Purpose The Cylex Immune Cell Function Assay (ImmuKnow; Cylex, Inc., Columbia, MD: IK) was approved by the U.S. Food and Drug Administration (FDA) to measure global immune response in solid-organ transplant patients receiving immunosuppressive treatment. We determined the number of infections arising in our cohort of lung transplant and correlated blood levels of ImmuKnow with blood levels of immunosuppressive drugs. Methods and Materials We used 102 determinations of ImmuKnow (IK) from 58 lung recipients (LTR) from October 2008 to September 2011. The values of CD4 + T cell activation (in ng/mL ATP) were categorized as strong (n°13), moderate (n°39) and low (n°50) with >525, 225 to 525, and <225 respectively. IK response was correlated with through blood levels of tacrolimus and with peripheral and BAL cell subsets. Results Patients with a low IK had a significantly higher risk of acquiring a graft infection than those who had a normal or high immune response. Total n° of samples associated to an infectious episodes was 51 with a significant number of co-infections (35 bacterial,5 fungal and 25 viral). Thirty-three infectious episodes (including16 co-infections) were observed among low IK samples, while only 18 among strong and moderate IK samples (chi square test 0.0018). Therefore low IK response was associated with a two fold increase in risk of infection. Values of IK response did not correlate with the levels of tacrolimus (p=0.9). A very low correlation coefficient was present with CD3+CD4+ counts (+0.19) while no correlation was found with other analysed peripheral and BAL cell subset. Immunosuppressive regimen was changed according to IK results and was decreased in 86% of low test results. Conclusions The Immuknow assay reliably reflects the cellular immune function of LTx patients in relationship with the risk of developing infections, thus can be used as an additional tool in the immune monitoring and management of lung recipients.
Experience with Cylex Immune Cell Function Assay in Clinical Immune Monitoring of Lung Transplant Recipients
BINI, FRANCESCO;MISERERE, SIMONA MARGHERITA;MOROSINI, MONICA;PELLEGRINI, CARLO;MELONI, FEDERICA
2012-01-01
Abstract
Purpose The Cylex Immune Cell Function Assay (ImmuKnow; Cylex, Inc., Columbia, MD: IK) was approved by the U.S. Food and Drug Administration (FDA) to measure global immune response in solid-organ transplant patients receiving immunosuppressive treatment. We determined the number of infections arising in our cohort of lung transplant and correlated blood levels of ImmuKnow with blood levels of immunosuppressive drugs. Methods and Materials We used 102 determinations of ImmuKnow (IK) from 58 lung recipients (LTR) from October 2008 to September 2011. The values of CD4 + T cell activation (in ng/mL ATP) were categorized as strong (n°13), moderate (n°39) and low (n°50) with >525, 225 to 525, and <225 respectively. IK response was correlated with through blood levels of tacrolimus and with peripheral and BAL cell subsets. Results Patients with a low IK had a significantly higher risk of acquiring a graft infection than those who had a normal or high immune response. Total n° of samples associated to an infectious episodes was 51 with a significant number of co-infections (35 bacterial,5 fungal and 25 viral). Thirty-three infectious episodes (including16 co-infections) were observed among low IK samples, while only 18 among strong and moderate IK samples (chi square test 0.0018). Therefore low IK response was associated with a two fold increase in risk of infection. Values of IK response did not correlate with the levels of tacrolimus (p=0.9). A very low correlation coefficient was present with CD3+CD4+ counts (+0.19) while no correlation was found with other analysed peripheral and BAL cell subset. Immunosuppressive regimen was changed according to IK results and was decreased in 86% of low test results. Conclusions The Immuknow assay reliably reflects the cellular immune function of LTx patients in relationship with the risk of developing infections, thus can be used as an additional tool in the immune monitoring and management of lung recipients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
