Praditpornsilpa K, Avihingsanon Y, Kupatawintu P, Songpanich S, Pisitkul T, Kansanabuch T, Eiam-Ong S, Chusil S, O-Charoen R, Tungsanga K
Division of Nephrology, Faculty of Medicine, Chulalongkorn University Hospital, Bangkok, Thailand.
Transplant Proc. 2004 Mar;36(2 Suppl):487S-491S. doi: 10.1016/j.transproceed.2004.01.071.
Daclizumab and basiliximab, the antibodies to the interleukin-2 receptor (anti-IL-2R), decrease the incidence of acute rejection in renal transplantation. However, prolonged blockade of IL-2 receptor (IL-2R:CD25) may hamper apoptosis of reactive T-cell clones and thus may obstruct tolerance induction. We determined the effect of varying doses of anti-IL-2R on the number of CD3+CD25+ cells as an index of CD 25 blockade. The number of CD3+CD25+ cells was determined in four groups of induction therapies: no antibody induction; two doses of 50 or 25 mg daclizumab on day 0 and day 14; and two doses of 20 mg basiliximab at day 0 and day 4 (n=10, 24, 10, and 10, respectively). The number of CD3+CD25+ cells were monitored in whole blood before antibody infusion as well as 24 hours thereafter and weekly after transplantation. With two doses of 50 mg daclizumab, two doses of 25 mg daclizumab, and two doses of 20 mg basiliximab, the expression of CD3+CD25+ cells was completely suppressed for 12, 10, and 12 weeks posttransplantation, respectively. The reappearance of CD3+CD25+ cells above the baseline for each induction regimen was: 17 weeks for two doses of 50 mg daclizumab, 11 weeks for two doses of 25 mg daclizumab, and 13 weeks for two doses of 20 mg basiliximab. Monitoring of CD3+CD25+ cells may be utilized to tailor anti-IL-2R administration at a minimal dosage, yet retaining adequate IL-2R blockade for at least 3 months posttransplantation.
抗白细胞介素-2受体抗体（抗IL-2R）达利珠单抗和巴利昔单抗可降低肾移植急性排斥反应的发生率。然而，长期阻断白细胞介素-2受体（IL-2R:CD25）可能会阻碍反应性T细胞克隆的凋亡，从而可能妨碍免疫耐受的诱导。我们测定了不同剂量的抗IL-2R对CD3+CD25+细胞数量的影响，以此作为CD25阻断的指标。在四组诱导治疗中测定CD3+CD25+细胞的数量：无抗体诱导；在第0天和第14天给予两剂50mg或25mg达利珠单抗；在第0天和第4天给予两剂20mg巴利昔单抗（每组分别为10例、24例、10例和10例）。在抗体输注前以及输注后24小时和移植后每周监测全血中CD3+CD25+细胞的数量。给予两剂50mg达利珠单抗、两剂25mg达利珠单抗和两剂20mg巴利昔单抗后，移植后CD3+CD25+细胞的表达分别在12周、l0周和12周完全受到抑制。每种诱导方案中CD3+CD25+细胞数量重新出现高于基线水平的时间分别为：两剂50mg达利珠单抗为17周，两剂25mg达利珠单抗为11周，两剂20mg巴利昔单抗为13周。监测CD3+CD25+细胞数量可用于以最小剂量调整抗IL-2R给药，同时在移植后至少3个月保持足够的IL-2R阻断。
