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Nephrology Dialysis Transplantation, Vol 14, Issue 3 713-716, Copyright © 1999 by Oxford University Press

ORIGINAL ARTICLES

T lymphocyte subsets and cytokine production by graft-infiltrating cells in FSGS recurrence post-transplantation

J de Oliveira, P Xavier, E Carvalho, J Ramos, M Magalhaes, A Mendes, V Faria and L Guerra
Renal Department, Anatomy-Pathology Department and Immunology Department, Hospital S. Joao, Porto, Portugal; Tissue Typing Department, R. Roberto Frias, Porto, Portugal

Background. Focal segmental glomerulosclerosis (FSGS) aetiology remains undefined although a derangement of lymphocytes and monocytes-macrophages, at least, has been strongly suspected. We report the graft-infiltrating phenotypes and their cytokine production in a case of FSGS recurrence post-transplantation. Methods. The kidney transplant recipient suffered immediate FSGS recurrence. Aspiration biopsies were done at the first and second week post-surgery and were analysed by flow cytometry. The cytokine analysis was done on aspiration sample culture supernatants and serum by enzyme-linked immunosorbent assay. Results. High expression of CD3CD69, CD3CD71 and CD4CD29 was found on infiltrating lymphocytes. Biopsy cultures pointed to a Th0/Th1 pattern of cytokine production as well as significant synthesis of transforming growth factor-{beta}1. Interestingly, monocyte chemokines were absent. Conclusion. We report evidence of intragraft lymphocyte activation in the early days of FSGS recurrence. Aspiration biopsy cultures showed failure of cyclosporin A to inhibit interleukin-2 (IL-2) production by infiltrating lymphocytes. If our findings are confirmed in similar patients, a trial with anti-IL-2 receptor antibody could be warranted. Keywords: cytokines; flow cytometry; focal segmental glomerulosclerosis; recurrence; transplantation
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