title: Dynamic analysis of B-cell subsets in de novo living related kidney transplantation with induction therapy of basiliximab.
abstract: BACKGROUND
  Accumulative evidence has suggested B-cell-mediated alloimmune response plays an important role in kidney transplantation. Monitoring the dynamics of B-cell subsets could enhance understanding of B-cell immunology in clinical transplantation, and may facilitate optimization of current immunosuppressive regimens.
  
  
  METHODS
  Between June 2011 and June 2012, 16 de novo living related kidney transplant recipients were enrolled in this study. All patients were given basiliximab as induction therapy. The maintenance therapy consisted of tacrolimus, mycophenolate mofetil (MMF), and steroids. Phenotype of B-cell subsets in peripheral blood was examined at day 0, day 1, day 3, day 7, day 14, month 1, month 3, and month 6.
  
  
  RESULTS
  CD19(+) B cells in peripheral lymphocytes significantly increased by 1.8-2.1 times within 1 month after transplantation, and recovered to the baseline level at month 3. Notably in B cells, CD5(+)CD19(+)B cells dramatically decreased by 45% at month 6. CD19(+)CD27(+) memory B cells increased by 127% at month 6. B-cell activating factor receptor (BAFF-R) expression on the B-cell population was maintained at a high level of 91.7%-97.9%. Within 7 days after transplantation, Bm1 (IgD(+)CD38(-)) did not change apparently, Bm2 (IgD(+)CD38(int)) significantly increased, whereas Bm2' (IgD(+)CD38(high), germinal center founder cells), Bm3+Bm4 (IgD(-)CD38(high), germinal center B cells), early Bm5 (IgD(-)CD38(int)), and late Bm5 (IgD(-)CD38(-)) significantly decreased. After day 7, Bm1 stayed stable, Bm2 decreased to the baseline level (day 0), and Bm2' and Bm3+Bm4 kept decreasing, whereas early Bm5 and late Bm5 increased to baseline level. At month 6, Bm1 significantly increased, Bm2 was maintained at the baseline level, Bm2' constantly decreased to the lowest, and Bm3+Bm4 was slightly lower than the baseline, whereas early and late Bm5 increased to the baseline level.
  
  
  CONCLUSIONS
  The proportion of B cells in peripheral lymphocytes significantly increased at the early stage, whereas CD5(+)CD19(+)B cells consistently decreased after transplantation. Mature circulating B-cell subsets dynamically changed, especially at the early stage after transplantation, which might be attributed to the induction therapy.
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: L
authors.initials: L
authors.lastname: Longshan
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: L
authors.initials: L
authors.lastname: Dongwei
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: F
authors.initials: F
authors.lastname: Qian
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: L
authors.initials: L
authors.lastname: Jun
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: D
authors.initials: D
authors.lastname: Suxiong
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Yitao
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: X
authors.initials: X
authors.lastname: Yunyi
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: H
authors.initials: H
authors.lastname: Huiting
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: C
authors.initials: C
authors.lastname: Lizhong
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Electronic address: feijg@126.com.
authors.forename: F
authors.initials: F
authors.lastname: Jiguang
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Electronic address: wcx6363@163.com.
authors.forename: W
authors.initials: W
authors.lastname: Changxi
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D015703:Antigens, CD / Q000276:immunology; D016175:B-Lymphocyte Subsets; D000077552:Basiliximab; D005190:Family; D005434:Flow Cytometry; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D019520:Living Donors; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab