Tacrolimus has immunosuppressive effects on heavy/light chain pairs and free light chains in patients after heart transplantation: A relationship with infection.
The aim of the study was to investigate the relationship between tacrolimus (TAC) immunosuppressive treatment and serum concentrations of immunoglobulin heavy/light chain pairs (sHLC) and free light chains (sFLC) in patients after heart transplantation (HTX) and to use these biomarkers to predict the risk of infection in these patients. A total of 88 patients with an immunosuppressive regimen involving tacrolimus who underwent HTX were analyzed over 24 months of follow-up. sFLC and sHLC levels were determined before and at three time points after HTX. TAC concentrations were determined at several time points after HTX, and mean TAC concentrations and areas under the curve (AUCs) of TAC concentration were calculated. Relevant clinical data were obtained from patients' medical records. A larger AUC of TAC was associated with decreases in the concentrations of IgG total (p < 0.05); similarly, cumulative AUC of TAC during 18 post-transplant months correlated inversely with sHLC IgG kappa (r = -0.228, p < 0.05) and IgG total (r = -0.352, p < 0.05). Concentrations of sFLC kappa, sFLC lambda, sHLC IgG kappa, and sHLC IgG total were significantly lower in infected patients (in the 9th month after HTX, all p < 0.05). Combined criteria for increased AUC (greater than the median of 12.9 mg·d/l) and decreased sFLC kappa (less than the median of 12.5 mg/l) correlated with the presence of infection (p < 0.03) in the 9th month after HTX. Ratio of concentration of TAC to sFLC kappa or lambda was significantly higher in infected patients (both p < 0.05). Intensive treatment with tacrolimus after HTX is possibly reflected by decreases in sFLC and sHLC (mainly sHLC IgG). Patients with decreased concentrations of these biomarkers are at increased risk for infection, primarily in the 9th month after HTX, when the concentrations of tacrolimus were the highest.
['Lavríková|Petra|P|', 'Sečník|Peter|P|', 'Kubíček|Zdenek|Z|', 'Jabor|Antonín|A|', 'Hošková|Lenka|L|', 'Franeková|Janka|J|']
D000328:Adult D000368:Aged D015415:Biomarkers D064420:Drug-Related Side Effects and Adverse Reactions D005260:Female D005500:Follow-Up Studies D006084:Graft Rejection D016027:Heart Transplantation D006801:Humans D007143:Immunoglobulin Heavy Chains D007147:Immunoglobulin Light Chains D007166:Immunosuppressive Agents D007239:Infections D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D011379:Prognosis D012306:Risk D016559:Tacrolimus D055815:Young Adult
Tacrolimus Immunosuppression Heavy/light chain pairs Free light chains Heart transplantation Infection