Immunophenotypic Profile and Increased Risk of Hospital Admission for Infection in Infants Born to Female Kidney Transplant Recipients

• Published in: American journal of transplantation Vol. 15; no. 6; pp. 1654 - 1665
• Main Authors: Ono, E., dos Santos, A. M., Viana, P. O., Dinelli, M. I. S., Sass, N., De Oliveira, L., Goulart, A. L., de Moraes‐Pinto, M. I.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.06.2015
• Subjects: Adaptive Immunity - drug effects; Adolescent; Adult; B cell biology; basic (laboratory) research / science; Case-Control Studies; clinical research / practice; Female; Gestational Age; Graft Rejection - prevention & control; Hospitalization - statistics & numerical data; Humans; immune deficiency; Immune system; Immunity, Innate - drug effects; Immunophenotyping; immunosuppressant; immunosuppression / immune modulation; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - pharmacology; Immunosuppressive Agents - therapeutic use; Infant; Infant, Newborn; infection and infectious agents; Infections - epidemiology; infectious disease; Kidney Transplantation; Medical research; pediatrics; Pregnancy; Prenatal Exposure Delayed Effects - epidemiology; Risk Factors; T-Lymphocytes, Regulatory - pathology; Transplant Recipients; Young Adult; immune deficiency; immunosuppression / immune modulation; basic (laboratory) research / science; infectious disease; B cell biology; pediatrics; pregnancy; clinical research / practice; immunosuppressant; infection and infectious agents
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/ajt.13143

Children born to female kidney recipients are exposed to immunosuppressive drugs during gestation. Little is known about their immune system at birth or in the long term. Twenty‐eight children born to female kidney recipients and 40 full‐term children born to healthy mothers were evaluated. T, B, NK, NKT, γδT cells were assessed by flow cytometry and functional evaluation of T and dendritic cells after in vitro activation was performed at birth and at 8 months of age. At birth, infants born to female kidney recipients showed lower numbers of CD4+ T, NKT and intense reduction of B cells (median cells/mm3, transplant: 153.7 X control: 512.4; p < 0.001). There was also a reduced percentage of activated CD8+ T and of CD4+ regulatory T cells. Activated memory and exhausted memory B cells showed higher percentages among children exposed to immunosuppressors when compared to control group. At 8 months, most immune alterations were no longer observed, but four children still had low numbers of some lymphocyte subsets at this age. Children born to female kidney recipients had 4.351 (95% CI: 1.026–15.225; p = 0.046) higher risk of hospital admission in the first months of life—some, with severe clinical manifestations—than those born to healthy women. This prospective cohort study shows that infants born to female kidney recipients have lower numbers of CD4+ T, NKT and intense reduction of B cells at birth, but not at 8 months, and a higher risk of hospital admission for infectious diseases when compared to children born to healthy women.