Abstract:
:Few data are available concerning immune factors involved in the occurrence of new onset diabetes after transplantation (NODAT). Our objective was to determine an immune profile associated with the subsequent development of NODAT. The secondary objective was to build a predictive model of NODAT. We studied a prospective cohort of incident kidney transplant patients to determine whether pre-transplant immune characteristics could be associated with the occurrence of NODAT. 818 patients were included. We observed a significant inverse correlation between BMI and recent thymic emigrants (RTE) % at transplant time (p < 0.001). 177 (17.3%) of 677 non-diabetic patients experienced NODAT in the first year post-transplant. In multivariate analysis, age, body mass index (BMI), use of Tacrolimus, use of anti-thymocyte globulins (ATG), higher B cell count, and lower recent thymic emigrants (RTE) % were associated with NODAT. A differential effect of immune profile was observed in ATG-treated patients and non-ATG-treated patients. B cell count predicts NODAT only in non-ATG-treated patients whereas lower RTE% was associated with NODAT only in ATG-treated patients. Tacrolimus sparing and B cell depletion may efficiently prevent NODAT in selected patients. We identified an immune profile associated with the occurrence of post-transplant diabetes. Further studies should better precise the exact mechanisms involved in this association. Trial registration NCT02843867, registered July 8, 2016 - retrospectively registered https://clinicaltrials.gov/ct2/show/record/NCT02843867.
journal_name
Hum Immunoljournal_title
Human immunologyauthors
Ducloux D,Courivaud C,Bamoulid J,Crepin T,Gaiffe E,Laheurte C,Vauchy C,Rebibou JM,Saas P,Borot Sdoi
10.1016/j.humimm.2019.08.006subject
Has Abstractpub_date
2019-11-01 00:00:00pages
937-942issue
11eissn
0198-8859issn
1879-1166pii
S0198-8859(19)30284-8journal_volume
80pub_type
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