Recovery of functional memory T cells in lung transplant recipients following induction therapy with alemtuzumab

Am J Transplant. 2007 Feb;7(2):471-5. doi: 10.1111/j.1600-6143.2006.01641.x.

Abstract

Profound T-cell depletion with the monoclonal antibody alemtuzumab facilitates reduced maintenance immunosuppression in abdominal and lung transplantation. While the phenotype of the post-depletional T cells has been characterized, little is known about their function. In the present study, global and CMV-specific T-cell function was assessed longitudinally in 23 lung transplant (LTx) recipients using T-cell assays (ImmuKnow and T Cell Memory, Cylex, Columbia, MD) during the first year posttransplant after induction therapy. Recovery of mitogen responses were seen at 2 weeks posttransplantation (65%PHA; 58% Con A), despite the low number of circulating T cells (<2%). These responses declined at 4-5 months (24%PHA; 54% Con A) and were partially reconstituted by 9 months (46% PHA; 73% Con A). CMV-specific responses recovered in 80% of R+ patients as early as 2 weeks posttransplant (n = 5) and 72% of patients had a memory response by 3 months (n = 11). In contrast, only 2 of 5 patients who did not exhibit memory responses pre-transplant (R-) developed transient CMV-specific T-cell responses. Our results show that profound depletion of T cells induced by alemtuzumab spares the functional subset of CMV-specific memory T cells. Conversely, CMV R- patients predepletion may require a prolonged period of prophylaxis.

MeSH terms

  • Alemtuzumab
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm / therapeutic use*
  • Concanavalin A / immunology
  • Cytomegalovirus / immunology
  • Cytomegalovirus Infections / etiology
  • Humans
  • Immunologic Memory / immunology*
  • Immunosuppression Therapy / methods*
  • Longitudinal Studies
  • Lung Transplantation / adverse effects
  • Lung Transplantation / immunology*
  • Lung Transplantation / pathology*
  • Lymphocyte Depletion / methods
  • Mitogens / immunology
  • Phytohemagglutinins / immunology
  • Risk Factors
  • T-Lymphocyte Subsets / immunology*
  • T-Lymphocyte Subsets / pathology

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm
  • Mitogens
  • Phytohemagglutinins
  • Concanavalin A
  • Alemtuzumab