Predominant Inflammatory and Th1 biased cytokine secretion pre- and post- kidney transplantation

A key goal in post-transplant monitoring is the diagnostic detection of harmful processes in the allograft early which can be easily and non-invasively assessed. Cytokines are crucial mediators involved in immune responses leading to rejection. It is known that episodes of viral infections and acute rejection can cause an increase in pro-inflammatory cytokines in transplant recipients. This study is significant since detailed analysis of cytokines was performed in kidney transplant patients pre- and post-transplant to assess the impact of graft implantation. Twenty patients with mean age of 35 years and comprising 8 females who underwent renal transplantation were included in the study. The mean follow-up time for the study cohort was 5 months. Using a multiplex microassay, twelve cytokines [IL-1?, IL-1?, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, IL-12, granulocyte–macrophage colony-stimulating factor, IFN-? and tumour necrosis factor] were measured simultaneously before and after transplant. A strong pro-inflammatory response was seen as the levels of circulating IL-1? (p<0.02) and IL-6 (p<0.01) increased post-transplant. A Th1 bias was due to increased IFN? (p<0.05) and absent IL-4 and IL-10 post-transplant. Levels of IL-1?, IL-2, IL-7, IL-12, GM-CSF and TNF? remained low and unchanged whilst IL-8 levels was reduced (p<0.02). These findings show a strong pro-inflammatory response with a Th1 cytokine bias and this immunological outcome places the patient at risk of graft rejection. We suggest that diagnostic parameters such as cytokines can be used to monitor allografts non-invasively and may have the potential to guide clinical decisions regarding immunosuppressive therapy which could improve outcomes post-transplantation.