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Variability of Immune Biomarkers with the Graft Function in Kidney Transplant Patients in India, an Observational Prospective Cohort Study

Received: 31 July 2023     Accepted: 30 August 2023     Published: 14 September 2023
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Abstract

In renal transplantation (RT), the major issue is to maintain the immune homeostasis, limiting graft rejection (GR), and promoting transplant tolerance. A total of 70 subjects of chronic kidney disease patients on maintenance haemodialysis, opted for RT and 20 controls were recruited. The Tregs% (CD4+CD25+), concentration of cytokines IL –10 and IL 17 were measured in pre-and post-transplant at a defined timelines with stable graft function (SGF) and with GR for two years, using flow cytometer and sandwich ELISA method. With SGF, Tregs% Baseline [8.5 (6.5–10.7) vs. HCs [14.25 (13–18), p < 0.01)], at Baseline vs. six months [11.54 (8.9–15)], p < 0.001); At Baseline [3.05 (1.05–5.2) vs. GR 8.5 (6.5–10.7), p < 0.05]. Serum IL 10 baseline [3.6 (2.56–4.6) vs. HC (6.4 (4.8-9.8), p<0.001]. Serum IL 17 levels at baseline [120 (92 - 176) vs. HC [20.88 (18-55), p<0.05], day four vs. baseline [180 (160.5-257.45); p<0.05], day 90 vs. baseline [53.3 (48-100), p< 0.05] and this was maintained for two years, with GR vs. baseline [190 (105-372); p<0.05]. ROC analysis of Tregs% (AUC of 0.758 and a p – value of <0.05), IL-10 (AUC of 0.8 and a p – value of 0.117), IL-17 (AUC of 0.937 and a p – value of <0.05). With SGF, Tregs % increased from 6 months, IL-17 decreased from 3 months, IL-10 did not show changes and continued till two years; with GR, Tregs% decreased from baseline, IL-10 did not show changes, and IL-17 increased due to high inflammation. ROC analysis showed that the Tregs% and IL-17 are better predictors of graft outcome. However, the association between biomarkers with graft function couldn’t be evaluated which needs further studies.

Published in International Journal of Immunology (Volume 11, Issue 1)
DOI 10.11648/j.iji.20231101.12
Page(s) 6-12
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Renal Transplantation, Immune Biomarkers, Graft Function, Enzyme-linked Immunosorbent Assay, Flow Cytometer

References
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[2] Cooper JE. Evaluation and Treatment of Acute Rejection in Kidney Allografts. Clin J Am Soc Nephrol. 2020 Mar 6; 15 (3): 430-438. doi: 10.2215/CJN.11991019. Epub 2020 Feb 17. PMID: 32066593; PMCID: PMC7057293.
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[5] Huang DL, He YR, Liu YJ, He HY, Gu ZY, Liu YM, Liu WJ, Luo Z, Ju MJ. The immunomodulation role of Th17 and Treg in renal transplantation. Front Immunol. 2023 Feb 1; 14: 1113560. doi: 10.3389/fimmu.2023.1113560. PMID: 36817486; PMCID: PMC9928745.
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[10] Presser D, Seste U et al. Differential kinetics of effector and regulatory T cells in patients on calcineurin inhibitor-based drug regimen. Kidney International (2009) 76, 557–569.
[11] Krajewska M, Kościelska-Kasprzak K, Kamińska D, et al. Kidney Transplant Outcome Is Associated with Regulatory T Cell Population and Gene Expression Early after Transplantation. J Immunol Res. 2019; 7452019. doi: 10.1155/2019/7452019.
[12] Chu Z-Q Q Ji. Sirolimus did not affect CD4 (+) CD25 (high) fork head box p3 (+) T cells of peripheral blood in renal transplant recipients. Transplant Proc. Jan-Feb 2013; 45 (1): 153-6.
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    Bejugama Katyayani, Guditi Swarnalatha, Taduri Gangadhar. (2023). Variability of Immune Biomarkers with the Graft Function in Kidney Transplant Patients in India, an Observational Prospective Cohort Study. International Journal of Immunology, 11(1), 6-12. https://doi.org/10.11648/j.iji.20231101.12

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    ACS Style

    Bejugama Katyayani; Guditi Swarnalatha; Taduri Gangadhar. Variability of Immune Biomarkers with the Graft Function in Kidney Transplant Patients in India, an Observational Prospective Cohort Study. Int. J. Immunol. 2023, 11(1), 6-12. doi: 10.11648/j.iji.20231101.12

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    AMA Style

    Bejugama Katyayani, Guditi Swarnalatha, Taduri Gangadhar. Variability of Immune Biomarkers with the Graft Function in Kidney Transplant Patients in India, an Observational Prospective Cohort Study. Int J Immunol. 2023;11(1):6-12. doi: 10.11648/j.iji.20231101.12

