Tacrolimus has immunosuppressive effects on heavy/light chain pairs and free light chains in patients after heart transplantation: A relationship with infection
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
29913223
DOI
10.1016/j.trim.2018.06.005
PII: S0966-3274(17)30079-5
Knihovny.cz E-zdroje
- Klíčová slova
- Free light chains, Heart transplantation, Heavy/light chain pairs, Immunosuppression, Infection, Tacrolimus,
- MeSH
- biologické markery krev MeSH
- dospělí MeSH
- imunosupresiva škodlivé účinky terapeutické užití MeSH
- infekce epidemiologie etiologie MeSH
- lehké řetězce imunoglobulinů krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- následné studie MeSH
- nežádoucí účinky léčiv epidemiologie MeSH
- prediktivní hodnota testů MeSH
- prognóza MeSH
- rejekce štěpu etiologie prevence a kontrola MeSH
- riziko MeSH
- senioři MeSH
- takrolimus škodlivé účinky terapeutické užití MeSH
- těžké řetězce imunoglobulinů krev MeSH
- transplantace srdce * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- biologické markery MeSH
- imunosupresiva MeSH
- lehké řetězce imunoglobulinů MeSH
- takrolimus MeSH
- těžké řetězce imunoglobulinů MeSH
The aim of the study was to investigate the relationship between tacrolimus (TAC) immunosuppressive treatment and serum concentrations of immunoglobulin heavy/light chain pairs (sHLC) and free light chains (sFLC) in patients after heart transplantation (HTX) and to use these biomarkers to predict the risk of infection in these patients. A total of 88 patients with an immunosuppressive regimen involving tacrolimus who underwent HTX were analyzed over 24 months of follow-up. sFLC and sHLC levels were determined before and at three time points after HTX. TAC concentrations were determined at several time points after HTX, and mean TAC concentrations and areas under the curve (AUCs) of TAC concentration were calculated. Relevant clinical data were obtained from patients' medical records. A larger AUC of TAC was associated with decreases in the concentrations of IgG total (p < 0.05); similarly, cumulative AUC of TAC during 18 post-transplant months correlated inversely with sHLC IgG kappa (r = -0.228, p < 0.05) and IgG total (r = -0.352, p < 0.05). Concentrations of sFLC kappa, sFLC lambda, sHLC IgG kappa, and sHLC IgG total were significantly lower in infected patients (in the 9th month after HTX, all p < 0.05). Combined criteria for increased AUC (greater than the median of 12.9 mg·d/l) and decreased sFLC kappa (less than the median of 12.5 mg/l) correlated with the presence of infection (p < 0.03) in the 9th month after HTX. Ratio of concentration of TAC to sFLC kappa or lambda was significantly higher in infected patients (both p < 0.05). Intensive treatment with tacrolimus after HTX is possibly reflected by decreases in sFLC and sHLC (mainly sHLC IgG). Patients with decreased concentrations of these biomarkers are at increased risk for infection, primarily in the 9th month after HTX, when the concentrations of tacrolimus were the highest.
Citace poskytuje Crossref.org
