Several efforts have been made in past years to identify markers for patients at heightened risk of acute and chronic immune-mediated allograft rejection. The ex vivo monitoring of cellular immunity by Enzyme-Linked Immunosorbent Spot (ELISPOT) assay has recently emerged as a primary tool in predicting either short and long-term outcomes in kidney allograft recipients. Therefore we started the systematic application of Interferon-gamma (IFN-g) ELISPOT assay to measure the frequency of producing IFN-g in recipient peripheral blood lymphocytes (PBLs) stimulated with donor lymphocytes before and 7, 14, 21,28 and 60 days after the transplant, respectively. Very preliminary results on 8 kidney transplant patients indicated that the number of HLA mismatches never correlated with the number of IFN-g spots. The frequencies of pre-transplant IFN-g spots were positively and significantly correlated with the number of post-transplant IFN-ã spots. Clinical outcome was better in recipients with low frequencies than in recipients with high frequencies of pre and/or post-transplant IFN-g spots. The highest pre-and post-transplant number of IFN-g spots was observed in a patient who developed early acute rejection. Significant increases of the number of IFN-g spots preceded the onset of acute rejection events and decreased after supplemental i.v. steroid administration. Considering the low number of observations, these preliminary results must be considered cautiously; nevertheless we are encouraged to extend the systematic application of serial IFN-g ELISPOT assay measurements in a more consistent cohort of patients.
Monitoring of cellular immunity by interferon gamma (IFN-g) Enzyme-Linked Immunosorbent Spot (ELISPOT) assay in kidney allograft recipients: preliminary results of a longitudinal study.
BELLISOLA, GIUSEPPE;TRIDENTE, Giuseppe;
2006-01-01
Abstract
Several efforts have been made in past years to identify markers for patients at heightened risk of acute and chronic immune-mediated allograft rejection. The ex vivo monitoring of cellular immunity by Enzyme-Linked Immunosorbent Spot (ELISPOT) assay has recently emerged as a primary tool in predicting either short and long-term outcomes in kidney allograft recipients. Therefore we started the systematic application of Interferon-gamma (IFN-g) ELISPOT assay to measure the frequency of producing IFN-g in recipient peripheral blood lymphocytes (PBLs) stimulated with donor lymphocytes before and 7, 14, 21,28 and 60 days after the transplant, respectively. Very preliminary results on 8 kidney transplant patients indicated that the number of HLA mismatches never correlated with the number of IFN-g spots. The frequencies of pre-transplant IFN-g spots were positively and significantly correlated with the number of post-transplant IFN-ã spots. Clinical outcome was better in recipients with low frequencies than in recipients with high frequencies of pre and/or post-transplant IFN-g spots. The highest pre-and post-transplant number of IFN-g spots was observed in a patient who developed early acute rejection. Significant increases of the number of IFN-g spots preceded the onset of acute rejection events and decreased after supplemental i.v. steroid administration. Considering the low number of observations, these preliminary results must be considered cautiously; nevertheless we are encouraged to extend the systematic application of serial IFN-g ELISPOT assay measurements in a more consistent cohort of patients.
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