GÜRKAN TELLİOĞLU, GÜLBU IŞITMANGİL, BÜLENT YİĞİT, İBRAHİM BERBER, HİLMİ TOZKIR, SARPER DİLER, TÜLAY KILIÇASLAN, AYDIN TÜRKMEN, İZZET TİTİZ, MAHMUT ÇARİN
Advances in Molecular Medicine - 2007;3(1):41-44
Objectives: The optimum induction and maintenance immunosuppressive therapy in renal transplantation is not yet established. In this study immunomonitorization of cytokine levels was performed to determine the immunologic status of kidney transplant patients to optimize the immunosuppressive therapy regimen. Methods: We determined IL-1alpha, TNF-alpha, IFN-gamma, IL-10 and TGF-beta in 87 blood samples by ELISA (RayBiotech, Inc). Group1 (n=35) included kidney transplant patients at postoperative 1st year whose preoperative blood samples were studied (n=35) and all were cross-match negative. Group 2 (n=10) were cross-match positive preoperative patients. Group 3 was the control group (7 healthy subjects). Those patients were immunosuppressed by Cyclosporine (CyA) based triple immunosuppressive regimen (CyA+Mycophenolate mophetyl+steroid). Results: Cyclosporine (CyA) based triple immunosuppressive regimen was associated with acute rejection (p<0.001) and also with IL-10 (p<0.001), TGF-beta (p<0.001), IL-1alpha (p<0.005), IFN-gamma (p<0.001) positivity. In the healthy control group all of the cytokines were measured negative indicating an immunological balance. Hemodialysis for over 5 years significantly leads to TGF-beta (p=0.021) positivity but it does not correlate with acute rejection after renal transplantation. Conclusion: We found that immunomonitorization by cytokine secretion profile is a promising tool to determine immunological risk at renal transplantation patients and is necessary to optimize individual therapy decisions related to immunosuppression regimens, thereby improving transplant outcomes.
