Use of the ImmuKnow assay to evaluate the effect of alemtuzumab-depleting induction therapy on cell-mediated immune function after renal transplantation.
BACKGROUND
Good outcomes after renal transplantation are dependent on effective immunosuppression while minimizing infection. Alemtuzumab (Campath or Campath-1H) is an anti-CD52 humanized monoclonal IgG1 antibody which induces rapid and sustained depletion of circulating lymphocytes and has been effectively used as an immunosuppressant in post-transplant induction therapy.


METHODS
We used the ImmuKnow assay to compare cell-mediated immune function in renal transplant patients treated with alemtuzumab or with conventional immunosuppressive tri-therapy. The ImmuKnow method determines the levels of adenosine triphosphate (ATP) released from CD4 cells following stimulation with a mitogen.


RESULTS
We showed a statistically significant difference in the distribution of outcome after transplantation between the conventional and the Campath groups (P = 0.010). A significantly higher number of patients treated with alemtuzumab induction therapy were stable after transplantation compared to those treated with conventional immunosuppressive tri-therapy (96.6 vs. 75.7 %). ATP values were significantly higher in the conventional group compared to the Campath group at 180 days after transplantation (P < 0.001). ATP levels did not change significantly over time in clinically stable kidney recipients treated with alemtuzumab induction therapy (P = 0.554).


CONCLUSIONS
The ImmuKnow assay is a useful tool for evaluating the global immune response in alemtuzumab-treated renal transplant patients. Alemtuzumab-depleting induction therapy remains effective for at least 180 days.
Department of Urology, People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine (The People's Hospital of Fujian Province), No. 602, Middle Road 817, Fuzhou, 350004, China. okhao@hotmail.com
Hao
H
Zhou
Jian
J
Lin
Shushang
S
Chen
Liqiang
L
Ma
Zhenzhen
Z
Qiu
Weidong
W
Chen
Xin'an
X
Zhang
Yi
Y
Zhang
Xiuquan
X
Lin
D000255:Adenosine Triphosphate / Q000097:blood; D000293:Adolescent; D000328:Adult; D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects*; D007118:Immunoassay / Q000379:methods*; D007165:Immunosuppression Therapy / Q000379:methods*; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010835:Phytohemagglutinins / Q000494:pharmacology; D014511:Uremia / Q000601:surgery; D055815:Young Adult
D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D010835:Phytohemagglutinins; D000074323:Alemtuzumab; D000255:Adenosine Triphosphate; D003404:Creatinine