CD25, CD28 and CD38 expression in peripheral blood lymphocytes as a tool to predict acute rejection after liver transplantation.
OBJECTIVE
The aim of this study was to determine whether the expression of CD25, CD28 and CD38 (which reflects the degree of T-cell activation) by peripheral blood mononuclear cells constitutes a useful means of measuring the immune status of liver transplant recipients.


METHODS
Fifty-two patients enrolled in a prospective randomized study comparing cyclosporine and tacrolimus as the principal immunosuppressive drugs were monitored prospectively. The expression of CD25, CD28 and CD38 was analyzed on CD3-, CD4- and CD8-positive cells from whole blood using flow cytometry. The prognostic value of baseline and day 14 measurements regarding acute rejection was examined using Kaplan-Meier estimates for univariate analyses and the Cox model for multivariate analyses.


RESULTS
The mean frequencies of CD28 and CD38-expressing T cells were significantly higher in patients with acute rejection (p = 0.01 and p = 0.001, respectively), whereas the frequency CD25-expressing T cells did not differ significantly. Under univariate analysis, baseline CD25 levels, the type of calcineurin inhibitor, as well as the CD28 and CD38 frequencies obtained at day 14 were associated with the subsequent development of acute rejection. Under multivariate analysis, only CD28 and CD38 frequencies obtained at day 14 were independently associated with acute rejection.


CONCLUSIONS
The evaluation of CD28 and CD38 expression in peripheral blood lymphocytes is a simple marker that could be used routinely in clinical practice to assess the level of immunosuppression.
Laboratoire de Biologie Cellulaire, UPRES 1833, Faculté de Médecine Paris 5, France.
Emmanuel
E
Boleslawski
Samia
S
BenOthman
Sophie
S
Grabar
Leonor
L
Correia
Philippe
P
Podevin
Sandrine
S
Chouzenoux
Olivier
O
Soubrane
Yvon
Y
Calmus
Filomena
F
Conti
D051997:ADP-ribosyl Cyclase 1 / Q000378:metabolism*; D000328:Adult; D018106:CD28 Antigens / Q000378:metabolism*; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005434:Flow Cytometry; D006084:Graft Rejection / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053645:Interleukin-2 Receptor alpha Subunit / Q000378:metabolism*; D008107:Liver Diseases / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013601:T-Lymphocytes / Q000276:immunology*; D016559:Tacrolimus / Q000627:therapeutic use; D055815:Young Adult
D018106:CD28 Antigens; D007166:Immunosuppressive Agents; D053645:Interleukin-2 Receptor alpha Subunit; D016572:Cyclosporine; D051997:ADP-ribosyl Cyclase 1; D016559:Tacrolimus