T lymphocyte subsets and cytokine production by graft-infiltrating cells in FSGS recurrence post-transplantation

Background. Focal segmental glomerulosclerosis (FSGS) aetiology remains und efined although a derangement of lymphocytes and monocytes-macrophages, at least, has been strongly suspected. We report the graft-infiltrating phenot ypes and their cytokine production in a case of FSGS recurrence post; trans plantation. Methods. The kidney transplant recipient suffered immediate FSGS recurrence . Aspiration biopsies were done at the first and second week post-surgery a nd were analysed by flow cytometry. The cytokine analysis was done on aspir ation sample culture supernatants and serum by enzyme-linked immunosorbent assay. Results. High expression of CD3CD69, CD3CD71 and CD4CD29 was found on infil trating lymphocytes. Biopsy cultures pointed to a Th-0/Th-1 pattern of cyto kine production as well as significant synthesis of transforming growth fac tor-beta 1. Interestingly, monocyte chemokines were absent. Conclusion. We report evidence of intragraft lymphocyte activation in the e arly days of FSGS recurrence. Aspiration biopsy cultures showed failure of cyclosporin A to inhibit interleukin-2 (IL-2) production by infiltrating ly mphocytes. If our findings are confirmed in similar patients, a trial with anti-IL-2-receptor antibody could be warranted.