Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Nutritional status is known to modulate immunologic responses in non-immunosuppressed individuals. We utilized the Immune Development in Pediatric Transplantation (IMPACT) study to assess differences in T cell phenotype associated with nutritional status in pediatric kidney recipients.
*Methods: Ninety-eight (98) patients from IMPACT were stratified as having obesity (BMI z-score 2 standard deviations [SD] greater than mean), having normal weight, or being undernourished (BMI, weight- or height-for-age z-score 2 SD less than mean). Memory T Cell markers (CD45RA/CCR7) and markers of terminal differentiation (CD57/PD1) were examined on CD4 and 8 T cells over time by flow cytometry. Differences between groups were determined by generalized estimating equations.
*Results: Of the inlcuded patients, 59% (n=58) had normal weight, 11% (n=11) had obesity, and 30% (n=29) were undernourished. Children with obesity had a significantly higher frequency of CD8+ Temra and a significantly lower frequency of CD8+ T naive cells at 9 months (Figure 1 a&c). These patients had a higher frequency of CD4+ CD57+ PD1- (Figure 2c) and lower frequency of CD8+CD57-PD1+ T cells at 12 months (Figure 2e). Frequencies of CD8+CD57+PD1- and CD8+CD57+PD1+ T cells at baseline and throughout the study were higher among children with obesity (Figure 2g-h).
*Conclusions: Children with obesity undergoing kidney transplant developed a more terminally differentiated T cell repertoire. Given the importance of CD57+ T cells in costimulation blockade resistant rejection, this may have implications for tailoring the use of costimulation blockade based immunosuppression in patients with obesity.
To cite this abstract in AMA style:Shaw BI, Lee H, Chan C, Ettenger RB, Grimm P, Reed EF, Sarwal M, Stempora L, Warshaw B, Martinez OM, Kirk AD, Chambers ET. Obesity and Terminally Differentiated T Cells in Pediatric Kidney Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/obesity-and-terminally-differentiated-t-cells-in-pediatric-kidney-transplantation/. Accessed November 24, 2020.
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