Immunophenotyping of peripheral immunoregulatory as well as Th17A and Th22 cell subpopulations in kidney transplant recipients under belatacept or cyclosporine treatment
Furuzawa-Carballeda J, Bostock IC, et alTransplant Immunology 2014;30:107–113
Aims
To immunophenotype the peripheral blood subsets, with particular focus on regulatory B cells, regulatory T cells and regulatory dendritic cells as well as Th17A and Th22 subpopulations, in patients on treatment with belatacept compared with patients on chronic cyclosporine at ~6 years post-transplantation.
Interventions
Belatacept or cyclosporine therapy
Participants
41 kidney transplant recipients; 30 receiving belatacept and 11 receiving cyclosporine, and 26 healthy donors
Outcomes
Outcomes were biopsy proven acute rejection, peripheral IL-10-producing B cells, peripheral IDO+ plasmacytoid dendritic cells and frequency of Foxp3+ regulatory T cells
Follow-up
6 years
CET Conclusions
The authors have determined the number of immunophenotypes that are relevant to tolerance induction in patients selected from the BENEFIT trial in Mexico. Thirty recipients were receiving Belatacept while 11 recipients were in the cyclosporine arm of the BENEFIT trial. They also used a third group of age matched blood donors as controls. In the patients on Belatacept there was a significantly higher frequency of IL-10 producing B regs, IDO-expressing dendritic cells and T regs, both CD4+ and CD8+, in the patients on Belatacept than in the cyclosporine group. The results of this carefully done study suggest that Belatacept does produce an immunological phenotype that is compatible with tolerance whereas patients on cyclosporine had higher levels of Th17A and TH22 proinflammatory cells. Although these patients have been selected from a randomised controlled trial it is really an observational study but an important one which needs more extensive study in patients receiving Belatacept.
Data analysis
Modified intention-to-treat analysis
Quality notes
Previously assessed as Vincenti, F., B. Charpentier, et al. (2010). "A phase III study of belatacept-based immunosuppression regimens versus cyclosporine in renal transplant recipients (benefit study)." American Journal of Transplantation 10(3): 535-546.
Trial registration
Not reported