Expression of class II antigens on T lymphocytes during cyclosporine immunosuppression for kidney transplantation

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Abstract
Since peripheral blood T lymphocytes may express class II antigens during immunologic activation, we monitored 40 cadaveric renal allograft recipients treated with cyclosporine. Peripheral blood T lymphocytes were monitored by flow cytometry for expression of DR antigen after transplantation and during rejection. Patients were treated with an ALG/CsA‐based sequential immunosuppressive protocol. All patients exhibited an early post‐transplantation increase in the percentage of HLA‐DR antigen expression on peripheral blood T lymphocytes (p < 0.001; Student's t‐test), with a gradual decrease 1–2 weeks after transplantation. In 14 of 16 patients with biopsy‐proven rejection, the percentage and the absolute numbers of T lymphocytes expressing HLA‐DR antigen increased significantly during rejection episodes (p < 0.001 and p < 0.001; Student's t‐test). In 13 of 16 patients who underwent biopsy‐proven rejection, a significant decrease was noted in the percentage and absolute numbers of T lymphocytes expressing HLA/DR– antigen 3 to 4 days prior to rejection (p < 0.001 and p < 0.001; Student's t‐test). Patients who did not undergo rejection episodes exhibited an early increase (p < 0.05; Student's t‐test) followed by a gradual decrease in DR expression on T lymphocytes. These values remained relatively stable (p = N.S.) thereafter in 8 of 12 patients. Two of 4 patients with symptomatic viral infections exhibited increased DR expression on peripheral T‐lymphocytes.