[Immuknow and long term kidney graft]

Area of Science:

• Nephrology
• Immunology
• Oncology

Background:

• Kidney transplant survival has improved, but cancer risk, particularly non-melanoma skin cancer (NMSC), increases.
• Evaluating immunosuppression (IS) in long-term transplant patients, especially after NMSC diagnosis, remains challenging.
• The Immuknow assay offers a potential tool for assessing immune response in transplant recipients.

Purpose of the Study:

• To investigate whether long-term kidney transplant patients diagnosed with NMSC exhibit altered levels of immunosuppression compared to those without NMSC.
• To evaluate the utility of the Immuknow assay in differentiating immunosuppression status in kidney transplant recipients with and without NMSC.

Main Methods:

• A cohort of 33 long-term kidney transplant patients (16 with NMSC, 17 without) was studied.
• Blood samples were collected at multiple time points (baseline, 4, 8, 12 months) for renal function, calcineurin inhibitor (CNI) levels, and Immuknow assay.
• The Immuknow assay measures T CD4+ cell reactivity as an indicator of immune response.

Main Results:

• Most patients exhibited moderate immunosuppression, with T CD4+ reactivity between 225-525 ng/ml.
• No significant differences in T CD4+ reactivity were observed between the NMSC and no-NMSC groups.
• No correlation was found between T CD4+ reactivity and blood CNI levels; however, some patients showed persistently low reactivity.

Conclusions:

• The Immuknow assay, in this limited study, did not reveal significant differences in cell-mediated immunity between kidney transplant patients with and without NMSC.
• T CD4+ reactivity varied over time and did not correlate with CNI levels.
• The assay identified some cases with low cell reactivity, warranting further investigation.