Impact of Induction Immunosuppressants on T Lymphocyte Subsets after Kidney Transplantation: A Prospective Observational Study with Focus on Anti-Thymocyte Globulin and Basiliximab Induction Therapies

Hyung Duk Kim; Hyunjoo Bae; Sojeong Yun; Hanbi Lee; Sang Hun Eum; Chul Woo Yang; Eun-Jee Oh; Byung Ha Chung

doi:10.3390/ijms241814288

Impact of Induction Immunosuppressants on T Lymphocyte Subsets after Kidney Transplantation: A Prospective Observational Study with Focus on Anti-Thymocyte Globulin and Basiliximab Induction Therapies

Int J Mol Sci. 2023 Sep 19;24(18):14288. doi: 10.3390/ijms241814288.

Authors

Hyung Duk Kim¹, Hyunjoo Bae², Sojeong Yun², Hanbi Lee³, Sang Hun Eum⁴, Chul Woo Yang³, Eun-Jee Oh^{5

6}, Byung Ha Chung³

Affiliations

¹ Division of Nephrology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea.
² Department of Biomedical Science, Graduate School, The Catholic University of Korea, Seoul 06591, Republic of Korea.
³ Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
⁴ Division of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Republic of Korea.
⁵ Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
⁶ Research and Development Institute for In Vitro Diagnostic Medical Devices, The Catholic University of Korea, Seoul 06591, Republic of Korea.

Abstract

Induction immunosuppressive therapy for kidney transplant recipients (KTRs) primarily includes interleukin-2 receptor antagonists, such as basiliximab (BXM) or lymphocyte-depleting agents, and anti-thymocyte globulin (ATG). This study aimed to investigate their effects on T cell dynamics during the early post-transplantation period. This prospective observational study included 157 KTRs. Peripheral blood samples were collected from each patient within 5 days before and 4 and 12 weeks after transplantation. Flow cytometric analysis was performed to assess various T cell subsets whose changes were then analyzed. In the ATG group, CD4⁺ T cell expression decreased significantly compared with that in the BXM group. However, CD4⁺CD161⁺ and CD4⁺CD25⁺CD127low T cell expression levels increased significantly. In the CD8⁺ T cell subset, a decrease in CD8⁺CD28nullCD57⁺ and CD8⁺CCR7⁺ T cell expression was observed in the ATG group. However, among patients diagnosed with biopsy-proven acute rejection, T cell subset expression did not significantly differ relative to non-rejection cases. In conclusion, ATG induction therapy resulted in more pronounced changes in T lymphocyte subsets than BXM induction, with increased CD4⁺CD161⁺ and CD4⁺CD25⁺CD127low T cells and an early decrease in CD8⁺CD28nullCD57⁺ and CD8⁺CCR7⁺ T cells, some of which are associated with acute rejection.

Keywords: T lymphocyte subsets; anti-thymocyte globulin; basiliximab; kidney transplantation.

Grants and funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (NRF-2020R1A2B5B01001859), Republic of Korea.