T lymphocyte subsets and cytokine production by graft-infiltrating cells in FSGS recurrence post-transplantation.
BACKGROUND
Focal segmental glomerulosclerosis (FSGS) aetiology remains undefined although a derangement of lymphocytes and monocytes macrophages, at least, has been strongly suspected. We report the graft-infiltrating phenotypes and their cytokine production in a case of FSGS recurrence post-transplantation.


METHODS
The kidney transplant recipient suffered immediate FSGS recurrence. Aspiration biopsies were done at the first and second week post-surgery and were analysed by flow cytometry. The cytokine analysis was done on aspiration sample culture supernatants and serum by enzyme-linked immunosorbent assay.


RESULTS
High expression of CD3CD69, CD3CD71 and CD4CD29 was found on infiltrating lymphocytes. Biopsy cultures pointed to a Th0/Th1 pattern of cytokine production as well as significant synthesis of transforming growth factor-beta1. Interestingly, monocyte chemokines were absent.


CONCLUSIONS
We report evidence of intragraft lymphocyte activation in the early days of FSGS recurrence. Aspiration biopsy cultures showed failure of cyclosporin A to inhibit interleukin-2 (IL-2) production by infiltrating lymphocytes. If our findings are confirmed in similar patients, a trial with anti-IL-2-receptor antibody could be warranted.
de Oliveira
J G
JG
Renal Department, Hospital S. João, Porto, Portugal.
Xavier
P
P
Carvalho
E
E
Ramos
J P
JP
Magalhães
M C
MC
Mendes
A A
AA
Faria
V
V
Guerra
L E
LE
D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D016207:Cytokines / Q000096:biosynthesis*; D005434:Flow Cytometry; D005923:Glomerulosclerosis, Focal Segmental / Q000209:etiology / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008213:Lymphocyte Activation; D008297:Male; D012008:Recurrence; D016176:T-Lymphocyte Subsets / Q000276:immunology*
D015703:Antigens, CD; D016207:Cytokines