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Low responsiveness to Candida antigens in kidney transplant recipients
C M Ausiello1, G C Spagnoli, G Sconocchia
1Istituto CNR Tipizzazione Tissutale, II Università, Rome, Italy.
Abstract:
Infections caused by commensal microorganisms, such as Candida albicans often represent a severe complication in pharmacologically immunosuppressed kidney transplanted patients. A mannoprotein (MP) antigenic preparation derived from the C. albicans cell wall was used to measure the specific immune responsiveness in 44 kidney transplanted patients and matched healthy controls. Patients immune responses were analyzed considering the transplant age. In group I, patients transplanted from greater than 1 month to less than 12 months were considered, whereas in groups II and III patients had been transplanted 1 to 3 years or 4 to 6 years earlier. A statistically significant low responsiveness to MP was recorded in peripheral blood mononuclear cells (PBMC) from patients belonging to groups II and III. Addition of exogenous IL-2 to PBMC cultures restored MP-induced proliferation in about 50% of patients studied. Responsiveness to mitogenic stimulation (PHA and SEB) was in the normal range in all transplanted patients. No correlation could be detected between hyporesponsiveness to MP and C. albicans infections.
Insights
Kidney transplant patients show reduced immune response to Candida albicans mannoprotein (MP), especially years after transplant. Interleukin-2 (IL-2) partially restored this immune response in some patients.
Area of Science:
- Immunology
- Transplantation
- Mycology
Background:
- Kidney transplant recipients on immunosuppression are susceptible to infections from commensal microorganisms like Candida albicans.
- Candida albicans mannoprotein (MP) is a key antigen involved in immune responses.
Purpose of the Study:
- To assess the specific immune responsiveness to C. albicans mannoprotein (MP) in kidney transplanted patients.
- To analyze how transplant age affects immune responsiveness to MP.
- To investigate the role of Interleukin-2 (IL-2) in restoring MP-specific immune responses.
Main Methods:
- Studied 44 kidney transplanted patients and healthy controls.
- Measured immune responsiveness using peripheral blood mononuclear cells (PBMC) stimulated with MP.
- Categorized patients into groups based on transplant age (1-12 months, 1-3 years, 4-6 years).
- Assessed proliferation and response to mitogens (PHA, SEB) and IL-2 addition.
Main Results:
- Kidney transplant patients in later transplant stages (1-3 and 4-6 years) exhibited significantly lower PBMC responsiveness to MP.
- Addition of exogenous IL-2 restored MP-induced proliferation in approximately 50% of the studied patients.
- Responsiveness to general mitogenic stimulation (PHA, SEB) remained normal across all transplanted patients.
- No correlation was found between MP hyporesponsiveness and documented C. albicans infections.
Conclusions:
- Long-term kidney transplant recipients may have a diminished specific immune response to Candida albicans mannoprotein.
- IL-2 administration shows potential in partially restoring T-cell function against fungal antigens in this population.
- The observed hyporesponsiveness to MP does not directly correlate with the incidence of C. albicans infections in these patients.