title: Large decrease of anti-tetanus anatoxin and anti-pneumococcal antibodies at one year after renal transplantation.
abstract: OBJECTIVE
  In kidney transplant recipients (KTR), antibody (Ab) synthesis is hampered by AZA and CsA. We here report in a prospective cohort study, the effects of mycophenolate mofetil (MMF) associated to a calcineurin inhibitor on plasma levels of anti-tetanus anatoxin Ab (TAnAb) and anti-pneumococcal Ab (PnPsAb).
  
  
  METHODS
  Serum titers of the TAnAb and the PnPsAb against serotypes 14, 19F and 23F were measured in 94 KTR on Day 0 (T0) and 1 year (T12) after renal transplantation and in 49 healthy controls.
  
  
  RESULTS
  1) At T0, TAnAb were detected in only 71% of patients vs. 98% of controls (p < 0.0001) and the titers were significantly lower in KTR (1.46 UI/ml vs. 2.74 in controls, p = 0.01); they further decreased between T0 and T12 (1.46 UI/ml to 0.31, p < 0.0001). The calculated half-life (t1/2) of TAnAb was 7.7 months, as compared to more than 10 years in a normal population. 2) In KTR, PnPsAb titers decreased significantly between T0 and T12 (p < 0.005); the t1/2 of the different PnPsAb ranged from 9.2 to 11.9 months.
  
  
  CONCLUSIONS
  In KTR treated by MMF and CNI, the TAnAbs and PnPsAbs titers decrease significantly and profoundly during the first year. Immunization pre-transplantation should be encouraged to maintain adequate post-transplant Abs levels.
authors.affiliation: Universite Libre de Bruxelles, Brussels, Belgium. ebroeder@ulb.ac.be
authors.forename: Emine Nilufer
authors.initials: EN
authors.lastname: Broeders
authors.forename: Karl M
authors.initials: KM
authors.lastname: Wissing
authors.forename: Lidia
authors.initials: L
authors.lastname: Ghisdal
authors.forename: Anne
authors.initials: A
authors.lastname: Lemy
authors.forename: Anh-Dung
authors.initials: AD
authors.lastname: Hoang
authors.forename: Pierre
authors.initials: P
authors.lastname: Vereerstraeten
authors.forename: Françoise
authors.initials: F
authors.lastname: Mascart
authors.forename: Daniel
authors.initials: D
authors.lastname: Abramowicz
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D000917:Antibody Formation / Q000187:drug effects; D065095:Calcineurin Inhibitors; D016022:Case-Control Studies; D016572:Cyclosporine / Q000009:adverse effects; D015536:Down-Regulation; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006207:Half-Life; D006801:Humans; D007114:Immunization; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives; D022242:Pneumococcal Vaccines / Q000276:immunology*; D011446:Prospective Studies; D016559:Tacrolimus / Q000009:adverse effects; D013745:Tetanus Toxoid / Q000276:immunology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000907:Antibodies, Bacterial; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D022242:Pneumococcal Vaccines; D013745:Tetanus Toxoid; D016572:Cyclosporine; D009173:Mycophenolic Acid; D016559:Tacrolimus