Comparison of Tacrolimus and Sirolimus Based Regimens on Regulatory T Cell Levels in Renal Transplant Recipients: A Study from a Tertiary Care Centre in Kerala, India

• Main Authors: Roshan Nasimudeen, Saji Francis, Melemadathil Sreelatha, Sathi Puthenparambath
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2019-10-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: calcineurin inhibitors; flow cytometry; immune tolerance; immunosuppression
• Online Access: https://jcdr.net/articles/PDF/13190/42355_CE[Ra1]_F(SHU)_PF1(AG_SHU)_PFA(SHU)_PB(AG_SHU)_PN(SL).pdf

Introduction: A subset of CD4 lymphocytes known as regulatory T (Treg) cells is known to downregulate the immune system. If their levels are raised, immune tolerance can be increased. It was seen that certain drugs like tacrolimus (calcineurin inhibitor) and sirolimus (mTOR inhibitor) used for immunosuppression in renal transplant recipients influenced the Treg counts. Aim: To evaluate the varied effect of calcineurin inhibitors and mTOR inhibitors on the peripheral blood Treg count in renal transplant recipients. We also sought to find the Treg cell levels in the general population. Materials and Methods: It was a cross-sectional comparative study conducted on renal transplant recipients. The study included 58 subjects, of which 36 were renal transplant recipients on immunosuppressive regimens. Among these 21 were on tacrolimus and 15 on sirolimus. The remaining 22 individuals were healthy controls. Immunophenotyping with flow cytometry was done on peripheral blood of the study subjects and their Treg levels ascertained. Data was analysed using SPSS software, version 18. Results: The mean percentage of regulatory T cells in patients on tacrolimus, sirolimus and the control population were 13.1±7.8%, 13.4±5.6% and 11.9±5.4%, respectively of the CD4 lymphocytes. There were no statistically significant differences between the three groups with a p-value of 0.75. Conclusion: Immunosuppression with tacrolimus or sirolimus based regimens did not influence the Treg cell levels. The regulatory T cell levels in patients on these regimens were similar to the healthy control population.