Sialyl Lewis(x) (CD15s) monitoring as a means to select antirejection therapy in patients with rejection after renal transplantation

Background Sialyl Lewis(X) (CD15s), which is known to serve as a Ligand for the cell adhesion molecules E-selectin and P-selectin, is expressed on per ipheral lymphocytes in renal transplant patients with rejection. In this st udy, we examined whether CD15s monitoring could differentiate the patients with rejection in whom steroids were effective from those in whom steroids were not effective. Methods. To investigate CD15s expression on peripheral lymphocytes, flow cy tometry was performed before and after steroid pulse therapy in 20 recipien ts with rejection after renal transplantation, including 5 recipients resis tant to steroid therapy. We also compared CD15s expression with pathologica l findings before and after steroid pulse therapy. Results. CD15s expression was stronger before steroid pulse therapy in the 5 patients resistant to steroids than in the 15 patients responsive to ster oid treatment. In addition, CD15s expression remained high without any path ological improvement in the 5 patients resistant to steroids after steroid treatment, although CD15s recovered to normal levels with remarkable improv ement of pathological findings in the other 15 patients. Five patients in w hom steroids were not effective, had fall recovery of serum creatinine leve ls as well as CD15s expression after muromonab (OKT3) therapy. Conclusions. CD15s monitoring might help clinicians to select antirejection therapy.