Irure Juan, Sango Cristina, Segundo David San, Fernández-Fresnedo Gema, Ruiz Juan Carlos, Benito-Hernández Adalberto, Asensio Esther, López-Hoyos Marcos, Rodrigo Emilio
From the Immunology Service, University Hospital Marqués de Valdecilla-IDIVAL, University of Cantabria, Santander, Spain.
Exp Clin Transplant. 2019 Dec;17(6):732-738. doi: 10.6002/ect.2018.0261. Epub 2019 Apr 9.
Induction therapy with rabbit antithymocyte globulin is frequently used in kidney transplant recipients and contributes to regulating the humoral alloantibody response. However, the effect of rabbit antithymocyte globulin on B-cell subpopulations, including plasma cells, has not been previously studied in humans in vivo.
We prospectively studied a cohort of 39 adult kidney transplant recipients. Twenty patients received rabbit antithymocyte globulin as induction therapy. Peripheral blood samples were obtained pretransplant and at 6 and 12 months posttransplant. T and B cells were acquired by flow cytometry.
Total lymphocytes and CD3 and CD4 cells significantly decreased at 6 and 12 months only in patients who received rabbit antithymocyte globulin. In contrast, the CD19 population did not change after rabbit antithymocyte globulin induction. One-year circulating plasma cells remained significantly lower than pretransplant levels in patients who received rabbit antithymocyte globulin. We observed sig-nificant differences in plasma cell numbers at 12 months after transplant between patients who received rabbit antithymocyte globulin and those patients who did not receive it (median of 5 and interquartile range of 3-17 vs median of 25 and interquartile range of 12-35; P = .001).
Rabbit antithymocyte globulin induction leads to a late reduction in the number of circulating plasma cells at 1 year after kidney transplant. This effect can contribute to down-regulation of the humoral alloantibody response.
兔抗胸腺细胞球蛋白诱导疗法常用于肾移植受者，有助于调节体液同种异体抗体反应。然而，兔抗胸腺细胞球蛋白对包括浆细胞在内的B细胞亚群的影响此前尚未在人体进行过体内研究。
我们前瞻性地研究了一组39名成年肾移植受者。20名患者接受兔抗胸腺细胞球蛋白作为诱导疗法。在移植前以及移植后6个月和12个月采集外周血样本。通过流式细胞术获取T细胞和B细胞。
仅接受兔抗胸腺细胞球蛋白的患者在6个月和12个月时总淋巴细胞以及CD3和CD4细胞显著减少。相比之下，兔抗胸腺细胞球蛋白诱导后CD19细胞群没有变化。接受兔抗胸腺细胞球蛋白的患者1年时循环浆细胞水平仍显著低于移植前水平。我们观察到接受兔抗胸腺细胞球蛋白的患者与未接受该治疗的患者在移植后12个月时浆细胞数量存在显著差异（中位数分别为5，四分位间距为3 - 17，与中位数25，四分位间距为12 - 35；P = 0.001）。
兔抗胸腺细胞球蛋白诱导导致肾移植后1年循环浆细胞数量后期减少。这种效应有助于下调体液同种异体抗体反应。
