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Metabolism and Immune Tolerance

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Front. Immunol. | doi: 10.3389/fimmu.2018.00352

Serial Monitoring of Immune Markers Being Represented Treg/Th17 Ratio: Indicating Tolerance for Tapering Immunosuppression after Liver Transplantation

JooYeon Jhun1, Seung Hoon Lee1, Soon Kyu Lee2, Hee Yeon Kim2, Eun Sun Jung2, Dong Goo Kim2,  JeongWon Choi1, Si Hyun Bae2,  Seung Kew Yoon2, Byung Ha Chung1, Chul Woo Yang1,  Mi-La Cho1* and Jong Young Choi2
  • 1Catholic University of Korea, South Korea
  • 2Division of Hepatology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, South Korea

Recipients of liver transplantation (LT) require long-term immunosuppressive drug treatment, but lifelong immunosuppressive treatment has severe side effects. It is known that some LT recipients develop immune tolerance, and although the development of such operational tolerance should allow a decrease in the burden of immunosuppressive drug treatment, the factors that indicate operational tolerance are not clear. This study aimed to monitor immunological markers over time in LT recipients to identify those markers indicating the development of operational tolerance. We performed a prospective pilot study measuring immune markers including the ratio of regulatory T (Treg) and helper T (Th) 17 cells in peripheral blood in the 14 most immunologically stable patients among 70 clinically stable LT recipients. The doses of immunosuppressive drugs given to these 14 LT recipients were tapered over time, and they were monitored for immunological markers related to the development of immune tolerance. As the doses of immunosuppressive drugs were reduced, the Treg/Th17, Th1/Th17 and CD8/Th17 ratio in tolerant recipients was significantly increased compared with that in nontolerant recipients. These results suggest that monitoring of changes in the immune makers including Treg/Th17 ratio during tapering of immunosuppression may allow prediction of the development of tolerance.

Keywords: Regulatory T Cell, T helper 17 cell, Liver Transplantation, tolerance, Immunosuppression

Received: 23 Nov 2017; Accepted: 07 Feb 2018.

Edited by:

Duncan Howie, University of Oxford, United Kingdom

Reviewed by:

Nick D. Jones, University of Birmingham, United Kingdom
Alberto Baroja-Mazo, Instituto Murciano de Investigación Biosanitaria, Spain  

Copyright: © 2018 Jhun, Lee, Lee, Kim, Jung, Kim, Choi, Bae, Yoon, Chung, Yang, Cho and Choi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Mi-La Cho, Catholic University of Korea, Seoul, South Korea,