Cyclosporin but not Everolimus Inhibits Chemokine Receptor Expression on CD4(+) T Cell Subsets Circulating in the Peripheral Blood of Renal Transplant Recipients.
Hoerning A, Kohler S, et al.Clinical & Experimental Immunology, 168(2): 251-259, 2012.
Aims
To investigate the expression of peripheral chemokine Receptor 3 (CXCR3) and CC chemokine receptor 5 (CCR5) on circulating CD4+ T cells in renal transplant patients receiving cyclosporin A (CsA) and/or everolimus.
Interventions
Initial immunosuppression consisted of basiliximab, CsA, mycophenolate sodium and corticosteroids. At three months post-transplant, patients were randomised to standard-dose CsA, mycophenolate sodium (MPA) plus corticosteroids or low-dose CsA, everolimus plus corticosteroids or low-dose everolimus, MPA and corticosteroids.
Participants
20 renal transplant recipients.
Outcomes
Renal function assessed by serum creatinine, estimated glomerular filtration rate (GFR) and calculated by modified diet in renal disease; laboratory parameters included amount of peripheral circulating regulatory CD4+ T cells and percentage of their subsets (CD4+FoxP3 positive and CD4+FoxP3 negative), expression of CXCR3 and CCR5 on peripheral circulating CD4+ T cells subsets.
Follow-up
12 months
CET Conclusions
In this subgroup analysis, 20 patients were examined for the expression of CXCR3 and CCR5 chemokine receptors in a sub group analysis of the HERAKLES trial. At three months, patients were receiving cyclosporine, MPA and steroids, cyclosporine and everolimus and steroids, or everolimus, MPA and steroids. There was an increase in the two chemokine receptors on CD4+ FoxP3 negative cells between 3 and 12 months after transplantation. There was a suggestion that the chemokine receptor expressing CD4+ FoxP3 negative T cells were associated with early loss in allograft function. This data can only be suggestive at this point in time.
Data analysis
Per protocol analysis
Trial registration
NCT00514514 (ClinicalTrials.gov)