Do Anti-CD25 Monoclonal Antibodies Potentiate Posttransplant Diabetes Mellitus?

Abstract

Anti-CD25 monoclonal antibodies (MAbs) are directed against the IL-2 (CD-25) receptor, which is associated with the pathogenesis of diabetes mellitus (DM). Measuring CD25 on peripheral blood lymphocytes could be a new immunologic marker to identify patients with prediabetes. Objective The study aimed to analyze whether administration of anti-CD25 MAbs was an independent risk factor for posttransplant diabetes mellitus (PTDM) in kidney transplant (KT) patients at 3 months after transplantation. Patients and methods Seventy-four stable, nondiabetic KT patients were included in the study. The overall sex distribution was 70% men and mean overall age, 52 ± 10 years. Thirty-eight subjects where treated with anti-CD25 antibodies (basiliximab). The diagnosis of PTDM was made if patients required insulin or oral antidiabetic drugs and/or had glycemia >200 mg/dL at 120 minutes after an oral glucose tolerance test (75 g glucose). We determined the age, weight, body mass index, acute rejection, chronic hepatitis C virus ( HCV) infection, and type of calcineurin inhibitor. Results Thirty-four percent of patients developed PTDM. Patients treated with anti-CD25 antibodies were older ( P = .022) and showed a greater incidence of PTDM ( P = .041). The logistic regression analysis (dependent variable: PTDM; independent variables: age, anti-CD25, tacrolimus vs cyclosporine) showed that treatment with anti-CD25 is an independent risk factor for PTDM ( P = .041; OR 3.28; CI 95% 1.04–10.31). Conclusion Patients treated with anti-CD25 MAbs showed greater incidence of PTDM.