T helper1/T helper2 and Interferon-γ/Interleukin-10 Ratios in Liver Transplant Rejection

Immune monitoring in transplant recipients, examining lymphocyte subsets and cytokine levels, is pivotal for advancing individualized medicine in transplantation. This study aims to assess T helper 1 and 2 cells in acute liver transplant rejection.

Thirty liver transplantation candidates were enrolled pre- and six months post-transplantation under stable condition. Additionally, fifteen recipients with acute rejection, matched for age and transplantation duration, were included. Flow cytometry and ELISA assessed TCD4+CXCR3+IFN-γ (T helper 1) and TCD4+CCR4+IL-4+ (Th2) cell frequencies, as well as serum IFN-γ and IL-10 levels.

Stable recipients showed significant decreases in Th1 and Th2 cell percentages six months post-transplant (both p < 0.0001), maintaining a comparable Th1/Th2 ratio. Serum IFN-γ levels also decreased. Conversely, the rejection group exhibited higher Th1 cell proportions and increased IFN-γ concentration compared to stable recipients (P = 0.03 and 0.001, respectively). IL-10 levels slightly decreased in both groups. Consequently, the IFN-γ/IL-10 ratio significantly increased during acute rejection (p < 0.0001). Th1 cell frequency and IFN-γ levels negatively correlated with allograft function.

Six months post-transplant, stable recipients experienced decreased Th1 and Th2 cell percentages, maintaining Th1/Th2 balance. The IFN-γ/IL-10 ratio significantly increased during acute rejection, indicating an immunological imbalance. Elevated Th1 frequency and IFN-γ levels were negatively correlated with allograft function, emphasizing their potential role in rejection dynamics.