title: The immune phenotype may relate to cancer development in kidney transplant recipients.
abstract: High regulatory T-cell (Treg) numbers predict recurrent cutaneous squamous cell carcinoma in kidney transplant recipients, and the Treg immune phenotype may identify kidney transplant recipients at risk of developing squamous cell carcinoma and/or solid-organ cancer. To investigate this, a total of 116 kidney transplant recipients, of whom 65 had current or past cancer, were immune-phenotyped and followed up prospectively for a median of 15 months. Higher Treg (CD3+CD4+FOXP3+CD25(Hi)CD127(Lo)) proportion and numbers significantly increased the odds of developing cancer (odds ratios (95% CI) 1.61 (1.17-2.20) and 1.03 (1.00-1.06), respectively) after adjusting for age, gender, and duration of immunosuppression. Class-switched memory B cells (CD19+CD27+IgD-) had a significant association to cancer, 1.04 (1.00-1.07). Receiver operator characteristic (ROC) curves for squamous cell carcinoma development within 100 days of immune phenotyping were significant for Tregs, memory B cells, and γδ T cells (AUC of 0.78, 0.68, and 0.65, respectively). After cancer resection, Treg, NK cell, and γδ T-cell numbers fell significantly. Immune-phenotype profiles associated with both squamous cell carcinoma and solid-organ cancer in kidney transplant recipients and depended on the presence of cancer tissue. Thus, immune profiling could be used to stratify kidney transplant recipients at risk of developing cancers to identify those who could qualify for prevention therapy.
authors.affiliation: 1] The Centre of Clinical and Experimental Transplantation (CCET), Central Northern Adelaide Renal and Transplantation Services (CNARTS), Adelaide, South Australia, Australia [2] Department of Medicine, The University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Hope
authors.affiliation: 1] Department of Medicine, The University of Adelaide, Adelaide, South Australia, Australia [2] The Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), Adelaide, South Australia, Australia.
authors.forename: Blair S
authors.initials: BS
authors.lastname: Grace
authors.affiliation: 1] Detmold Family Imaging Facility, Hanson Institute, Adelaide, South Australia, Australia [2] Department of Haematology, South Australia Pathology, Adelaide, South Australia, Australia.
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Pilkington
authors.affiliation: 1] The Centre of Clinical and Experimental Transplantation (CCET), Central Northern Adelaide Renal and Transplantation Services (CNARTS), Adelaide, South Australia, Australia [2] Department of Medicine, The University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Coates
authors.affiliation: Department of Nephrology and Hypertension, University Hospital Berne, Berne, Switzerland.
authors.forename: Ivo P
authors.initials: IP
authors.lastname: Bergmann
authors.affiliation: 1] The Centre of Clinical and Experimental Transplantation (CCET), Central Northern Adelaide Renal and Transplantation Services (CNARTS), Adelaide, South Australia, Australia [2] Department of Medicine, The University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Carroll
mesh_terms: D000328:Adult; D001402:B-Lymphocytes / Q000276:immunology; D002294:Carcinoma, Squamous Cell / Q000209:etiology / Q000276:immunology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007156:Immunologic Memory; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000276:immunology; D009369:Neoplasms / Q000209:etiology* / Q000276:immunology* / Q000517:prevention & control; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D016037:Single-Blind Method; D012878:Skin Neoplasms / Q000209:etiology / Q000276:immunology; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*
chemical_list: D007166:Immunosuppressive Agents