1. The number of circulating recent thymic emigrants is severely reduced 1 year after a single dose of alemtuzumab in renal transplant recipients.
- Author
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Scarsi M, Bossini N, Malacarne F, Valerio F, Sandrini S, and Airò P
- Subjects
- Adult, Alemtuzumab, Antibodies, Monoclonal administration & dosage, Antibodies, Monoclonal, Humanized, Antibodies, Neoplasm administration & dosage, Antineoplastic Agents administration & dosage, Antineoplastic Agents adverse effects, Basiliximab, Biomarkers metabolism, Cell Movement immunology, Female, Humans, Immunophenotyping, Immunosuppressive Agents administration & dosage, Leukocyte Reduction Procedures methods, Lymphocyte Count, Male, Middle Aged, Platelet Endothelial Cell Adhesion Molecule-1 metabolism, Recombinant Fusion Proteins administration & dosage, T-Lymphocyte Subsets drug effects, T-Lymphocyte Subsets metabolism, Thymus Gland drug effects, Antibodies, Monoclonal adverse effects, Antibodies, Neoplasm adverse effects, Cell Movement drug effects, Kidney Transplantation immunology, Lymphopenia chemically induced, T-Lymphocyte Subsets cytology, Thymus Gland cytology
- Abstract
To better understand the kinetics of the delayed reconstitution of peripheral CD4+ T-cells after depletion with a single administration of alemtuzumab (AL) for renal transplantation, we evaluated in these patients the percentage and absolute number of recent thymic emigrants (RTEs) CD4+ T cells, together with naive and memory subsets, defined by the analysis of CD31, CD45RA and CCR7 expression, and compared with patients treated with a nondepleting protocol based on basiliximab, and with healthy controls. In AL-treated patients, the number of circulating CD4+ T cells was greatly reduced 1 year after the infusion (P < 0.01), but the proportions of central memory, effector memory and terminally differentiated effector memory subsets among CD4+ cells were significantly increased. On the contrary, the proportion and the absolute number of naïve CD4+ T cells, although progressively increasing with time, were severely reduced. In particular, the absolute number of RTEs had only very slight increase with time (P = 0.049) and was dramatically low 1 year after the therapy (P < 0.01 vs. healthy controls; P < 0.05 vs. basiliximab-treated transplant recipients). These data suggest that a prolonged defective thymic output after AL therapy in renal transplant recipients is one of the main causes of the persistent CD4+ T-cell lymphopenia observed in these patients.
- Published
- 2010
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