Correlaciones clínicas de los recuentos en sangre periférica de células T reguladoras en el post-trasplante renal

  1. Francisco Herrera Gómez 1
  2. Mercedes Nocito Colón 2
  3. Waldo del Águila 3
  4. Débora Martín García 4
  5. Ruth Herrera Gómez
  6. Anunciación González López 5
  7. Pilar Pascual Núñez
  8. Jesús Grande Villoria 5
  9. Raúl Ortiz de Lejarazu Leonardo 2
  10. Jesús Bustamante Bustamante
  11. Christian Genin
  12. Alicia Mendiluce Herrero
  13. Claude Lambert
  1. 1 Departamento de Biología Celular, Histología y Farmacología, Facultad de Medicina, Universidad de Valladolid
  2. 2 Servicio de Microbiología e Inmunología. Hospital Clínico Universitario de Valladolid-Sacyl
  3. 3 Innere Medizin-Kardiologie, Donau-Ries Klinik Nördlingen
  4. 4 Servicio de Nefrología, Unidad de Hipertensión e Investigación en Riesgo Cardiovascular, Hospital Clínico Universitario de Valladolid-Sacyl
  5. 5 Servicio de Nefrología, Hospital Virgen de la Concha, Complejo Asistencial de Zamora-Sanidad de Castilla y León (Sacyl)
Aldizkaria:
Diálisis y trasplante: publicación oficial de la Sociedad Española de Diálisis y Trasplante

ISSN: 1886-2845

Argitalpen urtea: 2017

Alea: 38

Zenbakia: 2

Orrialdeak: 82-91

Mota: Artikulua

Beste argitalpen batzuk: Diálisis y trasplante: publicación oficial de la Sociedad Española de Diálisis y Trasplante

Laburpena

Background: Peripheral blood regulatory T cell counts might be used for decision-making in the clinical management of kidney transplant recipients. Objectives: Evaluation of the relationships between regulatory T cells and various clinical kidney transplant outcomes. Methods: The percentage of regulatory T cells (CD4+CD25+CD127–) was determined in 35 stable kidney transplant patients treated with calcineurin inhibitors or mammalian Target Of Rapamycin inhibitors, and 11 kidney recipients developing cancer or severe infections under treatment with sirolimus or everolimus. These percentages were interpreted according to clinical circumstances associated with an increased risk of acute rejection, cancer and severe infections in the post-transplant period, that were assessed by the Delphi method. Results: High regulatory T cell percentages were observed in stable patients under sirolimus or everolimus, and in patients with cancer and severe infections. These high percentages were not associated with rejection. The Delphi showed that these cells may be insufficient in the setting of an overwhelming inflammatory process and using nephrotoxic immunosuppressants, so that this may contribute to an increased risk of rejection. These cells may also be associated with an in- creased risk of cancer or severe infections in the post-transplant period in the cases of, respecti- vely, a past cancer for a new tumor, and recurrent infections and treatment with sirolimus or everolimus for severe infections. Conclusions: Regulatory T cell counts should be interpreted considering the impact of pro-inflam- matory factors and immunosuppressants. Regarding cancer, probably other factors should be considered. There is a relationship between regulatory T cells and post-transplant infections.