SEVERE B CELL DEPLETION IN NEWBORNS FROM RENAL TRANSPLANT MOTHERS TAKING IMMUNOSUPPRESSIVE AGENTS

Abstract

There have been several reports of successful pregnancies of kidney transplant mothers receiving immunosuppressive agents such as CsA and/or AZA. However, few papers have investigated immune function of neonates from those mothers. We investigated the lymphocyte subpopulations and T cell subsets in cord blood of newborn infants from those mothers. The subjects were 6 infants born to mothers following renal transplantation, who all were receiving CsA, AZA, and methylprednisolone. Cord blood and peripheral blood at 1 month and 3 months of age were obtained from the subjects. Control samples were obtained from 5 normal newborns. The polyclonal antibody used to investigate B cells was anti-F(ab')2 fragment of human immunoglobulin. Direct immunofluorescence staining and flow cytometry were used for the investigation. The number of B cells and the percentage of B cell in total mononuclear cells were significantly lower in the subjects than in normal controls. There was no significant difference between numbers of CD2+, CD4+, or CD8+ cells in the subjects and the controls. This severe B cell depletion remained low at 1 month and 3 months of life in many cases. From our result, it is very possible that the B cell line is more sensitive to immunosuppressants in utero than the T cell line. Infants of mothers taking immunosuppressive agents during their pregnancy should be followed carefully for possible insufficiency of immune function.