Changes in Immunophenotypes After Conversion from Calcineurin Inhibitors to mTOR Inhibitors in Renal Transplant Recipients

A. Yildiz,^1,4 M. Cavusoğlu,¹ S. Adin,² Y. çaliskan,¹ A. Ozkok,¹ H. Tasçi,³ G. Deniz,² M. Sariyar.³

¹Internal Medicine, Nephrology, Istanbul School of Medicine, Istanbul, Turkey
²Immunology, Experimental Medicine and Research Center, Istanbul, Turkey
³General Surgery, Medicana Organ Transplant Center, Istanbul, Turkey.

Meeting: 2015 American Transplant Congress

Abstract number: C249

Keywords: Immune deviation, Kidney transplantation, T cell clones

Session Information

Session Name: Poster Session C: Translational Biomarkers and Immune Monitoring

Session Type: Poster Session

Date: Monday, May 4, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Chronic toxicity of calcineurin inhibitors (CNI) is one of the major causes of chronic allograft loss. Conversion from CNI to mTOR ((mammalian target of rapamycin) inhibitors has been suggested to avoid CNI toxicity. However, the influence of this conversion on immunological parameters are not well known. We aim to compare Treg ratios and serum cytokine levels of patients converted from CNIs to m-TOR inhibitors.

Methods: Thirty CNI-treated renal transplant recipients with stable graft functions and low immunologic risk were included in the study; 19 were male (63%), 11 were female (37%). Mean age and posttransplant time were 40.8±12 years and 33.5±18 months, respectively. Fourteen patients were converted to everolimus, 16 patients served as control group and continued CNIs. We compared the baseline and 3rd month results of peripheric Treg (CD4+CD25highCD127low/-) ratios and serum levels of cytokines (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17, TNFα, IFNγ) by flow cytometry.

Results: No significant difference in Treg ratios, serum cytokine levels or other biochemical parameters between groups were present at the baseline. Treg ratios significantly increased in the everolimus group at 3rd month (%1.12±0.19 vs. %5.67±1.32; p<0.001) whereas there was no significant difference in the CNI group (%1.18±0.16 vs. %%1.39±0.09; p=0.144). Patients on everolimus had lower serum IL-17A and IL-8 levels than baseline (p=0.023 and p=0.045, respectively) whereas IL-1β, IL-2, IL-4, IL-6, IL-10, IL-12, TNFα and IFNγ levels did not change.

Comparison results of Treg and serum cytokine levels at baseline and 3rd months after conversion.
	Study Group (n:14)				Control group (n:16)
	Basal	3rd month	p value	Bazal	3rd months	p value
Treg (%)	1.12±0.19	5.67±1.32	<0.001	1.18±0.16	1.39±0.09	0.144
IL-8 (MFI)	9.69±1.63	6.45±0.69	0.045	9.28±1.77	6.35±0.90	0.181
IL-17A (MFI)	2.35±0.18	2.01±0.08	0.023	2.35±0.18	2.08±0.06	0.092

Conclusions: m-TOR inhibitors may facilititate immunologictolernce to the graft by increasing Treg ratios. After conversion to m-TOR inhibitors, inflammatory response is decreasing.

To cite this abstract in AMA style:

Yildiz A, Cavusoğlu M, Adin S, çaliskan Y, Ozkok A, Tasçi H, Deniz G, Sariyar M. Changes in Immunophenotypes After Conversion from Calcineurin Inhibitors to mTOR Inhibitors in Renal Transplant Recipients [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/changes-in-immunophenotypes-after-conversion-from-calcineurin-inhibitors-to-mtor-inhibitors-in-renal-transplant-recipients/. Accessed May 18, 2025.

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