Clinical Correlates and Outcomes of Dual Basiliximab and Antithymocyte Globulin Induction in Kidney Transplant Recipients: A National Study

Lam, Ngan N.; Jeong, Rachel; Quinn, Robert R.; Ravani, Pietro; Xiao, Huiling; McAdams‐DeMarco, Mara; Axelrod, David A.; Snyder, Jon J.; Lentine, Krista L.

doi:10.1097/txd.0000000000001190

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…Induction therapy can be subdivided into two strategies involving either the use of non-lymphocyte-depleting monoclonal antibodies or lymphocyte-depleting polyclonal antibodies ( 11 ). The non-lymphocyte-depleting strategy is represented by the interleukin-2 (IL-2) receptor antagonist basiliximab, which inhibits lymphocyte proliferation ( 12 , 13 ). The lymphocyte-depleting strategy is represented by the rabbit anti-human thymocyte immunoglobulin (rATG).…”

Section: Introductionmentioning

confidence: 99%

Porcine anti-human lymphocyte immunoglobulin depletes the lymphocyte population to promote successful kidney transplantation

Zhang

Zou

et al. 2023

Front. Immunol.

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IntroductionPorcine anti-human lymphocyte immunoglobulin (pALG) has been used in kidney transplantation, but its impacts on the lymphocyte cell pool remain unclear.MethodsWe retrospectively analyzed 12 kidney transplant recipients receiving pALG, and additional recipients receiving rabbit anti-human thymocyte immunoglobulin (rATG), basiliximab, or no induction therapy as a comparison group.ResultspALG showed high binding affinity to peripheral blood mononuclear cells (PBMCs) after administration, immediately depleting blood lymphocytes; an effect that was weaker than rATG but stronger than basiliximab. Single-cell sequencing analysis showed that pALG mainly influenced T cells and innate immune cells (mononuclear phagocytes and neutrophils). By analyzing immune cell subsets, we found that pALG moderately depleted CD4+T cells, CD8+T cells, regulatory T cells, and NKT cells and mildly inhibited dendritic cells. Serum inflammatory cytokines (IL-2, IL-6) were only moderately increased compared with rATG, which might be beneficial in terms of reducing the risk of untoward immune activation. During 3 months of follow-up, we found that all recipients and transplanted kidneys survived and showed good organ function recovery; there were no cases of rejection and a low rate of complications.DiscussionIn conclusion, pALG acts mainly by moderately depleting T cells and is thus a good candidate for induction therapy for kidney transplant recipients. The immunological features of pALG should be exploited for the development of individually-optimized induction therapies based on the needs of the transplant and the immune status of the patient, which is appropriate for non-high-risk recipients.

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Section: Introductionmentioning

confidence: 99%