Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany.
Transpl Int. 2012 Mar;25(3):302-13. doi: 10.1111/j.1432-2277.2011.01405.x. Epub 2011 Dec 21.
T-cell-depleting strategies are an integral part of immunosuppressive regimens used in the hematological and solid organ transplant setting. Besides prevention of alloreactivity, treatment with rabbit antithymocyte globulin (rATG) has been related to the induction of immunoregulatory T cells (Treg) in vitro and in vivo. To investigate Treg induced by rATG, we prospectively studied the effect of rATG induction therapy in liver-transplanted recipients in vivo (n = 28). Treg induction was further evaluated by means of Treg-specific demethylation region (TSDR) analysis within the FOXP3 locus. Whereas no induction of CD4(+) CD25(high) CD127(-) Treg could be observed by phenotypic analysis, we could demonstrate an induction of TSDR(+) T cells within CD4(+) T cells exclusively for rATG-treated patients in the long-term (day 540) compared with controls (P = NS). Moreover, although in vitro experiments confirm that rATG primarily led to a conversion of CD4(+) CD25(-) into CD4(+) CD25(+) T cells displaying immunosuppressive capacities, these cells cannot be classified as bona fide Treg based on their FOXP3 demethylation pattern. Consequently, the generation of Treg after rATG co-incubation in vitro does not reflect the mechanisms of Treg induction in vivo and therefore the potential clinical relevance of these cells for transplant outcome remains to be determined.
T 细胞耗竭策略是血液学和实体器官移植中免疫抑制方案的一个组成部分。除了预防同种异体反应外,兔抗胸腺细胞球蛋白(rATG)的治疗与体外和体内诱导免疫调节性 T 细胞(Treg)有关。为了研究 rATG 诱导的 Treg,我们前瞻性地研究了 rATG 诱导治疗在肝移植受者体内的效果(n=28)。通过 FOXP3 基因座内的 Treg 特异性去甲基化区域(TSDR)分析进一步评估 Treg 的诱导。虽然通过表型分析不能观察到 CD4+CD25+高 CD127- Treg 的诱导,但我们可以证明在长期(第 540 天)与对照组相比,rATG 治疗的患者中 CD4+T 细胞内 TSDR(+)T 细胞的诱导(P=NS)。此外,尽管体外实验证实 rATG 主要导致 CD4+CD25-转化为具有免疫抑制能力的 CD4+CD25+T 细胞,但根据其 FOXP3 去甲基化模式,这些细胞不能被归类为真正的 Treg。因此,rATG 体外共孵育后 Treg 的产生不能反映体内 Treg 诱导的机制,因此这些细胞对移植结果的潜在临床意义仍有待确定。