Recipient memory-like lymphocytes remain unresponsive to graft antigens after CAMPATH-1H induction with reduced maintenance immunosuppression.

BACKGROUND: Treatment with CAMPATH-1H at the time of transplantation allows reduced maintenance immunosuppression. We hypothesized that CAMPATH-1H induction would modulate the response of repopulating leukocytes to donor alloantigens. METHODS: The phenotype, proliferative and stimulatory capacity o...

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Main Authors: Trzonkowski, P, Zilvetti, M, Friend, P, Wood, K
Format: Journal article
Language:English
Published: 2006
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author Trzonkowski, P
Zilvetti, M
Friend, P
Wood, K
author_facet Trzonkowski, P
Zilvetti, M
Friend, P
Wood, K
author_sort Trzonkowski, P
collection OXFORD
description BACKGROUND: Treatment with CAMPATH-1H at the time of transplantation allows reduced maintenance immunosuppression. We hypothesized that CAMPATH-1H induction would modulate the response of repopulating leukocytes to donor alloantigens. METHODS: The phenotype, proliferative and stimulatory capacity of peripheral blood leukocytes from 14 renal transplant recipients treated with CAMPATH-1H and reduced immunosuppression with mycophenolate mofetil and tacrolimus were investigated for the first six months after transplantation. The impact of immunosuppressive drugs on leukocytes that escape depletion was also evaluated in vitro. RESULTS: CAMPATH-1H therapy caused a significant decrease in the number of B and T cells, with CD4 T central memory cells being the most resistant to depletion. The recovery of CD8 T cells was faster than that of CD4 T cells. Lymphopenia correlated with a decrease in both proliferative and effector responses, however, the recipient T cells remained responsive to third-party antigens. Dendritic cells (DC) were also depleted but to a lesser extent than lymphocytes; lymphoid DC were more resistant than myeloid DC; these changes correlated with decreased allostimulatory capacity. One of the patients experienced rejection that was treated successfully. The rejection was associated with a high proportion of CD4 T effector memory cells and myeloid DC, increased proliferation and enhanced effector activity to donor antigens. In vitro studies confirmed that the reduced dose of immunosuppressive drugs used could prevent activated T cells from switching to the effector compartment, suppressing both their proliferation and effector activity. CONCLUSIONS: CAMPATH-1H induction combined with reduced maintenance immunosuppression is sufficient to control the effector phase of immune response to donor antigens.
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spelling oxford-uuid:a07aa16b-da69-4a94-bf13-41a7b0abf66e2022-03-27T02:05:43ZRecipient memory-like lymphocytes remain unresponsive to graft antigens after CAMPATH-1H induction with reduced maintenance immunosuppression.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a07aa16b-da69-4a94-bf13-41a7b0abf66eEnglishSymplectic Elements at Oxford2006Trzonkowski, PZilvetti, MFriend, PWood, K BACKGROUND: Treatment with CAMPATH-1H at the time of transplantation allows reduced maintenance immunosuppression. We hypothesized that CAMPATH-1H induction would modulate the response of repopulating leukocytes to donor alloantigens. METHODS: The phenotype, proliferative and stimulatory capacity of peripheral blood leukocytes from 14 renal transplant recipients treated with CAMPATH-1H and reduced immunosuppression with mycophenolate mofetil and tacrolimus were investigated for the first six months after transplantation. The impact of immunosuppressive drugs on leukocytes that escape depletion was also evaluated in vitro. RESULTS: CAMPATH-1H therapy caused a significant decrease in the number of B and T cells, with CD4 T central memory cells being the most resistant to depletion. The recovery of CD8 T cells was faster than that of CD4 T cells. Lymphopenia correlated with a decrease in both proliferative and effector responses, however, the recipient T cells remained responsive to third-party antigens. Dendritic cells (DC) were also depleted but to a lesser extent than lymphocytes; lymphoid DC were more resistant than myeloid DC; these changes correlated with decreased allostimulatory capacity. One of the patients experienced rejection that was treated successfully. The rejection was associated with a high proportion of CD4 T effector memory cells and myeloid DC, increased proliferation and enhanced effector activity to donor antigens. In vitro studies confirmed that the reduced dose of immunosuppressive drugs used could prevent activated T cells from switching to the effector compartment, suppressing both their proliferation and effector activity. CONCLUSIONS: CAMPATH-1H induction combined with reduced maintenance immunosuppression is sufficient to control the effector phase of immune response to donor antigens.
spellingShingle Trzonkowski, P
Zilvetti, M
Friend, P
Wood, K
Recipient memory-like lymphocytes remain unresponsive to graft antigens after CAMPATH-1H induction with reduced maintenance immunosuppression.
title Recipient memory-like lymphocytes remain unresponsive to graft antigens after CAMPATH-1H induction with reduced maintenance immunosuppression.
title_full Recipient memory-like lymphocytes remain unresponsive to graft antigens after CAMPATH-1H induction with reduced maintenance immunosuppression.
title_fullStr Recipient memory-like lymphocytes remain unresponsive to graft antigens after CAMPATH-1H induction with reduced maintenance immunosuppression.
title_full_unstemmed Recipient memory-like lymphocytes remain unresponsive to graft antigens after CAMPATH-1H induction with reduced maintenance immunosuppression.
title_short Recipient memory-like lymphocytes remain unresponsive to graft antigens after CAMPATH-1H induction with reduced maintenance immunosuppression.
title_sort recipient memory like lymphocytes remain unresponsive to graft antigens after campath 1h induction with reduced maintenance immunosuppression
work_keys_str_mv AT trzonkowskip recipientmemorylikelymphocytesremainunresponsivetograftantigensaftercampath1hinductionwithreducedmaintenanceimmunosuppression
AT zilvettim recipientmemorylikelymphocytesremainunresponsivetograftantigensaftercampath1hinductionwithreducedmaintenanceimmunosuppression
AT friendp recipientmemorylikelymphocytesremainunresponsivetograftantigensaftercampath1hinductionwithreducedmaintenanceimmunosuppression
AT woodk recipientmemorylikelymphocytesremainunresponsivetograftantigensaftercampath1hinductionwithreducedmaintenanceimmunosuppression