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Volume: 4 Issue: 2 December 2006 - Supplement - 1

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CALCITRIOL,STARTED ON DONOR SIDE EXPANDS THE POPULATION OF CD4+CD25+TCELLS IN RENAL TRANSPLANT RECEPIENTS

Allo reactive T cells recognize alloantigens via direct and indirect pathways. In either, the competency of co-stimulatory molecules on antigen presenting cells (APC) is important. Active form of Vitamin D ( 1,25 (OH)2D3, calcitriol ) inhibits APC cells maturation and expression of costimulatory molecules, here we studied the immunosuppressive effect of calcitriol, that was started on donor side and continued in recipients. In this prospective study candidates of living donor renal transplantation randomly assigned in two groups, in treatment group calcitriol was started in Donor, 250 microgram twice a day, in the last six days before donation, this was continued after transplantation in recipient side for six months. Control group only received conventional Immunosuppressive regimen that in both groups were; cyclosporine/mycophenolate mofetil and prednisolon. In each groups recipients blood sample was taken before and six months after transplantation. Diagnostic study of the T- cell markers: CD3, CD4, CD8 CD25 were performed with Flow cytometery technique. Mean value of CD3+ CD4+CD25+ T cells in treatment group (F4/M5 40.8+/- 8.5 years) and control group (F4/M 6 37.2+/-10) were: 14.2+/-4.2 and 15.4+/-4.5 percent of total peripheral lymphocytes. This percentage six months after transplantation increased to 29+/-6.3 in treatment group and decreased to 12.1+/-4.5 percent in control (P<0.0001). No clinical rejection was detected in each groups during the study period. calcitriol started on donors side and continued in recipient side lead to expansion of toleronenic CD4+CD25+ regulatory T cells in recipients. We speculated that co-stimulatory deficient APC of both direct and indirect pathways may play a role.



Volume : 4
Issue : 2
Pages : 56


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