Immunological monitoring and early prediction of rejection in renal allograft recipients.
Graft rejection remains the major problem complicating renal allograft transplantation. A reliable posttransplant predictor of impending rejection will be valuable to help maintain better graft function. We monitored 47 patients with end-stage renal disease treated by renal allograft starting 1 day pretransplantation and continuing for up to 90 days postgrafting. Peripheral blood mononuclear cells (PBMC) from both patients and 71 healthy subjects were compared for: (1) DNA synthesis in T and B lymphocytes in response to mitogens; (2) interleukin-2 (IL-2) production; (3) natural killer (NK) and antibody-dependent cell-mediated cytotoxic (ADCC) activities; (4) induced augmentation of NK and ADCC activities by the biological response modifiers (BRM), lymphoblastoid interferon, recombinant alpha-2-interferon, gamma-interferon and recombinant IL-2. During the 2 weeks preceding rejection we found lower than normal levels of IL-2 production (p less than 0.0005) and DNA synthesis (p less than 0.01) in concanavalin A-stimulated PBMC. IL-2 yield reached its lowest level on the day of rejection and increased sharply the following week after antirejection therapy was started. Mitogen-stimulated DNA synthesis rose in parallel with increasing levels of IL-2 production. Both NK and ADCC activities increased during rejection (p less than 0.05). The ADCC response to BRM activation measured during the first 2 weeks postgrafting was found to correlate with the stability of the graft. Recipients whose graft function remained stable had a minimal ADCC response to BRM.(ABSTRACT TRUNCATED AT 250 WORDS)
Attallah
A M
AM
Abdelghaffar
H
H
Alghraoui
F
F
Fawzy
A
A
Alijani
M R
MR
Mahmoud
L A
LA
Ghoneim
M A
MA
Helfrich
G B
GB
D000920:Antibody-Dependent Cell Cytotoxicity; D001402:B-Lymphocytes / Q000276:immunology*; D003602:Cytotoxicity, Immunologic; D004261:DNA Replication; D006084:Graft Rejection; D006801:Humans; D007376:Interleukin-2 / Q000096:biosynthesis; D016030:Kidney Transplantation; D007694:Killer Cells, Natural / Q000276:immunology; D008213:Lymphocyte Activation; D011379:Prognosis; D012016:Reference Values; D013601:T-Lymphocytes / Q000276:immunology*; D014184:Transplantation, Homologous
D007376:Interleukin-2