MONITORING OF IMMUNE SYSTEM IN PATIENTS AFTER KIDNEY TRANSPLANTATION

Objective. To study the features of the immune system humoral component in patients after kidney transplantation.

Materials and methods. The dynamics of the subpopulations of CD19+, CD19+IgD+CD27–, CD19+ IgD+CD27+, CD19+IgD–CD27+, CD19+CD5+, CD19+CD40+, CD19+CD86+, immunoglobulins G, M, A, and C3, C4-components of the complements  has been determined in 94 recipients of renal allograft in 0, 1, 3, 10, 30, 90, 180 days. All the patients have received induction therapy of anti-CD25 monoclonal antibodies and triple immunosuppressive therapy including calcineurin inhibitors, antiproliferative drugs (mycophenolate or azathioprine) and corticosteroids.

Results. The levels of CD19+IgD+CD27+ (non-switched memory B lymphocytes) and CD19+CD40+ (activated lymphocytes) were found to be significantly lower in the group of recipients at the pretransplantation stage than in the comparison group (p=0.026 and p=0.031, respectively). The levels of CD19+IgD+CD27 naive B lymphocytes had risen for 6 months after the kidney transplantations progressively: on the 10th and 180th days they were significantly higher than in the comparison group (р10=0.022; р180=0.008). In turn, the number of the switched memory B lymphocytes (CD19+IgD–CD27+) practically did not differ from the same in the comparison group over the entire observation period whereas it significantly decreased (р180=0.003) on the 180th day of the observation. The negative dynamics of the IgG content was observed throughout the whole observation period (р1=0.0003; р3<0.00001; р10<0.00001; р30=0.033; р90<0.00001; р180=0.0001). The IgA levels in the kidney transplant recipients were lower than in the comparison group (р1=0.044; р3=0.03; р10=0.11; р30=0.035; р90=0.018; р180=0.034) during 6 months. The IgM contents had not differed significantly from those in the comparison group for up to 180 days and had become significantly higher (р180=0,048).

Conclusion. The changes identified in the immune status and characterized by decreasing of the switched memory
B-lymphocytes CD19+IgD–CD27+ and immunoglobulins A and G levels and increasing of the CD19+IgD+CD27 naive B-lymphocytes and immunoglobulins M levels in the allotransplant recipients in the post-transplant period are a positive prognostic factor and can be recommended to be used for immunological monitoring in the post-transplantation period.

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Автор(ы): S. V. Zybleva, S. L. Zyblev