两种免疫抑制疗法的对T淋巴细胞子集的影响 移植接受者的老年人
Geraldo Rubens R Freitas1,2, Maria da Luz Fernandes1, Fabiana Agena1
1Serviço de Transplante Renal, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Frontiers in immunology
|October 7, 2024
概括
老年移植接受者在抗细胞球蛋白 (rATG) 诱导后经历了淋巴细胞枯竭,但转换为everolimus (EVL) 并没有改变他们的调节性T细胞 (Treg) 概况. 降低老年患者的rATG剂量可能是必要的,以期望EVL的淋巴细胞变化.
科学领域:
- 免疫学 免疫学 免疫学
- 移植科学 移植科学
- 老年医学 老年医学
背景情况:
- 越来越多的老年移植 (Ktx) 接受者.
- 在这个人群中,免疫抑制对淋巴细胞形状的影响的研究有限.
- 需要了解老Ktx患者的免疫反应.
研究的目的:
- 评估早期从菌酸盐 (MPS) 转换为Everolimus (EVL) 对老年脏移植接受者的淋巴细胞概况的影响.
- 为了比较年轻和老年Ktx受体之间的淋巴细胞子集 (天真,记忆,调节性TCD4+细胞).
- 评估子抗细胞球蛋白 (rATG) 诱导和随后的免疫抑制策略对免疫细胞群体的影响.
主要方法:
- 对三组人的比较研究:年轻人 (标准免疫抑制),老年人 (标准免疫抑制) 和老年人 (转换为EVL).
- 在基线,移植后的30天和365天内对天真,记忆和调节性外围血液TCD4+淋巴细胞的量化.
- 标准免疫抑制包括普得尼松,塔克罗利斯和MPS;转换组在移植后早期从MPS转换为EVL.
主要成果:
- 老年接受者在rATG后出现了最初的淋巴细胞枯竭,在365天后恢复,与年轻的接受者不同.
- rATG在年轻和老年接受者中暂时降低了中央记忆T细胞和调节性T细胞 (Treg) 的百分比.
- 在老年接受者中转换为EVL并没有显著改变淋巴细胞概况,与标准免疫抑制相比.
结论:
- 衰老似乎促进了在晚期移植期间的Treg维持,尽管免疫抑制.
- 在老年接受者中,rATG诱导的淋巴缺血更为明显,影响记忆T细胞子集.
- 早期EVL转换没有影响Treg概况;对于预期的EVL影响,老年患者可能需要减少rATG剂量.
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