Use of the ImmuKnow assay to evaluate the effect of alemtuzumab-depleting induction therapy on cell-mediated immune function after renal transplantation

• DOI: 10.1007/s10157-012-0688-1
• Publication Date: 2012-10-05T09:39:28Z
• Authors: Hao Zhou; Jian Lin; Shushang Chen; Liqiang Ma; Zhenzhen Qiu; Weidong Chen; Xin’an Zhang; Yi Zhang; Xiuquan Lin
• Keywords: Adult; CD4-Positive T-Lymphocytes; Graft Rejection; Immunoassay; Immunosuppression Therapy; Male; Immunity, Cellular; Adolescent; Antineoplastic Agents; Middle Aged; Antibodies, Monoclonal, Humanized; Kidney Transplantation; 3. Good health; 03 medical and health sciences; Adenosine Triphosphate; 0302 clinical medicine; Creatinine; Humans; Female; Phytohemagglutinins; Alemtuzumab; Monitoring, Physiologic; Uremia

Good outcomes after renal transplantation are dependent on effective immunosuppression while minimizing infection. Alemtuzumab (Campath or Campath-1H) is an anti-CD52 humanized monoclonal IgG1 antibody which induces rapid and sustained depletion of circulating lymphocytes and has been effectively used as an immunosuppressant in post-transplant induction therapy.We used the ImmuKnow assay to compare cell-mediated immune function in renal transplant patients treated with alemtuzumab or with conventional immunosuppressive tri-therapy. The ImmuKnow method determines the levels of adenosine triphosphate (ATP) released from CD4 cells following stimulation with a mitogen.We showed a statistically significant difference in the distribution of outcome after transplantation between the conventional and the Campath groups (P = 0.010). A significantly higher number of patients treated with alemtuzumab induction therapy were stable after transplantation compared to those treated with conventional immunosuppressive tri-therapy (96.6 vs. 75.7 %). ATP values were significantly higher in the conventional group compared to the Campath group at 180 days after transplantation (P < 0.001). ATP levels did not change significantly over time in clinically stable kidney recipients treated with alemtuzumab induction therapy (P = 0.554).The ImmuKnow assay is a useful tool for evaluating the global immune response in alemtuzumab-treated renal transplant patients. Alemtuzumab-depleting induction therapy remains effective for at least 180 days.