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https://hdl.handle.net/2440/17327
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Type: | Journal article |
Title: | Intracellular cytokines in blood T cells in lung transplant patients - a more relevant indicator of immunosuppression than drug levels |
Author: | Hodge, G. Hodge, S. Reynolds, P. Holmes, M. |
Citation: | Clinical and Experimental Immunology, 2005; 139(1):159-164 |
Publisher: | Blackwell Publishing Ltd |
Issue Date: | 2005 |
ISSN: | 0009-9104 1365-2249 |
Abstract: | Allograft rejection remains a major cause of morbidity and mortality following lung transplantation and is associated with an increase in T-cell pro-inflammatory cytokine expression. Systemic levels of immunosuppressive drugs used to reduce pro-inflammatory cytokine expression are closely monitored to their 'therapeutic range'. However, it is currently unknown if levels of these drugs correlate with pro-inflammatory cytokine expression in peripheral blood T cells. To investigate the immunomodulatory effects of currently used immunosuppressive regimes on peripheral blood T-cell cytokine production, whole blood from stable lung transplant patients and control volunteers were stimulated in vitro and cytokine production by CD8+ and CD4+ T-cell subsets determined using multiparameter flow cytometry. T-cell IL-2 and TNFalpha production was significantly reduced from lung transplant patients compared to controls. CD4+ T-cell production of IFNgamma was also significantly reduced from lung transplant patients but production of IFNgamma by CD8+ T cells remained unchanged. There was an excellent correlation between the percentage of CD8+ T cells and the percentage of CD8+ T cells producing IFNgamma from transplant patients. T-cell IL-4 and CD8+ T-cell production of TGFbeta was significantly increased from lung transplant patients. We now provide evidence that current immunosuppression protocols have limited effect on peripheral blood IFNgamma production by CD8+ T-cells but do up-regulate T-cell anti-inflammatory cytokines. Drugs that effectively reduce IFNgamma production by CD8+ T cells may improve current protocols for reducing graft rejection in these patients. Intracellular cytokine analysis using flow cytometry may be a more appropriate indicator of immunosuppression than drug levels in these patients. This technique may prove useful in optimizing therapy for individual patients. |
Keywords: | T-Lymphocytes CD4-Positive T-Lymphocytes CD8-Positive T-Lymphocytes Humans Transforming Growth Factor beta Tumor Necrosis Factor-alpha Interleukin-2 Cytokines Lymphocyte Count Lung Transplantation Flow Cytometry Adult Interferon-gamma Immunosuppression Therapy |
DOI: | 10.1111/j.1365-2249.2005.02671.x |
Published version: | http://dx.doi.org/10.1111/j.1365-2249.2005.02671.x |
Appears in Collections: | Aurora harvest 2 Paediatrics publications |
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