Background:The development of immunosuppressants has enabled remarkable progress in kidney transplantation (KT). However, current immunosuppressants cannot achieve induction of immune tolerance and their nonspecific immunosuppressive effects result in many adverse effects. Regulatory T cells (Tregs) play crucial roles in controlling allospecific immune responses. This study evaluated the distribution of Tregs and their effects on kidney allograft function in Korean KT recipients. Methods: We enrolled 144 KT recipients with stable graft function between 1989 and 2018. Differentiation and expansion of Tregs were studied by flow cytometry to compare the Tregs subpopulations. Tregs were defined as CD4 + CD25 high CD-127 low/-FoxP3 + cells. Results: Among the 144 patients, 75 patients (65.8%) were males and mean follow-up period was 144.3±111.5 months. All patients received calcineurin inhibitors as maintenance immunosuppressants. Patients with follow-up period more than 144.3 months tended to have more gating Tregs numbers than that in shorter follow-up period (92.3±142.4 vs. 50.1±76.4, P=0.061; respectively). There were no significant differences in Tregs subpopulations between patients with serum creatinine more than 1.5 md/dL and patients with serum creatinine less than 1.5 mg/dL. In terms of the number of Tregs, when the trough level of tacrolimus was at an appropriate level, the number of Tregs tended to be higher than that of Tregs when the trough level of tacrolimus was low or high, and the organ function of the transplant was also stable. Conclusions: Tregs counts may be associated with transplant outcomes considering that there is a relationship between these cells and kidney graft function.
Background:The mechanism of acute renal injury is complex. Previous studies have shown that the immune inflammatory response plays an important role in acute kidney injury. Regulatory T cells, one of the CD4-positive T cells, express IL-2 receptor (CD25). Foxp3 (Forkhead Box P3), a transcription factor that regulates immunosuppressive activity, and FoxP3-positive regulatory T cells are the drugs normal kidney monocytes, which accounts for 2%. Recent studies have shown that regulatory T cells play a role in protecting the kidney and are the expected immunotherapy target in acute renal injury. In this study, regulatory T cells were isolated and proliferated from patients with acute renal injury to confirm the kidney prognosis. Regulatory T cells that proliferated in vitro were re-administered to the same patient to reduce kidney damage, prevent chronic kidney disease, and reduce the occurrence of end-stage renal disease. Methods: Thirty patients with acute kidney injury between March and December 2020 were enrolled in this study. Differentiation and expansion of Tregs were determined using flow cytometry to compare Treg subpopulations. Tregs were defined as CD4 + C-D25 high CD127 low/-FoxP3 + cells. Results: In patients with acute renal injury, the number of regulatory T cells increased immediately after the decrease in renal function, and the number of regulatory T cells was normalized after the renal function was restored. Conclusions: In patients with acute renal injury, the number of regulatory T cells increased immediately after the decrease in renal function, and the number of regulatory T cells was normalized after the renal function was restored. In the future, it is expected to reduce kidney damage, the occurrence of chronic kidney disease, and end-stage kidney disease by re-administering regulatory T cells grown in vitro to the same patient.
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