ATG induction in renal transplant recipients: long-term hazard of severe infection is associated with long-term functional T cell impairment but not the ATG-induced CD4 cell decline

Background and methods - We showed previously that rabbit ATG induction induces a strong decrease of CD4+ T cells together with impaired in vitro IL-2 secretion up to 1year post-transplant. To further characterize long-term immunological effects of ATG induction 2 and 5years post-transplant, we used...

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Hauptverfasser: Weimer, Rolf (VerfasserIn) , Ettrich, Maryam (VerfasserIn) , Renner, Fabrice (VerfasserIn) , Dietrich, Hartmut (VerfasserIn) , Süsal, Caner (VerfasserIn) , Deisz, Sabine (VerfasserIn) , Padberg, Winfried (VerfasserIn) , Opelz, Gerhard (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 12 February 2014
In: Human immunology
Year: 2014, Jahrgang: 75, Heft: 6, Pages: 561-569
ISSN:1879-1166
DOI:10.1016/j.humimm.2014.02.015
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.humimm.2014.02.015
Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S0198885914000858
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Verfasserangaben:Rolf Weimer, Maryam Ettrich, Fabrice Renner, Hartmut Dietrich, Caner Süsal, Sabine Deisz, Winfried Padberg, Gerhard Opelz

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520 |a Background and methods - We showed previously that rabbit ATG induction induces a strong decrease of CD4+ T cells together with impaired in vitro IL-2 secretion up to 1year post-transplant. To further characterize long-term immunological effects of ATG induction 2 and 5years post-transplant, we used sensitive intracellular cytokine analysis in the same prospective study of 84 renal transplant recipients (ATG, n=44). - Results - A significantly increased frequency of severe infectious disease (HR=2.0, p=0.027) as well as suppressed T cell functions were found within 2years after ATG induction but not beyond (logistic regression (logreg): CD4 cell IL-10 responses, p=0.064; T cell proliferation, p=0.038). Impaired T cell proliferation at 2years was associated with occurrence of severe infection (p=0.017). Importantly, a strong and persistent decrease of CD4 cell counts (p<0.0005 at 5years) was independently associated with ATG induction (logreg p=0.002) but not related to functional CD4 cell impairment (helper activity/cytokine production) or an increased risk of infection. - Conclusions - Severe infection up to 2years after ATG induction was associated with impaired T cell proliferative capacity but not with the profound decline in CD4 cell counts that occurred after ATG induction and persisted up to 5years. 
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