Effects of three immunosuppressive regimens on CD4 helper function, B cell monocyte and cytokine responses in renal transplant recipients: 4-month follow-up of a prospective randomized study

Weimer, Rolf; Streller, Sabine; Staak, A.; Heilke, M; Li, D; Dietrich, Hartmut; Daniel, Volker; Feustel, Andreas; Rainer, L.; Zinn, S. A.; Friemann, S; Ernst, Wolfgang; Grimm, H.; Padberg, Winfried; Zimmermann, Thomas; Opelz, Gerhard

doi:10.1016/s0041-1345(02)03278-5

Cited by 10 publications

(14 citation statements)

References 4 publications

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“…We analyzed whether the predictive value of sCD30 in renal transplant recipients may be attributed to typical Th2-type responses, namely CD4 helper function or in vitro IL-4 or IL-10 responses. These parameters were previously shown to predict the risk of acute kidney graft rejection and 3-year graft function (14,15,19). However, we found a significant positive association between sCD30 levels and Th2 cytokine secretion only for CD4+ T cellmediated IL-10 responses in CsA/Aza-treated patients at 1 year post-transplant.…”

Section: Post-transplant Scd30 and Cancontrasting

confidence: 41%

Post-Transplant sCD30 and Neopterin as Predictors of Chronic Allograft Nephropathy: Impact of Different Immunosuppressive Regimens

Weimer

Süsal

Yildiz

et al. 2006

American Journal of Transplantation

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Section: Post-transplant Scd30 and Cancontrasting

confidence: 41%

Post-Transplant sCD30 and Neopterin as Predictors of Chronic Allograft Nephropathy: Impact of Different Immunosuppressive Regimens

Weimer

Süsal

Yildiz

et al. 2006

American Journal of Transplantation

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“…Intention to treat analysis was confirmed for 12 trials,16 19 21 25 – 27 29 – 31 37 40 41 not done for eight trials,15 18 22 24 28 32 34 36 and unclear for 10 trials. Completeness of follow-up was neither reported nor deducible for 10 trials12 – 14 17 23 28 31 32 36 38; it ranged between 77% and 100% for the remainder.…”

Section: Resultsmentioning

confidence: 98%

“…Three trials varied the antiproliferative agent across three trial arms, investigating combinations of tacrolimus and ciclosporin with mycophenolate or azathioprine 14 21 38. Azathioprine was used in both tacrolimus and ciclosporin arms in 16 trials and mycophenolate in eight trials.…”

Section: Resultsmentioning

confidence: 99%

“…One trial used sirolimus,26 one used mirzoribine,20 and one used no antiproliferative agent39; one trial did not state which was used 32. Seventeen trials reported their corticosteroid regimen in detail; the remaining 13 trials noted only that “local protocol” or “a standard reducing schedule” was followed 12 13 15 17 – 20 22 23 32 33 35 38…”

Section: Resultsmentioning

confidence: 99%

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Tacrolimus versus ciclosporin as primary immunosuppression for kidney transplant recipients: meta-analysis and meta-regression of randomised trial data

Webster

Woodroffe

Taylor

et al. 2005

BMJ

518

301

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Objective To compare the positive and negative effects of tacrolimus and ciclosporin as initial treatment for renal transplant recipients. Design Systematic review. Data sources and study selection Reports of comparative randomised trials of tacrolimus and ciclosporin identified by searches of Medline, Embase, the Cochrane Register of Controlled Trials, the Cochrane Renal Group Specialist Register, and conference proceedings. Data extraction and synthesis Two reviewers assessed trials for eligibility and quality and extracted data independently. Data were synthesised (random effects model) and results expressed as relative risk (RR), with values < 1 favouring tacrolimus. Subgroup analysis and meta-regression were used to examine potential effect modification by differences in trial design and immunosuppressive co-interventions. Results 123 reports from 30 trials (4102 patients) were included. At six months, graft loss was significantly reduced in tacrolimus treated recipients (RR = 0.56, 95% confidence interval 0.36 to 0.86), and this effect persisted up to three years. The relative reduction in graft loss with tacrolimus diminished with higher concentrations of tacrolimus (P = 0.04) but did not vary with ciclosporin formulation (P = 0.97) or ciclosporin concentration (P = 0.38). At one year, tacrolimus treated patients had less acute rejection (RR = 0.69, 0.60 to 0.79) and less steroid resistant rejection (RR = 0.49, 0.37 to 0.64) but more diabetes mellitus requiring insulin (RR = 1.86, 1.11 to 3.09), tremor, headache, diarrhoea, dyspepsia, and vomiting. The relative excess of diabetes increased with higher concentrations of tacrolimus (P = 0.003). Ciclosporin treated recipients had significantly more constipation and cosmetic side effects. No differences were seen in infection or malignancy. Conclusions Treating 100 recipients with tacrolimus instead of ciclosporin for the first year after transplantation avoids 12 patients having acute rejection and two losing their graft but causes an extra five patients to develop insulin dependent diabetes. Optimal drug choice may vary between patients.

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“…Weimer et al demonstrated that IL-10 release from CD4(þ) T cells was elevated in kidney transplant recipients on tacrolimus-based immunosuppressive treatment. In that study, the authors suggested that cytokine-gene polymorphisms may have important consequences on predisposition of CD4(þ) T cells for IL-4 and IL-10 production [20].…”

Section: Discussionmentioning

confidence: 99%

Relationship of Interleukin-10 and Transforming Growth Factor–β Levels With Short-Term Graft Function After Kidney Transplantation

Çolak¹,

Ersan²,

Tanrısev³

et al. 2015

Transplantation Proceedings

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Effects of three immunosuppressive regimens on CD4 helper function, B cell monocyte and cytokine responses in renal transplant recipients: 4-month follow-up of a prospective randomized study

Cited by 10 publications

References 4 publications

Post-Transplant sCD30 and Neopterin as Predictors of Chronic Allograft Nephropathy: Impact of Different Immunosuppressive Regimens

Post-Transplant sCD30 and Neopterin as Predictors of Chronic Allograft Nephropathy: Impact of Different Immunosuppressive Regimens

Tacrolimus versus ciclosporin as primary immunosuppression for kidney transplant recipients: meta-analysis and meta-regression of randomised trial data

Relationship of Interleukin-10 and Transforming Growth Factor–β Levels With Short-Term Graft Function After Kidney Transplantation

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