Basiliximab is specific for CD25 and, therefore, can potentially affect the size and function of the CD25+ regulatory T cells (Tregs) pool in transplant recipients. Several recent reports have indeed suggested that this monoclonal antibody (mAb) decreased the number of circulating Tregs (1,2) but did not impair their suppressive function (1–3). Irrespective of its biologic effects, basiliximab can also hinder the detection of CD25 by certain flurochrome-conjugated antibodies, which bind a common CD25 epitope (4). Tregs depletion can, thus, artifactually be accentuated if a competing anti-CD25 clone is selected for flow cytometry detection. We have examined the most commonly available anti-CD25 clones regarding a possible epitopic competition with basiliximab and determined which of them can be used to rigorously monitor Tregs in basiliximab-treated transplant patients. An in vitro competition assay between basiliximab and eight different fluorochrome-conjugated anti-CD25 clones was carried out under the following conditions: immunomagnetically selected CD4+ cells (Miltenyi Biotec, Bergisch Gladbach, Germany) obtained from five healthy volunteers (after informed consent and with the approval of the local ethic committee) were activated for 2 days with 5 μg/mL of plate-coated anti-CD3 mAb and 2 μg/mL of soluble anti-CD28 mAb, then colabeled with fluorochrome conjugated anti-CD4 and anti-CD25 mAbs, alone or in the presence of increasing doses of basiliximab (basiliximab final concentrations ranging from 8×10−4 to 4×10−2 μg/mL). Proportion of CD25+ cells detected by flow cytometry (FACS Canto II, BD Biosciences, san Jose, CA) was analyzed for each anti-CD25 clones using FACS DIVA Software Version 2.0 (BD Biosciences). The eight anti-CD25 clones we tested were: B1 49.9 (Beckman Coulter, Fullerton, CA), ACT1 (Dako, Glostrup, Denmark), Bb10 and BF2 (Diaclone, Besançon, France), 2A3 (BD Biosciences), BC96 (eBioscience, San Diego, CA), MA251 (BD Biosciences), and 4E3 (Miltenyi Biotec). Two of these eight clones did not interfere with basiliximab and were able to correctly stain the CD25+ population regardless the concentration of basiliximab in which the cells have been preincubated (Fig. 1a). Accordingly, only these two clones, MA251 and 4E3, could detect the CD4+CD25+CD127− Tregs population in five basiliximab-treated transplant patients 1 month posttransplant (Fig. 1b).FIGURE 1.: Anti-CD25 clones MA251 and 4E3 can detect CD25+ cells in the presence of basiliximab. (a) CD25 expression on activated CD4+ T cells from a healthy volunteer was evaluated with eight different anti-CD25 fluorescent monoclonal antibodies (mAbs) (clones B1 49.9, ACT1, Bb10, BF2, 2A3, BC96, MA251, and 4E3) in the absence or the presence of basiliximab used at different concentrations. Percentages are the proportion of CD25+ cells among the CD4+ population. Similar results were observed with five different healthy volunteer. (b) Peripheral blood mononuclear cells from a transplant patient having received an induction therapy with basiliximab (20 mg intravenously at days 0 and 4) were obtained 1 month posttransplant and colabeled with the three CD4/CD25/CD127 fluorescent antibodies. The ability of eight different anti-CD25 fluorescent mAbs (clones B1 49.9, ACT1, Bb10, BF2, 2A3, BC96, MA251, and 4E3) to detect the CD4+CD25+CD127− regulatory T-cell subset (6,7) was compared. The direct comparison between the competing B1 49.9 clone with the noncompeting MA251 clone is shown. (Similar data to those obtained for clone B1 49.9 were observed for clones ACT1, Bb10, BF2, 2A3, and BC96; similar data to those obtained for clone MA251 were observed for clone 4E3; data shown are representative of data obtained from five different transplant patients.)At present, monitoring the Treg population is rather considered as a promising, albeit not yet validated, tool to guide immunosuppressive minimizing or weaning protocols after the initial period of transplantation, a period of time during which basiliximab is no longer detectable in serum. However, it is probably also informative to numerate Tregs during the earliest phase of transplantation when the relative expansion between the pools of regulatory and effector T cells might predict the outcome of the graft (5). Basiliximab interferes with the vast majority of commercially available anti-CD25 clones. We observed this interference within the 3 months after basiliximab treatment (data not shown). In the context of basiliximab induction therapy, intracellular forkhead box P3 staining should be privileged to properly detect the Tregs subset. When not available, a careful selection of the anti-CD25 clone used for flow cytometry is critical. Clones MA251 and 4E3 do not compete for a common epitope with basiliximab and can, thus, safely be used in this specific situation. ACKNOWLEDGMENTS The authors thank Solène MICHEL for her excellent technical assistance and Clémence MARIAT for her help in editing the manuscript. Farida Abadja Laboratoire de Néphrologie Université Jean Monnet France Eric Alamartine François Berthoux Christophe Mariat Laboratoire de Néphrologie Université Jean Monnet France Service de Néphrologie Dialyse et Transplantation rénale CHU de Saint-Etienne France Christian Genin Claude Lambert Laboratoire d'Immunologie Université Jean Monnet France
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