title: The effect of costimulatory and interleukin 2 receptor blockade on regulatory T cells in renal transplantation.
abstract: Regulatory T cells (Treg) are critical regulators of immune tolerance. Both IL-2 and CD28-CD80/CD86 signaling are critical for CD4(+)CD25(+)FOXP3(+) Treg survival in mice. Yet, both belatacept (a second-generation CTLA-4Ig) and basiliximab (an anti-CD25 monoclonal antibody) are among the arsenal of current immunotherapies being used in kidney transplant patients. In this study, we explored the direct effect of basiliximab and belatacept on the Tregs in peripheral blood both in the short term and long term and in kidney biopsies of patients with acute rejection. We report that the combined belatacept/basiliximab therapy has no long-term effect on circulating Tregs when compared to a calcineurin inhibitor (CNI)-treated group. Moreover, belatacept-treated patients had a significantly greater number of FOXP3(+) T cells in graft biopsies during acute rejection as compared to CNI-treated patients. Finally, it appears that the basiliximab caused a transient loss of both FOXP3(+) and FOXP3(-) CD25(+) T cells in the circulation in both treatment groups raising important questions about the use of this therapy in tolerance promoting therapeutic protocols.
authors.affiliation: Diabetes Center, Department of Medicine, University of California San Francisco, CA, USA. jbluest@diabetes.ucsf.edu
authors.forename: J A
authors.initials: JA
authors.lastname: Bluestone
authors.forename: W
authors.initials: W
authors.lastname: Liu
authors.forename: J M
authors.initials: JM
authors.lastname: Yabu
authors.forename: Z G
authors.initials: ZG
authors.lastname: Laszik
authors.forename: A
authors.initials: A
authors.lastname: Putnam
authors.forename: M
authors.initials: M
authors.lastname: Belingheri
authors.forename: D M
authors.initials: DM
authors.lastname: Gross
authors.forename: R M
authors.initials: RM
authors.lastname: Townsend
authors.forename: F
authors.initials: F
authors.lastname: Vincenti
mesh_terms: D000069594:Abatacept; D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D018122:B7-1 Antigen / Q000378:metabolism; D051940:B7-2 Antigen / Q000378:metabolism; D000077552:Basiliximab; D018106:CD28 Antigens / Q000378:metabolism; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism; D065095:Calcineurin Inhibitors; D005260:Female; D051858:Forkhead Transcription Factors / Q000378:metabolism; D006801:Humans; D018796:Immunoconjugates / Q000008:administration & dosage; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D053645:Interleukin-2 Receptor alpha Subunit / Q000096:biosynthesis; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015375:Receptors, Interleukin-2 / Q000037:antagonists & inhibitors* / Q000378:metabolism; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage; D050378:T-Lymphocytes, Regulatory / Q000378:metabolism*
chemical_list: D000911:Antibodies, Monoclonal; D018122:B7-1 Antigen; D051940:B7-2 Antigen; D018106:CD28 Antigens; D065095:Calcineurin Inhibitors; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D018796:Immunoconjugates; D007166:Immunosuppressive Agents; D053645:Interleukin-2 Receptor alpha Subunit; D015375:Receptors, Interleukin-2; D011993:Recombinant Fusion Proteins; D000069594:Abatacept; D000077552:Basiliximab