Large decrease of anti-tetanus anatoxin and anti-pneumococcal antibodies at one year after renal transplantation

Area of Science:

• Immunology
• Nephrology
• Transplantation

Background:

• Kidney transplant recipients (KTR) often have impaired antibody synthesis due to immunosuppressive drugs like azathioprine (AZA) and cyclosporine (CsA).
• Mycophenolate mofetil (MMF) is commonly used with calcineurin inhibitors (CNI) for immunosuppression in KTR.

Purpose of the Study:

• To prospectively evaluate the impact of MMF combined with a CNI on plasma antibody levels in kidney transplant recipients.
• To assess changes in anti-tetanus (TAnAb) and anti-pneumococcal (PnPsAb) antibody titers in KTR post-transplantation.

Main Methods:

• A prospective cohort study involving 94 KTR and 49 healthy controls.
• Measurement of serum titers for TAnAb and PnPsAb (against serotypes 14, 19F, 23F) at baseline (T0) and 12 months post-transplant (T12).

Main Results:

• KTR had significantly lower TAnAb detection rates (71% vs. 98%) and titers (1.46 UI/ml vs. 2.74) compared to controls at baseline.
• TAnAb titers in KTR decreased significantly from T0 to T12 (1.46 to 0.31 UI/ml) with a short half-life (7.7 months).
• PnPsAb titers also significantly decreased in KTR between T0 and T12, with half-lives ranging from 9.2 to 11.9 months.

Conclusions:

• MMF and CNI treatment in KTR leads to a profound and significant reduction in TAnAb and PnPsAb titers within the first year post-transplant.
• Pre-transplant immunization is crucial for KTR to establish and maintain adequate antibody levels after transplantation.