¿Son los recuentos de células T reguladoras en sangre periférica un biomarcador predictivo y pronóstico para mejorar los resultados en el trasplante renal?una revisión sistemática

  1. Francisco Herrera Gómez 1
  2. Mónica Vásquez Seoane 2
  3. Waldo del Águila 3
  4. Débora Martín García 4
  5. Álvaro Maurtua-Briseño Meiggs 5
  6. Anunciación González López 6
  7. Beatriz Andrés Martín 6
  8. Álvaro Nava Rebollo 6
  9. Fernando Casquero Fernández 6
  10. Pilar Pascual Núñez 7
  11. Jesús Grande Villoria 6
  12. Jesús Bustamante Bustamante 8
  13. Carlos Ochoa Sangrador 9
  14. Claude Lambert 10
  15. Alicia Mendiluce Herrero 11
  1. 1 Departamento de Biología Celular, Histología y Farmacología, Facultad de Medicina, Universidad de Valladolid
  2. 2 Servicio de Gastroenterología, Hospital Santos Reyes, Complejo Asistencial de Burgos-Sacyl
  3. 3 Innere Medizin, Kliniken Erlabrunn gGmbH
  4. 4 Servicio de Nefrología, Unidad de Hipertensión e Investigación en Riesgo Cardiovascular, Hospital Clínico Universitario-Sacyl
  5. 5 Servicio de Urgencias, Hospital Universitario Río Hortega-Sacyl
  6. 6 Servicio de Nefrología, Hospital Virgen de la Concha, Complejo Asistencial de Zamora-Sacyl
  7. 7 Servicio de Nefrología, Unidad de Trasplante Renal, Hospital Clínico Universitario-Sacyl
  8. 8 Facultad de Medicina, Departamento de Medicina, Dermatología y Toxicología, Universidad de Valladolid
  9. 9 Unidad de Apoyo a la Investigación Hospital Virgen de la Concha, Complejo Asistencial de Zamora-Sacyl
  10. 10 Immunology Laboratory, University Hospital of Saint-Etienne
  11. 11 Hospital Universitario de Valladolid
    info

    Hospital Universitario de Valladolid

    Valladolid, España

    ROR https://ror.org/04fffmj41

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Zeitschrift:
Diálisis y trasplante: publicación oficial de la Sociedad Española de Diálisis y Trasplante

ISSN: 1886-2845

Datum der Publikation: 2017

Ausgabe: 38

Nummer: 1

Seiten: 40-56

Art: Artikel

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Andere Publikationen in: Diálisis y trasplante: publicación oficial de la Sociedad Española de Diálisis y Trasplante

Zusammenfassung

Background: Peripheral blood regulatory T cell numbers could become a suitable biomarker for kidney transplant recipients. Objective: To evaluate the effect of mammalian Target Of Rapamycin (mTOR) inhibitors on regulatory T cell numbers, and the clinical interest of this effect. Design: Systematic review of published and unpublished studies. Data sources: Published and unpublished works databases. Review methods: Search of randomized controlled trials and cohort studies comparing regulatory T cell counts and acute rejection episodes between patients with and without mTOR inhibitors. Correlation between regulatory T cells and glomerular filtration rate might be supplied. Quality of all evidence retrieved was also evaluated. Results: 5 trials and 9 studies were included. Clinical differences made it difficult to obtain quantitative estimates of the effect of immunosuppression on regulatory T cell numbers. Nevertheless, qualitative analysis showed that there are higher regulatory T cell numbers under mTOR inhibitors treatment. Incidence of rejection was similar under calcineurin inhibitors and mTOR inhibitors despite different regultatory T cell numbers. Pooled correlation between regulatory T cells and glomerular filtration rate was, prospectively of 0.114 with 95% confidence interval –0.062-0.406, and retrospectively of 0.13 with 95% confidence interval 0.0-0.361. Evidence on regulatory T cells can relate to equal efficacy of calcineurin inhibitors and mTOR inhibitors in preventing acute rejection. Conclusions: Regulatory T cells counts may be associated with better outcomes under treatment with mTOR inhibitors. There is little relationship between regulatory T cells and glomerular filtration. Registration: PROSPERO (CRD42016046285).

Fuente de los datos: Dialnet