Discriminating rejection from CMV infection in renal allograft recipients using flow cytometry

Don L. Siegel, Ira Fox, Donald C. Dafoe, Michelle Power, Mark Asplund, Lydia Zellers, Clyde F. Barker, Michael B. Prystowsky

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

The ability to distinguish among rejection, cytomegalovirus (CMV) infection, and cyclosporin toxicity in the symptomatic renal allograft recipient remains one of the major issues in clinical transplantation. The practical application of immunologic monitoring of peripheral blood lymphocytes through the use of fluorescently labeled monoclonal antibodies and single-color flow cytometry has been limited by the inability to demonstrate significant correlations between the levels of specific T-cell subset populations and the cause of impaired renal function. In the present study using two-color analysis, we monitored the expression of interleukin-2 receptor (IL-2R) and HLA-DR antigen on the T-cells of a group of 51 renal cadaveric allograft recipients receiving cyclosporin, azathioprine, and prednisone for an average of 4 months after transplantation. We found that the proportion of CD3 + cells coexpressing IL-2R increased above baseline during 12 out of 14 rejection episodes that took place during the course of the study (P < 10-6). Alternatively, we found that the proportion of cells coexpressing HLA-DR antigen on CD2 + cells increased above baseline during 11 out of 11 CMV infections (P < 10-6). There was no correlation between the level of IL-2R + CD3 + cells and CMV infection or between the level of CD2 + DR + cells and rejection. These relationships showed a high degree of sensitivity and specificity when used to discriminate among possible etiologies for decreased renal function in the symptomatic patient.

Original languageEnglish (US)
Pages (from-to)157-171
Number of pages15
JournalClinical Immunology and Immunopathology
Volume51
Issue number2
DOIs
StatePublished - 1989
Externally publishedYes

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Cytomegalovirus Infections
Allografts
Flow Cytometry
Interleukin-2 Receptors
Kidney
HLA-DR Antigens
Cyclosporine
Color
Transplantation
Immunologic Monitoring
Azathioprine
T-Lymphocyte Subsets
Prednisone
Monoclonal Antibodies
Lymphocytes
T-Lymphocytes
Sensitivity and Specificity
Population

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Pathology and Forensic Medicine

Cite this

Discriminating rejection from CMV infection in renal allograft recipients using flow cytometry. / Siegel, Don L.; Fox, Ira; Dafoe, Donald C.; Power, Michelle; Asplund, Mark; Zellers, Lydia; Barker, Clyde F.; Prystowsky, Michael B.

In: Clinical Immunology and Immunopathology, Vol. 51, No. 2, 1989, p. 157-171.

Research output: Contribution to journalArticle

Siegel, Don L. ; Fox, Ira ; Dafoe, Donald C. ; Power, Michelle ; Asplund, Mark ; Zellers, Lydia ; Barker, Clyde F. ; Prystowsky, Michael B. / Discriminating rejection from CMV infection in renal allograft recipients using flow cytometry. In: Clinical Immunology and Immunopathology. 1989 ; Vol. 51, No. 2. pp. 157-171.
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