title: How immunosuppressive therapy affects T cells from kidney transplanted patients of different age: the role of latent cytomegalovirus infection.
abstract: The average age of patients receiving renal transplantation is increasing as programmes have been established which support the donation of organs from elderly donors to older recipients. Little is known about the effect of immunosuppressive therapy on the immune system of older patients. In this study, T cell function and the composition of the T cell repertoire were analysed in immunosuppressed renal transplant recipients of different age and cytomegalovirus (CMV) status in comparison to age- and CMV-matched controls. Independent of age and CMV status, the production of interleukin (IL)-2 and interferon (IFN)-γ by T cells was decreased in the patient groups and autologous serum from patients was capable of inhibiting the proliferation of CD3⁺ T cells. CXCR5 expression on T cells was increased in patients versus controls reflecting reduced endogenous IL-2 signalling under immunosuppressive therapy. In CMV-seronegative patients kidney transplantation and immunosuppressive therapy did not induce changes in the CD8⁺ T cell pool, but there was a moderate increase in CD4⁺CD28⁻ effector T cells when compared to age-matched controls. In contrast, latent CMV infection triggered a shift from early to late differentiated CD4⁺ and CD8⁺ T cells in patients and controls. This shift was most pronounced in elderly transplant patients under immunosuppressive therapy. In conclusion, our results demonstrate that immunosuppressive therapy following kidney transplantation is effective in patients older than 65 years. Latent CMV infection, however, accelerates age-related changes in the T cell repertoire in elderly people under immunosuppressive therapy. These patients should therefore be monitored with special care.
authors.affiliation: Immunology Division, Research Institute of Biomedical Aging Research, University of Innsbruck, Innsbruck, Austria; Division of Nephrology, Department of Internal Medicine IV, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Welzl
authors.forename: B
authors.initials: B
authors.lastname: Weinberger
authors.forename: A
authors.initials: A
authors.lastname: Kronbichler
authors.forename: G
authors.initials: G
authors.lastname: Sturm
authors.forename: G
authors.initials: G
authors.lastname: Kern
authors.forename: G
authors.initials: G
authors.lastname: Mayer
authors.forename: B
authors.initials: B
authors.lastname: Grubeck-Loebenstein
authors.forename: C
authors.initials: C
authors.lastname: Koppelstaetter
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D049109:Cell Proliferation / Q000187:drug effects; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000276:immunology / Q000821:virology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016867:Immunocompromised Host / Q000187:drug effects / Q000276:immunology*; D007166:Immunosuppressive Agents / Q000276:immunology* / Q000627:therapeutic use; D007371:Interferon-gamma / Q000276:immunology / Q000378:metabolism; D007376:Interleukin-2 / Q000276:immunology / Q000378:metabolism; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D054380:Receptors, CXCR5 / Q000276:immunology / Q000378:metabolism; D015398:Signal Transduction / Q000187:drug effects / Q000276:immunology; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology* / Q000378:metabolism; D013997:Time Factors
chemical_list: C095085:CXCR5 protein, human; D007166:Immunosuppressive Agents; D007376:Interleukin-2; D054380:Receptors, CXCR5; D007371:Interferon-gamma
keywords: T cells; ageing; immunosuppressive therapy
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