imunologia e Imunoterapia [ES] Cirurgia Geral e Digestiva

Several studies have shown that some liver transplant recipients may tolerate immunosuppression withdrawal. Mechanisms and biomarkers of tolerance are not well known.

METHODS:
Twenty-four LT patients with immunosuppression side-effects underwent progressive immunosuppression withdrawal. Peripheral lymphocyte populations and secretion of cytokines were analyzed at baseline and during withdrawal until tolerance (n = 15) or rejection (n = 9), as well as 3 months after tolerance achievement or rejection resolution (as follow-up). Immunological markers were compared among groups.

RESULTS:
The percentages of CD3+CD4+ cells progressively decreased in both groups. CD3+CD8+ cells gradually increased in tolerant patients. B lymphocytes gradually decreased in tolerant and initially in non-tolerant patients, reverting at rejection.

Regulatory T cells progressively increased until rejection in non-tolerants, decreasing to basal levels after renewing immunosuppression; no significant changes were found in tolerant patients. The percentages and absolute counts of natural killer cells significantly increased in both groups, being more evident in tolerant patients. The secretion of several cytokines was higher in non-tolerant patients when rejection was diagnosed.

CONCLUSIONS:
The greater increase of natural killer cells in tolerant patients suggests their potential role in the tolerance phenomenon.

CITAÇÃO DO ARTIGO  Transpl Immunol. 2015 Oct;33(2):110-6. doi: 10.1016/j.trim.2015.07.006. Epub 2015 Jul 29.

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