[Reduction of TNF-alpha release and clinical effects of the first injection of OKT3].
In order to prevent the adverse effects of a first OKT3 injection in renal transplant recipients, we administered polyclonal antilymphocyte globulins (ATG Fresenius, 4 mg/kg/j) for 3 days before OKT3 injection. Compared with a historical group of 5 patients who did not receive ATG pretreatment before OKT3 injection, the patients who were pretreated by ATG had a significantly lower absolute number of circulating lymphocytes before the first OKT3 injection (363 +/- 107 vs 1,230 +/- 80/mm3, P < 0.001), a lower raise in plasma TNF-alpha level 2 hours after OKT3 injection (178 +/- 42 vs 735 +/- 127 pg/ml, P < 0.005) and a significant decrease in frequency and intensity of clinical symptoms, mainly chills, dyspnea, and headaches. However, fever and peak creatinine level were similar in both groups. A 80 percent success rate of crisis treatment was achieved in both groups and there was no increase in infectious complications. In conclusion, pretreatment with ATG induces a lymphocyte depletion, and decreases the amounts of TNF-alpha released as well as the side-effects of a first OKT3 injection.
Meulders
Q
Q
INSERM U 64, Service de Néphrologie A, Hôpital Tenon, Paris.
Dallel
T
T
Peraldi
M N
MN
Kanfer
A
A
Sraer
J D
JD
Rondeau
E
E
D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000188:drug therapy; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D008212:Lymphocyte Depletion; D016853:Muromonab-CD3 / Q000627:therapeutic use*; D011446:Prospective Studies; D013601:T-Lymphocytes / Q000502:physiology*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D000961:Antilymphocyte Serum; D016853:Muromonab-CD3; D014409:Tumor Necrosis Factor-alpha
Réduction de la libération de TNF-alpha et des effets cliniques de la première injection d'OKT3.