Immunophenotypic Profile and Increased Risk of Hospital Admission for Infection in Infants Born to Female Kidney Transplant Recipients

Abstract

Children born to female kidney recipients are exposed to immunosuppressive drugs during gestation. Little is known about their immune system at birth or in the long term. Twenty-eight children born to female kidney recipients and 40 full-term children born to healthy mothers were evaluated. T, B, NK, NKT, T cells were assessed by flow cytometry and functional evaluation of T and dendritic cells after in vitro activation was performed at birth and at 8 months of age. At birth, infants born to female kidney recipients showed lower numbers of CD4+ T, NKT and intense reduction of B cells (median cells/mm(3), transplant: 153.7 X control: 512.4; p<0.001). There was also a reduced percentage of activated CD8+ T and of CD4+ regulatory T cells. Activated memory and exhausted memory B cells showed higher percentages among children exposed to immunosuppressors when compared to control group. At 8 months, most immune alterations were no longer observed, but four children still had low numbers of some lymphocyte subsets at this age. Children born to female kidney recipients had 4.351 (95% CI: 1.026-15.225; p=0.046) higher risk of hospital admission in the first months of lifesome, with severe clinical manifestationsthan those born to healthy women.Universidade Federal de São Paulo, Dept Pediat, Div Pediat Infect Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, Div Neonatal Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Obstet, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, Div Pediat Infect Dis, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, Div Neonatal Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Obstet, São Paulo, BrazilWeb of ScienceFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP: 01/11011-6FAPESP: 08/06232-