Regulatory T-cell Number in Peripheral Blood at 1 Year Posttransplant as Predictor of Long-term Kidney Graft Survival
Background. Regulatory T (Treg) cells play a role in limiting kidney transplant rejection and can potentially promote long-term transplant tolerance. There are no large prospective studies demonstrating the utility of peripheral blood Treg cells as biomarkers for long-term graft outcome in kidney tr...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2019-03-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000871 |
| _version_ | 1818131472866869248 |
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| author | David San Segundo, PhD Luis H. Galván-Espinoza, MD Emilio Rodrigo, MD, PhD Juan Irure, BSc Juan C. Ruiz, MD, PhD Gema Fernández-Fresnedo, MD, PhD Laura Riesco, BSc Jairo Bada, MD Lara Belmar, MD Marcos Lopez-Hoyos, MD, PhD |
| author_facet | David San Segundo, PhD Luis H. Galván-Espinoza, MD Emilio Rodrigo, MD, PhD Juan Irure, BSc Juan C. Ruiz, MD, PhD Gema Fernández-Fresnedo, MD, PhD Laura Riesco, BSc Jairo Bada, MD Lara Belmar, MD Marcos Lopez-Hoyos, MD, PhD |
| author_sort | David San Segundo, PhD |
| collection | DOAJ |
| description | Background. Regulatory T (Treg) cells play a role in limiting kidney transplant rejection and can potentially promote long-term transplant tolerance. There are no large prospective studies demonstrating the utility of peripheral blood Treg cells as biomarkers for long-term graft outcome in kidney transplantation. The aim of our study was to analyze the influence of the absolute number of peripheral blood Treg cells after transplantation on long-term death-censored graft survival.
Methods. We monitored the absolute numbers of Treg cells by flow cytometry in nonfrozen samples of peripheral blood in 133 kidney transplant recipients, who were prospectively followed up to 2 years after transplantation. Death-censored graft survival was determined retrospectively in January 2017.
Results. The mean time of clinical follow-up was 7.4 ± 2.9 years and 24.1% patients suffered death-censored graft loss (DCGL). Patients with high Treg cells 1 year after transplantation and above the median value (14.57 cells/mm3), showed better death-censored graft survival (5-year survival, 92.5% vs 81.4%, Log-rank P = .030). One-year Treg cells showed a receiver operating characteristic - area under curve of 63.1% (95% confidence interval, 52.9–73.2%, P = 0.026) for predicting DCGL. After multivariate Cox regression analysis, an increased number of peripheral blood Treg cells was a protective factor for DCGL (hazard ratio, 0.961, 95% confidence interval, 0.924–0.998, P = 0.041), irrespectively of 1-year proteinuria and renal function.
Conclusions. Peripheral blood absolute numbers of Treg cells 1 year after kidney transplantation predict a better long-term graft outcome and may be used as prognostic biomarkers. |
| first_indexed | 2024-12-11T08:21:29Z |
| format | Article |
| id | doaj.art-74ca887acc564fb1978dd6cd4008c2f5 |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-12-11T08:21:29Z |
| publishDate | 2019-03-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-74ca887acc564fb1978dd6cd4008c2f52022-12-22T01:14:39ZengWolters KluwerTransplantation Direct2373-87312019-03-0153e42610.1097/TXD.0000000000000871201903000-0001Regulatory T-cell Number in Peripheral Blood at 1 Year Posttransplant as Predictor of Long-term Kidney Graft SurvivalDavid San Segundo, PhD0Luis H. Galván-Espinoza, MD1Emilio Rodrigo, MD, PhD2Juan Irure, BSc3Juan C. Ruiz, MD, PhD4Gema Fernández-Fresnedo, MD, PhD5Laura Riesco, BSc6Jairo Bada, MD7Lara Belmar, MD8Marcos Lopez-Hoyos, MD, PhD91Immunology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.2Nephrology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.2Nephrology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.1Immunology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.2Nephrology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.2Nephrology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.1Immunology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.2Nephrology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.2Nephrology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.1Immunology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.Background. Regulatory T (Treg) cells play a role in limiting kidney transplant rejection and can potentially promote long-term transplant tolerance. There are no large prospective studies demonstrating the utility of peripheral blood Treg cells as biomarkers for long-term graft outcome in kidney transplantation. The aim of our study was to analyze the influence of the absolute number of peripheral blood Treg cells after transplantation on long-term death-censored graft survival. Methods. We monitored the absolute numbers of Treg cells by flow cytometry in nonfrozen samples of peripheral blood in 133 kidney transplant recipients, who were prospectively followed up to 2 years after transplantation. Death-censored graft survival was determined retrospectively in January 2017. Results. The mean time of clinical follow-up was 7.4 ± 2.9 years and 24.1% patients suffered death-censored graft loss (DCGL). Patients with high Treg cells 1 year after transplantation and above the median value (14.57 cells/mm3), showed better death-censored graft survival (5-year survival, 92.5% vs 81.4%, Log-rank P = .030). One-year Treg cells showed a receiver operating characteristic - area under curve of 63.1% (95% confidence interval, 52.9–73.2%, P = 0.026) for predicting DCGL. After multivariate Cox regression analysis, an increased number of peripheral blood Treg cells was a protective factor for DCGL (hazard ratio, 0.961, 95% confidence interval, 0.924–0.998, P = 0.041), irrespectively of 1-year proteinuria and renal function. Conclusions. Peripheral blood absolute numbers of Treg cells 1 year after kidney transplantation predict a better long-term graft outcome and may be used as prognostic biomarkers.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000871 |
| spellingShingle | David San Segundo, PhD Luis H. Galván-Espinoza, MD Emilio Rodrigo, MD, PhD Juan Irure, BSc Juan C. Ruiz, MD, PhD Gema Fernández-Fresnedo, MD, PhD Laura Riesco, BSc Jairo Bada, MD Lara Belmar, MD Marcos Lopez-Hoyos, MD, PhD Regulatory T-cell Number in Peripheral Blood at 1 Year Posttransplant as Predictor of Long-term Kidney Graft Survival Transplantation Direct |
| title | Regulatory T-cell Number in Peripheral Blood at 1 Year Posttransplant as Predictor of Long-term Kidney Graft Survival |
| title_full | Regulatory T-cell Number in Peripheral Blood at 1 Year Posttransplant as Predictor of Long-term Kidney Graft Survival |
| title_fullStr | Regulatory T-cell Number in Peripheral Blood at 1 Year Posttransplant as Predictor of Long-term Kidney Graft Survival |
| title_full_unstemmed | Regulatory T-cell Number in Peripheral Blood at 1 Year Posttransplant as Predictor of Long-term Kidney Graft Survival |
| title_short | Regulatory T-cell Number in Peripheral Blood at 1 Year Posttransplant as Predictor of Long-term Kidney Graft Survival |
| title_sort | regulatory t cell number in peripheral blood at 1 year posttransplant as predictor of long term kidney graft survival |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000000871 |
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