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  • @article{10.11648/j.iji.20231101.12,
      author = {Bejugama Katyayani and Guditi Swarnalatha and Taduri Gangadhar},
      title = {Variability of Immune Biomarkers with the Graft Function in Kidney Transplant Patients in India, an Observational Prospective Cohort Study},
      journal = {International Journal of Immunology},
      volume = {11},
      number = {1},
      pages = {6-12},
      doi = {10.11648/j.iji.20231101.12},
      url = {https://doi.org/10.11648/j.iji.20231101.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20231101.12},
      abstract = {In renal transplantation (RT), the major issue is to maintain the immune homeostasis, limiting graft rejection (GR), and promoting transplant tolerance. A total of 70 subjects of chronic kidney disease patients on maintenance haemodialysis, opted for RT and 20 controls were recruited. The Tregs% (CD4+CD25+), concentration of cytokines IL –10 and IL 17 were measured in pre-and post-transplant at a defined timelines with stable graft function (SGF) and with GR for two years, using flow cytometer and sandwich ELISA method. With SGF, Tregs% Baseline [8.5 (6.5–10.7) vs. HCs [14.25 (13–18), p < 0.01)], at Baseline vs. six months [11.54 (8.9–15)], p < 0.001); At Baseline [3.05 (1.05–5.2) vs. GR 8.5 (6.5–10.7), p < 0.05]. Serum IL 10 baseline [3.6 (2.56–4.6) vs. HC (6.4 (4.8-9.8), p<0.001]. Serum IL 17 levels at baseline [120 (92 - 176) vs. HC [20.88 (18-55), p<0.05], day four vs. baseline [180 (160.5-257.45); p<0.05], day 90 vs. baseline [53.3 (48-100), p< 0.05] and this was maintained for two years, with GR vs. baseline [190 (105-372); p<0.05]. ROC analysis of Tregs% (AUC of 0.758 and a p – value of <0.05), IL-10 (AUC of 0.8 and a p – value of 0.117), IL-17 (AUC of 0.937 and a p – value of <0.05). With SGF, Tregs % increased from 6 months, IL-17 decreased from 3 months, IL-10 did not show changes and continued till two years; with GR, Tregs% decreased from baseline, IL-10 did not show changes, and IL-17 increased due to high inflammation. ROC analysis showed that the Tregs% and IL-17 are better predictors of graft outcome. However, the association between biomarkers with graft function couldn’t be evaluated which needs further studies.},
     year = {2023}
    }
    

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    AU  - Bejugama Katyayani
    AU  - Guditi Swarnalatha
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    DO  - 10.11648/j.iji.20231101.12
    T2  - International Journal of Immunology
    JF  - International Journal of Immunology
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    AB  - In renal transplantation (RT), the major issue is to maintain the immune homeostasis, limiting graft rejection (GR), and promoting transplant tolerance. A total of 70 subjects of chronic kidney disease patients on maintenance haemodialysis, opted for RT and 20 controls were recruited. The Tregs% (CD4+CD25+), concentration of cytokines IL –10 and IL 17 were measured in pre-and post-transplant at a defined timelines with stable graft function (SGF) and with GR for two years, using flow cytometer and sandwich ELISA method. With SGF, Tregs% Baseline [8.5 (6.5–10.7) vs. HCs [14.25 (13–18), p < 0.01)], at Baseline vs. six months [11.54 (8.9–15)], p < 0.001); At Baseline [3.05 (1.05–5.2) vs. GR 8.5 (6.5–10.7), p < 0.05]. Serum IL 10 baseline [3.6 (2.56–4.6) vs. HC (6.4 (4.8-9.8), p<0.001]. Serum IL 17 levels at baseline [120 (92 - 176) vs. HC [20.88 (18-55), p<0.05], day four vs. baseline [180 (160.5-257.45); p<0.05], day 90 vs. baseline [53.3 (48-100), p< 0.05] and this was maintained for two years, with GR vs. baseline [190 (105-372); p<0.05]. ROC analysis of Tregs% (AUC of 0.758 and a p – value of <0.05), IL-10 (AUC of 0.8 and a p – value of 0.117), IL-17 (AUC of 0.937 and a p – value of <0.05). With SGF, Tregs % increased from 6 months, IL-17 decreased from 3 months, IL-10 did not show changes and continued till two years; with GR, Tregs% decreased from baseline, IL-10 did not show changes, and IL-17 increased due to high inflammation. ROC analysis showed that the Tregs% and IL-17 are better predictors of graft outcome. However, the association between biomarkers with graft function couldn’t be evaluated which needs further studies.
    VL  - 11
    IS  - 1
    ER  - 

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Author Information
  • Department of Microbiology, All India Institute of Medical Sciences, Bibinagar, India

  • Department of Nephrology, Nizams Institute of Medical Sciences, Hyderabad, India

  • Department of Nephrology, Nizams Institute of Medical Sciences, Hyderabad, India

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