The imbalance of T helper 17/regulatory T cells and memory B cells during the early post-transplantation period in peripheral blood of living donor liver transplantation recipients under calcineurin inhibitor-based immunosuppression

Immunology. 2013 Feb;138(2):124-33. doi: 10.1111/imm.12021.

Abstract

There is limited clinical research regarding the changes in peripheral lymphocyte subsets during the early post-operative period of liver transplantation. Serial changes of T cells and B cells in living donor liver transplantation (LDLT) recipients during the early post-transplantion period were prospectively investigated. From June 2010 to February 2011, 27 consecutive LDLT recipients were enrolled. Percentages of T helper type 1 (Th1; interferon-γ-producing), Th2 (interleukin-4-producing), Th17 (interleukin-17-producing), regulatory T (Treg; CD4(+) CD25(+) FoxP3(+) ), memory B (CD19(+) CD24(hi) CD38(-) ) and mature B (CD19(+) CD24(int) CD38(int) ) cells were measured using fluorescence-activated cell sorting. Patients were followed up for a median of 9.9 months (range 6.8-15.5 months) after transplantation. Serial monitoring of immunological profiles showed no significant suppression of Th1, Th2, Th17, mature B or memory B cells, whereas frequencies of Treg cells significantly decreased. Interleukin-17 production by central and effector memory cells was not suppressed during the early post-operative period. The continuous production of interleukin-17 by the memory T cells may contribute to the persistence of Th17 cells. This prospective study demonstrated that current immunosuppression maintained the effector T or memory B cells during the early post-transplantation period but significantly suppressed Treg cells. Serial immune monitoring may suggest clues for optimal or individualized immunosuppression during the early post-operative period in clinical practice.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • B-Lymphocytes / immunology*
  • B-Lymphocytes / pathology
  • Calcineurin / immunology
  • Calcineurin Inhibitors*
  • Cyclosporine / administration & dosage*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunologic Memory / drug effects*
  • Immunosuppression Therapy / methods
  • Immunosuppressive Agents / administration & dosage*
  • Liver Transplantation*
  • Living Donors*
  • Male
  • Middle Aged
  • Postoperative Period
  • Prospective Studies
  • Retrospective Studies
  • T-Lymphocytes, Regulatory / immunology*
  • T-Lymphocytes, Regulatory / pathology
  • Tacrolimus / administration & dosage*
  • Th1 Cells / immunology
  • Th1 Cells / pathology
  • Th17 Cells / immunology*
  • Th17 Cells / pathology
  • Th2 Cells / immunology
  • Th2 Cells / pathology

Substances

  • Calcineurin Inhibitors
  • Immunosuppressive Agents
  • Cyclosporine
  • Calcineurin
  • Tacrolimus