PMID- 17124279
OWN - NLM
STAT- MEDLINE
DCOM- 20070709
LR  - 20131121
IS  - 0931-0509 (Print)
IS  - 0931-0509 (Linking)
VI  - 22
IP  - 2
DP  - 2007 Feb
TI  - Stable T-cell reactivity after successful tapering of azathioprine in 
      HLA-identical living-related kidney transplant recipients despite minor 
      histocompatibility antigen mismatches.
PG  - 353-61
AB  - BACKGROUND: Human leukocyte antigen (HLA)-identical living-related (LR) kidney 
      transplant recipients often receive the standard regimen of immunosuppression. We 
      wondered whether these patients should be exposed to the side effects of these 
      drugs any longer. Safe tapering of immunosuppression should not result in 
      rejection and high donor-directed T-cell responses. In the present study, we 
      investigated the effect of tapering azathioprine (AZA) on T-cell reactivity. 
      METHODS: Fifteen HLA-identical LR kidney transplant recipients receiving a median 
      of 150 mg/day AZA and 5-10 mg/day prednisone were tapered to a median of 50 
      mg/day AZA. Donor-, third-party and tetanus toxoid (TET)-reactivity were 
      determined in interferon (IFN)-gamma and interleukin (IL)-13 Elispot assays, 
      which reflect the T-helper (Th)1 and T-helper (Th)2 response. RESULTS: After the 
      tapering of AZA, none of the patients developed acute rejection and the renal 
      function remained stable, even at 1-year follow-up. The frequency of 
      donor-specific IFN-gamma and IL-13 producing cells (pc) was low. Tapering of AZA 
      did not influence the frequency of both IFN-gamma and IL-13 pc. Also, the 
      reactivity against third-party cells and TET remained unchanged. CONCLUSIONS: The 
      AZA-dose can be safely reduced in recipients of an HLA-identical LR kidney 
      transplant without affecting kidney function and without increasing T-cell 
      responses directed against donor or other antigens.
FAU - Gerrits, Jeroen H
AU  - Gerrits JH
AD  - Erasmus MC, University Medical Center Rotterdam, Department of Internal 
      Medicine-Transplantation, Room Ee-563a, P.O. Box 2040, NL-3000 CA Rotterdam, The 
      Netherlands. j.gerrits@erasmusmc.nl
FAU - van de Wetering, Jacqueline
AU  - van de Wetering J
FAU - Postma, Saskia
AU  - Postma S
FAU - Drabbels, Jos J M
AU  - Drabbels JJ
FAU - Vaessen, Len M B
AU  - Vaessen LM
FAU - IJzermans, Jan N M
AU  - IJzermans JN
FAU - Rischen, Jacqueline
AU  - Rischen J
FAU - Claas, Frans H J
AU  - Claas FH
FAU - Weimar, Willem
AU  - Weimar W
FAU - van Besouw, Nicole M
AU  - van Besouw NM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20061123
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Interleukin-13)
RN  - 0 (Minor Histocompatibility Antigens)
RN  - 82115-62-6 (Interferon-gamma)
RN  - MRK240IY2L (Azathioprine)
SB  - IM
MH  - Azathioprine/*therapeutic use
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/*drug therapy/immunology/metabolism
MH  - HLA Antigens/immunology
MH  - Humans
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Interferon-gamma/blood
MH  - Interleukin-13/blood
MH  - Kidney Transplantation/*immunology/pathology
MH  - *Living Donors
MH  - Male
MH  - Minor Histocompatibility Antigens/*immunology
MH  - Prognosis
MH  - T-Lymphocytes/*immunology
EDAT- 2006/11/25 09:00
MHDA- 2007/07/10 09:00
CRDT- 2006/11/25 09:00
PHST- 2006/11/25 09:00 [pubmed]
PHST- 2007/07/10 09:00 [medline]
PHST- 2006/11/25 09:00 [entrez]
AID - gfl678 [pii]
AID - 10.1093/ndt/gfl678 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2007 Feb;22(2):353-61. doi: 10.1093/ndt/gfl678. Epub 
      2006 Nov 23.