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Nephrol Dial Transplant (2000) 15: 71-77
© 2000 European Renal Association-European Dialysis and Transplant Association

Soluble CD-4 and CD-8 as markers of immunological activation in renal transplant recipients

R. Willi Grunewald, G. Martin Fiedler, Birgit Stock, Julia M. Grunewald and Gerhard A. Müller

Division of Nephrology and Rheumatology, Department of Internal Medicine, University of Göttingen, Germany

Correspondence and offprint requests to: R. W. Grunewald, Zentrum Innere Medizin, Abteilung Nephrologie und Rheumatologie, Universitätsklinik Göttingen, Robert Koch Straße 40, D-37075 Göttingen, Germany.

Background. T lymphocytes are activated following kidney transplantation in cases of acute graft rejection and viral infections. In plasma, elevated levels of T-cell markers can be measured in soluble form. The reason for this shedding is still not entirely understood.

Methods. Plasma concentrations of soluble CD-4 and CD-8 (sCD-4, sCD-8) were determined in 78 patients following kidney transplantation by commercially available enzyme-linked immunosorbent assay (ELISA) test kits.

Results. The concentrations of both soluble T-cell markers increased significantly in the course of acute allograft rejections and cytomegalovirus (CMV) infections. Frequently, the parameters increased shortly before clinical diagnosis and decreased under successful therapy. Additionally, sCD-8 showed significant higher plasma concentrations in cases of CMV infection as compared with acute allograft rejections. Accordingly, the sCD-4/sCD-8 ratio increased in cases of acute allograft rejection and decreased during CMV infections. Cyclosporin A nephrotoxicity caused no significant changes in the sCD-4 and sCD-8 levels in plasma.

Conclusion. The present study demonstrates that sCD-4 and sCD-8 are markers of immunological activation and may enable a further differentiation of T-cell activation if serial measurements are performed. However, further prospective investigations are necessary to elucidate the diagnostic potential of sCD-4 and sCD-8 for monitoring acute rejection and viral infection in kidney graft recipients.

Keywords: CMV infection; cyclosporin A nephrotoxicity; immune monitoring; renal allograft rejection; soluble CD-4; soluble CD-8


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C. Grupp, U. Hemprich, H. John, F. Braun, T. Lorf, V. W. Armstrong, B. Sattler, B. Ringe, and G. A. Muller
Lectin staining for urine cytologic monitoring after kidney transplantation
Nephrol. Dial. Transplant., August 1, 2002; 17(8): 1491 - 1496.
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