Korean J Transplant.  2022 Nov;36(Supple 1):S134. 10.4285/ATW2022.F-2541.

The changes in immune markers including regulatory T, regulatory B and T helper 17 cells during tapering immunosuppressants in liver transplant patients

• Lee SK
• Lee SY
• Cho ML
• Choi HJ
• You YK
• Choi JY

• KMID: 2535650
• DOI: http://doi.org/10.4285/ATW2022.F-2541

Abstract

Background
In this study, we examined the changes in the proportion of B cells including regulatory B cells and their roles in im-mune homeostasis during the tapering the immunosuppressants (ISs) in long-term post-liver transplant (LT) patients.
Methods
A total of 16 long-term LT patients were prospectively enrolled in our study. Included LT patients had normal liver function without history of rejection and underwent LT more than 5 years ago. Patients were followed up every 3 months and the dose of ISs were tapered by 25%–30% every 6 months. In every visit, blood samples had been collected and the proportion of T cells and B cells including regulatory T (Treg), T helper 17 (Th17), T helper 1 (Th1), and regulatory B cells (CD19+CD24hiC-D38hi cells; Breg) were analyzed by flow cytometry. The changes of immune cells and their correlations were analyzed during tapering ISs in LT patients.
Results
Among 16 patients, eight patients (50%) totally tapered ISs without rejection and tolerant after stopping ISs. Other six patients minimized their dose of IS to 25% without rejection. The other two patients experienced rejection at the time of 25%, 50% reduction, respectively. During tapering ISs, the proportion of Treg and Breg cells were increased in tapering patients. At the time of 50% reduction, the frequency of Breg and Th17 cells were inversely correlated (P<0.005).
Conclusions
During tapering the ISs, the proportion of Breg and Treg cells were increased and inversely correlated with Th17 cells, suggesting the potential role of Breg cells in controlling immune homeostasis in LT patients.