Kidney Recipients with 10 Year Belatacept-Treatment Display an Altered T Cell Subset Composition and Low Plasma Cytokine Levels Compared to Matched Patients with CNI-Based Immunosuppression.
1Institute of Transplant Immunology, IFB-Tx, MHH, Hannover, Germany
2Department of Abdominal, Visceral and Transplantation Surgery, MHH, Hannover, Germany
Meeting: 2017 American Transplant Congress
Abstract number: B25
Keywords: Co-stimulation, Immunosuppression, Kidney transplantation
Session Information
Session Name: Poster Session B: Acute and Chronic Rejection
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Introduction/Background
More than 10 years ago, Belatacept (Bela)-based immunosuppression was investigated in the BENEFIT trial of kidney transplantation (KTx) compared to CNI-based immunosuppression. Bela inhibits T cell costimulation by blocking the binding of CD28 to CD80/CD86. This specific interaction is supposed to affect CD28-dependent de novo T cell responses and, thus, may have less side effects in contrast calcineurin inhibitors (CNI). Therefore, we investigated the long-term effects of Bela on lymphocyte subset composition and plasma cytokine/chemokine levels compared to the CNI group.
Methods
Peripheral blood samples of 5 kidney recipients with Bela- and 10 matched recipients with CNI-treatment were collected, PBMCs were analysed by flow cytometry for lymphocyte subsets using a newly developed Lyotube panel and plasma by multiplex technology for cytokine/ chemokine levels.
Results/Conclusions
In the T cell compartment, Bela-treated patients show some differences to CNI-treated patients: Frequencies of CD56+CD4+ T cells and HLA-DR+CD45RO+ memory Tregs were significantly lower (p<0.03) in the Bela than in the CNI group. Naïve, central, effector memory and TEMRA T cell subsets showed no differences between the two groups. Neither CD27-CD28- “virus-specific” memory T cells nor CCR7-CD57+CD4+ “senescent” T cells, discussed to be responsible for early rejection upon Bela-treatment, are altered. . Slightly reduced plasma levels were detected for many cytokines like IFN-g, TNF-a, IL-1, 4, 10, IL-17 and chemokine like CCL2-4, CXCL8-12. Only MIF was significantly lower in plasma of Bela-treated patients. Importantly, the creatinine levels in both groups were equal. Taken together, long-term treatment of KTx patients with Bela is associated with lower frequencies of activated effector and memory Treg subsets accompanied by low levels of cytokines/chemokines indicating that systemic immunosuppression with equal kidney function can be achieved by a CNI-free regimen.
CITATION INFORMATION: Falk C, Neudörfl C, Scherf A, Daemen K, Keil J, Klempnauer J, Lehner F, Grannas G. Kidney Recipients with 10 Year Belatacept-Treatment Display an Altered T Cell Subset Composition and Low Plasma Cytokine Levels Compared to Matched Patients with CNI-Based Immunosuppression. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Falk C, Neudörfl C, Scherf A, Daemen K, Keil J, Klempnauer J, Lehner F, Grannas G. Kidney Recipients with 10 Year Belatacept-Treatment Display an Altered T Cell Subset Composition and Low Plasma Cytokine Levels Compared to Matched Patients with CNI-Based Immunosuppression. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-recipients-with-10-year-belatacept-treatment-display-an-altered-t-cell-subset-composition-and-low-plasma-cytokine-levels-compared-to-matched-patients-with-cni-based-immunosuppression/. Accessed May 17, 2025.« Back to 2017 American Transplant Congress