Do anti-CD25 monoclonal antibodies potentiate posttransplant diabetes mellitus?
Anti-CD25 monoclonal antibodies (MAbs) are directed against the IL-2 (CD-25) receptor, which is associated with the pathogenesis of diabetes mellitus (DM). Measuring CD25 on peripheral blood lymphocytes could be a new immunologic marker to identify patients with prediabetes.


OBJECTIVE
The study aimed to analyze whether administration of anti-CD25 MAbs was an independent risk factor for posttransplant diabetes mellitus (PTDM) in kidney transplant (KT) patients at 3 months after transplantation.


METHODS
Seventy-four stable, nondiabetic KT patients were included in the study. The overall sex distribution was 70% men and mean overall age, 52 +/- 10 years. Thirty-eight subjects where treated with anti-CD25 antibodies (basiliximab). The diagnosis of PTDM was made if patients required insulin or oral antidiabetic drugs and/or had glycemia >200 mg/dL at 120 minutes after an oral glucose tolerance test (75 g glucose). We determined the age, weight, body mass index, acute rejection, chronic hepatitis C virus (HCV) infection, and type of calcineurin inhibitor.


RESULTS
Thirty-four percent of patients developed PTDM. Patients treated with anti-CD25 antibodies were older (P = .022) and showed a greater incidence of PTDM (P = .041). The logistic regression analysis (dependent variable: PTDM; independent variables: age, anti-CD25, tacrolimus vs cyclosporine) showed that treatment with anti-CD25 is an independent risk factor for PTDM (P = .041; OR 3.28; CI 95% 1.04-10.31).


CONCLUSIONS
Patients treated with anti-CD25 MAbs showed greater incidence of PTDM.
Bayés
B
B
Department of Nephrology, University Hospital, Germans Trias i Pujol, Badalona, Spain. bbayes@teleline.es
Pastor
M C
MC
Lauzurica
R
R
Granada
M L
ML
Salinas
I
I
Romero
R
R
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D015703:Antigens, CD / Q000276:immunology; D000077552:Basiliximab; D015992:Body Mass Index; D001835:Body Weight; D003920:Diabetes Mellitus / Q000276:immunology*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D053645:Interleukin-2 Receptor alpha Subunit / Q000276:immunology*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000276:immunology*; D011993:Recombinant Fusion Proteins / Q000009:adverse effects*
D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D007166:Immunosuppressive Agents; D053645:Interleukin-2 Receptor alpha Subunit; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab