Exploring the impact of tacrolimus on kidney transplant recipients: insights into immunological outcomes

doi:10.5246/jcps.2024.08.055

Abstract

Abstract:

To minimize graft rejection, it is crucial to reduce immunosuppression. In the present study, we investigated immunological markers in the blood of transplant patients who did not receive tacrolimus. We also assessed alloreactive CD4+CD25+FoxP3+ Tregs both before transplantation and after tacrolimus reduction. The comparative analysis included 50 individuals experiencing early rejection after tacrolimus discontinuation and 100 non-rejectors. Before reducing tacrolimus, rejectors exhibited elevated levels of memory CD8+ T cells compared to Tregs, while non-rejectors displayed a lower ratio of memory CD4+ T cells to Tregs. Following tacrolimus removal, rejectors showed an increase in naïve T cells and a decrease in effector T cells. After transplantation, CD4+ Treg levels declined, but their anti-donor regulatory function remained consistent in both rejectors and non-rejectors. Immunological correlation revealed an association between acute rejection after tacrolimus discontinuation and the pre-reduction ratio of memory T cells to regulatory T cells. These indicators identified individuals whose immunosuppression could be safely reduced.

Key words: Tacrolimus, Kidney, Transplant, Immune system, Rejection

Supporting:

Zainab A Abbood, Ahmed Hamza AL-Shammari, Eman M. Jasim, Amjad I. Oraibi. Exploring the impact of tacrolimus on kidney transplant recipients: insights into immunological outcomes[J]. Journal of Chinese Pharmaceutical Sciences, 2024, 33(8): 737-750.

Figures/Tables 14

Table 1. Case properties.

Table 2. Description of study statistics.

Table 3. Description of rejectors.

Table 4. Description of non-rejectors.

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