title: Pretransplant CD28 Biomarker (Levels of Expression and Quantification of Molecules per Cell) in Peripheral CD4+T Cells Predicts Acute Rejection Episodes in Liver and Kidney Recipients.
abstract: BACKGROUND
  Acute rejection (AR) remains a significant cause of graft loss. Better approaches to predict AR are being investigated. Surface CD28 protein is essential for T-cell proliferation and survival as well as cytokine production.
  
  
  METHODS
  Pretransplant CD4+CD28+peripheral T cells were examined in 30 liver recipients (LRs) and 31 kidney recipients (KRs) by flow cytometry.
  
  
  RESULTS
  Pretransplant CD4+CD28+T cells in LRs were significantly lower in rejectors than nonrejectors (P = .002). Furthermore, the total number of CD28 molecules per cell in LRs (P = .02) as well as KRs (P = .047) was significantly lower in rejectors than nonrejectors. The healthy group did not display differences when compared with patients with end-stage liver disease or renal failure; however, stratification analysis displayed higher levels of CD4+CD28+when compared with rejected LRs (P = .04) but not KRs. CD28 levels <41.94% were able to discriminate LRs at high risk of AR (P = .003). Similarly, a total number of CD28 molecules ≤8359 (P = .031) in LRs and ≤7669 (P = .046) in KRs correlated with high risk of AR.
  
  
  CONCLUSIONS
  The preliminary results presented herein exhibit a fast and noninvasive method that assists clinicians to prevent AR by monitoring CD4+CD28+peripheral T cells.
authors.affiliation: Department of Immunology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Boix
authors.affiliation: Department of Immunology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Bolarín
authors.affiliation: Department of Immunology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Eguía
authors.affiliation: Department of Immunology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Gonzalez-Martinez
authors.affiliation: Department of Pathology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: De La Peña
authors.affiliation: Department of Immunology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Galian
authors.affiliation: Department of Digestive Medicine, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: A M
authors.initials: AM
authors.lastname: Hernández-Martínez
authors.affiliation: Department of Immunology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: M R
authors.initials: MR
authors.lastname: Moya-Quiles
authors.affiliation: Department of Immunology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Legaz
authors.affiliation: Department of Immunology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Campillo
authors.affiliation: Department of Surgery, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Ramirez
authors.affiliation: Department of Surgery, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Sanchez-Bueno
authors.affiliation: Department of Immunology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: A M
authors.initials: AM
authors.lastname: García-Alonso
authors.affiliation: Department of Digestive Medicine, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Pons
authors.affiliation: Department of Immunology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Minguela
authors.affiliation: Department of Nephrology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Llorente
authors.affiliation: Department of Immunology, Clinical University Hospital, "Virgen Arrixaca"-IMIB, Murcia, Spain. Electronic address: manuel.muro@carm.es.
authors.forename: M
authors.initials: M
authors.lastname: Muro
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D018106:CD28 Antigens / Q000097:blood*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D058625:End Stage Liver Disease / Q000097:blood* / Q000209:etiology / Q000601:surgery; D005260:Female; D005434:Flow Cytometry; D006084:Graft Rejection / Q000097:blood* / Q000209:etiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008213:Lymphocyte Activation; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D018106:CD28 Antigens