title: T-cell function in maintenance renal transplant patients receiving mycophenolate mofetil and steroids with or without tacrolimus.
abstract: Nephrotoxicity-sparing protocols, using mycophenolate mofetil (MMF) and steroids without calcineurin inhibitors (CNIs) or mammalian target rapamycin (mTOR), could be used to treat maintenance renal transplant patients. However, the risk for acute rejection seems to be high. The aim of this pharmacodynamic study was to analyze T-cell function, T-cell activation, and T-cell proliferation among patients receiving MMF and steroids (n = 15) compared with patients receiving immunosuppression with CNI-based therapy including tacrolimus, MMF, and steroids. Our data suggested that among stable maintenance patients, dual therapy with MMF and steroids might provide a similar reduction in T-cell proliferation and T-cell activation as that observed among patients on standard immunosuppressive therapy. As expected, intralymphocytic interleukin-2 (IL-2) and tumor necrosis factor-alpha (TNF-alpha) expressions were higher in patients not receiving CNIs.
authors.affiliation: Department of Nephrology, Toulouse, France.
authors.forename: C
authors.initials: C
authors.lastname: Canivet
authors.forename: T
authors.initials: T
authors.lastname: Böhler
authors.forename: S
authors.initials: S
authors.lastname: Galvani
authors.forename: N
authors.initials: N
authors.lastname: Therville
authors.forename: R
authors.initials: R
authors.lastname: Salvayre
authors.forename: D
authors.initials: D
authors.lastname: Durand
authors.forename: M
authors.initials: M
authors.lastname: Thomsen
authors.forename: L
authors.initials: L
authors.lastname: Rostaing
authors.forename: N
authors.initials: N
authors.lastname: Kamar
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D065095:Calcineurin Inhibitors; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007297:Inpatients; D016030:Kidney Transplantation / Q000276:immunology*; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010045:Outpatients; D012189:Retrospective Studies; D012307:Risk Factors; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology*; D016559:Tacrolimus / Q000627:therapeutic use*
chemical_list: D000305:Adrenal Cortex Hormones; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D016559:Tacrolimus