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Th2 CYTOKINE PROFILE IN INFANTS PREDISPOSES TO IMPROVED GRAFT ACCEPTANCE AFTER LIVER TRANSPLANTATION

2001; Wolters Kluwer; Volume: 72; Issue: 5 Linguagem: Inglês

10.1097/00007890-200109150-00031

1534-6080

Rainer Ganschow, Dieter Broering, Daria Nolkemper, J Albani, Markus J. Kemper, Xavier Rogiers, M. Burdelski,

Pediatric Hepatobiliary Diseases and Treatments

The T helper cell type 1 (Th1) cytokines interleukin (IL)-2 and interferon (IFN)-gamma are mediators of acute graft rejection after liver transplantation and Th2 cytokines, such as IL-4 and IL-10, may have a protective role and correlate with graft acceptance. To test the hypothesis that infants aged 3 years, 71.8%. There was a significantly lower incidence of acute rejection in infants 0 to 12 months of age compared with children >1 year (11/41 vs. 38/64; P=0.001). In healthy infants, significant increasing Th1 cytokine concentrations and decreasing Th2 cytokine concentrations were found with increasing age. Patients with acute rejection had significantly higher values of Th1 cytokines compared with nonrejecting subjects, who had significantly higher concentrations of Th2 cytokines. A longitudinal analysis of serum cytokines from patients showed that changes of the cytokine patterns in the follow-up did not differ significantly from preoperative values, except in the 4 weeks posttransplant.We conclude from the data that the physiological balance toward a Th2 cytokine profile of infants in the first months of life predisposes to improved graft acceptance. Transplantation of children with biliary atresia as early as possible, avoiding Th1 stimulation by recurrent infections and vaccinations, may have a positive impact on overall tolerance.