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Influence of immunosuppressive therapy with azathioprine and prednisolone on serum-immunoglobuline concentration in renal transplanted patients

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Summary

Serological diagnosis of infectious diseases are based on the assumption that a change in virus-specific antibody — titer reflects the response to a certain viral infection due to changes in the concentration of the respective virus — specific antibodies. On the other hand immunosuppressive medication interacts with that system responsible in producing antigen-specific antibodies.

This study was outlined therefore to follow the variation of the concentration of serum immunoglobulines of classes IgG and IgM with regard to a better evaluation of virus-specific antibody titers especially for those viruses that remain persistant after a primary infection and an reactivate.

The study followed ten patients after allogenic cadaver kidney transplantation under immunosuppressive medication with azathioprine and corticosteroids. Concentration of serum-IgG and-IgM protein was continously measured for 6 months after transplantation along with measurement of virus-specific antibody-titers with enzyme immunoassay (Elisa) especially for cytomegalovirus. The results show a drastic decrease in serum immunoglobulines IgG and IgM — the lowest concentration being reached 25–50 days after transplantation.

The concentration of IgG increased thereafter if no severe infectious diseases occurred during the post-transplant period. The concentration of IgM seems to react more sensitively upon infectious processes. In general, virus-specific antibody-titers (IgG) follow the sometimes drastic variation in the respective immunoglobuline class. It therefore reveals that antigen-specific antibody-titers in those patients should be controlled continuously during the time after transplantation for better evaluation of titer variations that eventually occur in correlation to the absolute concentration of the immunoglobuline class.

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Abbreviations

ALG:

anti-lymphocyte globuline (Behring)

ATG:

anti-thymocyte, globuline (Fresenius)

CMV:

cytomegalovirus

d:

day(s)

Elisa:

enzyme-linked immuno sorbent assay

f:

female

m:

male

s-IgG:

serum-IgG

s-IgM:

serum-IgM

References

  1. Armstrong D, Balakrihnan SL, Steger L, Yu B, Stenzel KH (1971) Cytomegalovirus infections with viremia following renal transplantation. Arch Intern Med 127: 111–115.

    Google Scholar 

  2. Butler WT, Rossen RD (1973) Effects of corticosteroids on immunity in man. I. Decreased serum IgG concentration caused by 3 or 5 days high doses of methylprednisolone. J Clin Invest 52:2629–2640

    Google Scholar 

  3. Dennin RH, Schulz E, Herhahn J, Sack K (1984) Serological diagnosis of cytomegalovirus infection using the Elisatechnique in renal transplant recipients. Dtsch Med Wochenschr 109:214–218

    Google Scholar 

  4. Fiala M, Payne JE, Berne TV, Moore TC, Henle W, Montgomerie JZ, Chatterjee SN, Guze LB (1975) Epidemiology of cytomegalovirus infection after transplantation and immunosuppression. J Infect Dis 132:421–433

    Google Scholar 

  5. Friedman HM (1981) Cytomegalovirus: Subclinical infection or disease (editorial). Am J Med 70:215–217

    Google Scholar 

  6. Gadler H, Sundquist V, Tillegard A, Wahren B (1982) Studies of cytomegalovirus infection in renal allograft recipients. II. Serological response to various viral antigens. Scand J Infect Dis 14:89–94

    Google Scholar 

  7. Linnemann CC, Kauffman CA, First MR, Schief GM, Phair JP (1978) Cellular immune response to cytomegalovirus infection after renal transplantation. Infect Immun 22: 176–180

    Google Scholar 

  8. Lopez C, Simmons RL, Park BH, Najarian JS, Good RA (1974) Cell-mediated and humoral immune responses of renal transplant recipients with cytomegalovirus infections. Clin Exp Immunol 16: 565–573

    Google Scholar 

  9. Meyers JD, Leszezynski J, Zaia J, Flournoy N, Newton B, Snydman DR, Wright GG, Levin MJ, Thomas ED (1983) Prevention of cytomegalovirus infection by cytomegalovirus immune globulinc after marrow transplantation. Ann Intern Med 98:442–446

    Google Scholar 

  10. Osborne JE (1981) Cytomegalovirus: Pathogenicity, immunology and vaccine initiatives. J Infect Dis 143:618–630

    Google Scholar 

  11. Pass RF, Griffiths PD, August AM (1983) Antibody response to cytomegalovirus after renal transplantation: Comparison of patients with primary and recurrent infections. J Infect Dis 147:40–46

    Google Scholar 

  12. Pumper RW, Yamashiroya HM (1975) Essentials of medical virology WB Saunders, Philadelphia

    Google Scholar 

  13. Rasmussen L, Kelsall D, Nelson R, Carney W, Hirsch M, Winston D, Preiksaitis J, Merigan TC (1982) Virus-specific IgG- and IgM-antibodies in normal and immunocompromised subjects infected with cytomegalovirus. J Infect Dis 145:191–199

    Google Scholar 

  14. Rubin RH, Wolfson JS, Cosimi AB, Tolkoff-Rubin NE, (1981) Infection in renal transplant recipient. Am J Med 70:405–411

    Google Scholar 

  15. Rytel MW, Balay J (1976) Cytomegalovirus infection and immunity in renal allograft recipients: Assessment of the competence of humoral immunity. Infect Immun 13:1633–1637

    Google Scholar 

  16. Saxon A, Stevens RH, Ramer SJ, Clements PJ (1978) Glucocorticoids administered in vivo inhibit human suppressor T lymphocyte function and diminish B lymphocyte responsiviness in vitro immunoglobuline synthesis J Clin Invest 61:922–930

    Google Scholar 

  17. Suwansirikul S, Rao N, Dowling JN, Ho M (1977) Primary and secondary cytomegalovirus infection: Clinical manifestations after renal transplantation. Arch Intern Med 137:1026–1029

    Google Scholar 

  18. Winston DJ, Pollard RB, Ho WG, Gallagher JG, Rasmussen LE, Huang SN-Y, Lin Ch-H, Gossett TG, Merigan TC, Gale RP (1982) Cytomegalovirus immune plasma in bone marrow transplant recipients. Ann Intern Med 97:11–18

    Google Scholar 

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Dennin, R.H., Schulz, E., Sack, K. et al. Influence of immunosuppressive therapy with azathioprine and prednisolone on serum-immunoglobuline concentration in renal transplanted patients. Klin Wochenschr 63, 1110–1116 (1985). https://doi.org/10.1007/BF02291092

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  • DOI: https://doi.org/10.1007/BF02291092

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