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Published on: April 19, 2017
Lack of association of immune cell function test with rejection in kidney transplantation
A Torío1, E J Fernández, O Montes-Ares
1Unidad Inmunología, C.H.U. Insular Materno Infantil, Las Palmas, Spain. atorruib@gobiernodecanarias.org
Insights
The Immuknow assay effectively identifies kidney transplant patients at risk of infection. However, this immune function test cannot reliably differentiate patients experiencing acute rejection episodes.
Area of Science:
- Immunology
- Transplant Medicine
- Clinical Diagnostics
Background:
- The Cylex Immuknow assay measures CD4 T cell immune responses in whole blood for immunocompromised patients.
- It is considered for monitoring immunosuppressed transplant recipients.
- Previous research shows no consensus on its utility in detecting renal transplant rejection.
Purpose of the Study:
- To evaluate the utility of the Cylex Immuknow assay in identifying kidney transplant rejection and infection.
- To assess the assay's ability to guide immunosuppressive therapy.
Main Methods:
- Intracellular adenosine triphosphate (iATP) levels in CD4 cells were measured in 227 samples from 116 kidney transplant patients.
- Results were analyzed based on clinical status: rejection, infection, or stability.
- Immunologic responses were also measured in 108 healthy control subjects.
Main Results:
- Significant differences in iATP concentrations were found between stable and infected patients (P < .001) and between infected patients and controls (P < .001).
- No correlation was observed between the assay's response and acute rejection episodes.
- The assay identified patients at risk for infection.
Conclusions:
- The Immuknow assay can identify transplant patients at risk for infection.
- It may offer insights for guiding immunosuppressive therapy.
- The assay demonstrated a limited potential in differentiating patients experiencing rejection episodes.
Background:
The Cylex Immuknow assay provides a rapid assessment of global immune function in immunocompromised patients by measuring the global immune responses of CD4 T cells from a whole-blood sample. It may help to monitor the immune status of immunosuppressed transplant patients. However, earlier studies have shown that there is no consensus on the utility of the Immuknow assay in renal transplant rejection.
Methods:
T-cell activation was determined by measuring an increase of intracellular adenosine triphosphate (iATP) from CD4 cells in 227 samples from 116 kidney transplant patients. The results were analyzed regarding patient clinical status, namely, rejection, infection, or stability. In addition, we measured the immunologic response of 108 healthy control subjects.
Results:
There were 24 infectious and 36 rejection episodes. iATP concentrations differed significantly between stable and infected patients (180.5 ± 55.2 vs 375.3 ± 140.1 ng/mL; P < .001) and between infected patients and control subjects (180.5 ± 55.2 vs 436.5 ± 112 ng/mL; P < .001). No correlation was observed between patients suffering an acute rejection episode with this response.
Conclusions:
Our results confirmed that the Immuknow assay identified transplant patients at risk for infection. It may provide information to guide immunosuppressive therapy, but the assay did not seem to have the potential to differentiate subjects experiencing rejection.
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01:40Cell-mediated Immune Responses
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