title: Immune functional assay for immunosuppressive management in post-transplant malignancy.
abstract: Immunosuppression management in post-transplant malignancy is challenging because of a lack of objective immunologic assessment tools. The ImmuKnow assay measures the ATP level from CD4 T cells, quantifying cell-mediated immunity and providing an insight into the immune status of transplant recipients. Its potential use in patients with post-transplant de novo malignancy was evaluated. Thirteen adult transplant patients with de novo malignancy were divided into survivors (n = 9) and non-survivors (n = 4) after malignancy treatment. Tacrolimus and the ImmuKnow levels were monitored before, during, and after malignancy treatment. The ImmuKnow level in non-survivors group was significantly lower before and after malignancy treatment compared to survivors group (p = 0.013 and 0.0014 respectively). In survivor group, the ImmuKnow level was significantly decreased during malignancy treatment (p = 0.019) but recovered to the initial level after the treatment. However, in non-survivor group, the ImmuKnow level remained suppressed throughout the observed period despite a reduction in immunosuppressive drug levels. The ImmuKnow assay can be an objective means evaluating immune status of patients with de novo malignancy. The ImmuKnow assay can express the degree of immune suppression induced by chemotherapeutic or radiation therapy and may be a useful tool in optimizing the timing of re-introduction of immunosuppression after malignancy treatment.
authors.affiliation: Division of Transplantation, Department of Surgery, Penn State Milton S. Hershey Medical Center, College of Medicine, Penn State University, Hershey, PA 17033, USA.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Uemura
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Riley
authors.forename: Akhtar
authors.initials: A
authors.lastname: Khan
authors.forename: Christopher
authors.initials: C
authors.lastname: Hollenbeak
authors.forename: Ian
authors.initials: I
authors.lastname: Schreibman
authors.forename: Nasrollah
authors.initials: N
authors.lastname: Ghahramani
authors.forename: Brian
authors.initials: B
authors.lastname: Reeves
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Domen
authors.forename: Dani S
authors.initials: DS
authors.lastname: Zander
authors.forename: Zakiyah
authors.initials: Z
authors.lastname: Kadry
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000328:Adult; D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000209:etiology; D016903:Drug Monitoring; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D007159:Immunologic Tests; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D011183:Postoperative Complications; D011446:Prospective Studies; D015996:Survival Rate; D016559:Tacrolimus / Q000627:therapeutic use*; D014062:Tongue Neoplasms / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D000255:Adenosine Triphosphate; D016559:Tacrolimus