1.Heterogeneity of Human γδ T Cells and Their Role in Cancer Immunity
Hye Won LEE ; Yun Shin CHUNG ; Tae Jin KIM
Immune Network 2020;20(1):5-
The γδ T cells are unconventional lymphocytes that function in both innate and adaptive immune responses against various intracellular and infectious stresses. The γδ T cells can be exploited as cancer-killing effector cells since γδ TCRs recognize MHC-like molecules and growth factor receptors that are upregulated in cancer cells, and γδ T cells can differentiate into cytotoxic effector cells. However, γδ T cells may also promote tumor progression by secreting IL-17 or other cytokines. Therefore, it is essential to understand how the differentiation and homeostasis of γδ T cells are regulated and whether distinct γδ T cell subsets have different functions. Human γδ T cells are classified into Vδ2 and non-Vδ2 γδ T cells. The majority of Vδ2 γδ T cells are Vγ9δ2 T cells that recognize pyrophosphorylated isoprenoids generated by the dysregulated mevalonate pathway. In contrast, Vδ1 T cells expand from initially diverse TCR repertoire in patients with infectious diseases and cancers. The ligands of Vδ1 T cells are diverse and include the growth factor receptors such as endothelial protein C receptor. Both Vδ1 and Vδ2 γδ T cells are implicated to have immunotherapeutic potentials for cancers, but the detailed elucidation of the distinct characteristics of 2 populations will be required to enhance the immunotherapeutic potential of γδ T cells. Here, we summarize recent progress regarding cancer immunology of human γδ T cells, including their development, heterogeneity, and plasticity, the putative mechanisms underlying ligand recognition and activation, and their dual effects on tumor progression in the tumor microenvironment.
Allergy and Immunology
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Communicable Diseases
;
Cytokines
;
Homeostasis
;
Humans
;
Interleukin-17
;
Ligands
;
Lymphocytes
;
Mevalonic Acid
;
Plastics
;
Population Characteristics
;
Protein C
;
Receptors, Antigen, T-Cell, gamma-delta
;
Receptors, Growth Factor
;
T-Lymphocyte Subsets
;
T-Lymphocytes
;
Terpenes
;
Tumor Microenvironment
2.Dynamic inflammatory response in a critically ill COVID-19 patient treated with corticosteroids.
Sheng ZHAGN ; Danping LI ; Huazhong CHEN ; Dan ZHENG ; Yiping ZHOU ; Baoguo CHEN ; Weiwu SHI ; Ronghai LIN
Journal of Zhejiang University. Medical sciences 2020;49(2):220-226
OBJECTIVE:
To investigate the effect of corticosteroids therapy on the inflammatory response in a critically ill coronavirus disease 2019 (COVID-19) patient.
METHODS:
A 55-year old female patient with critical ill COVID-19 was admitted in Taizhou Hospital on January 19, 2020. The patient was treated with methylprednisolone 80 mg on the 2nd day after admission. Thereafter, the dose was adjusted in a timely manner and the therapy lasted for 13 days. The peripheral lymphocyte subsets (CD3T, CD4 T, CD8 T, NK cells, B cells), as well as serum levels of lymphocyte factors (IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ) were dynamically monitored.
RESULTS:
On D1 of admission, the numbers of peripheral blood CD3 T, CD4 T, CD8 T, and NK cells were significantly lower than the normal range. With the improvement of the disease, the numbers of CD3 T, CD8 T and CD4 T cells gradually recovered and showed a linear growth trend (linear fitting equation: =18.59+109.4, <0.05). On D2 of admission, the patient's IL-6 and IL-10 levels were significantly higher than normal values, IFN-γ was at a normal high value, and then rapidly decreased; IL-2, IL-4, and TNF-α were all in the normal range. On the D6 and D7, the IL-6 and IL-10 decreased to the normal range for the first time. On the D18, the sputum virus nucleic acid test was negative for the first time, and the fecal virus nucleic acid test was still positive; on the D20 the sputum and fecal virus nucleic acid test were both negative. On D34, the patient recovered and was discharged. At the discharge the muscle strength score of the patient was 44 and the daily life ability evaluation was 90.
CONCLUSIONS
In the absence of effective antiviral drugs, early use of appropriate doses of corticosteroids in critically ill patient with COVID-19 can quickly alleviate inflammatory response and improve clinical symptoms, however, it may reduce the number of T cells, and to adjust the dose in time is necessary.
Betacoronavirus
;
isolation & purification
;
Cell Count
;
Coronavirus Infections
;
diagnosis
;
drug therapy
;
immunology
;
physiopathology
;
Critical Illness
;
Cytokines
;
blood
;
Female
;
Humans
;
Methylprednisolone
;
administration & dosage
;
adverse effects
;
Middle Aged
;
Pandemics
;
Pneumonia, Viral
;
diagnosis
;
drug therapy
;
immunology
;
physiopathology
;
T-Lymphocyte Subsets
;
drug effects
;
Treatment Outcome
3.Relationship of Peripheral Blood IL-37 Expression with T Lymphocytes Subsets and NK Cells in Patients with Primary Immune Thrombocytopenia.
Zhen CHEN ; Wen QU ; Hua-Quan WANG ; Li-Min XING ; Yu-Hong WU ; Zhao-Yun LIU ; Yang ZHANG ; Hui LIU ; Xi-Feng DONG ; Jing-Lian TAO ; Zong-Hong SHAO
Journal of Experimental Hematology 2019;27(4):1201-1207
OBJECTIVE:
To study the correlation of IL-37 with T lymphocytes subsets and NK cells in ITP patients, and to explore its possible mechanisms involved in the pathogenesis of ITP.
METHODS:
Forty-five patients with newly diagnosed ITP(newly diagnosed group), 32 patients of complete remission (remission group) and 22 healthy persons(control group) were selected. The serum level of IL-37 in 3 groups was determined by enzyme linked immunosorbent assay (ELISA). The mRNA expression of IL-37, IL-17 and IL-18 in peripheral blood mononuclear cells(PBMNC) in 3 groups was measured by real-time fluorescence quantitative polymerase chain reaction (PCR). The number of IL-18RαCD4 T cells and Tim-3NK cells in the peripheral blood in 3 groups was detected by flow cytometry (FCM).
RESULTS:
The serum level of IL-37 in the peripheral blood of ITP patients in the newly diagnosed group was significantly higher than that in the control group and the remission group(P<0.01) . The expression level of IL-37 in PBMNC of the ITP patients in newly diagnosed group was higher than that in the control group and the remission group(P<0. 05). The expression level of IL-17 and IL-18 in PBMNC of the ITP patients in newly diagnosed group was higher than that in the control group and the remission group(P<0. 01); the expression of IL-18Rα in CD4 T cells in newly diagnosed group was significantly higher than that in both the control and the remission group(P<0.01).The expression of Tim-3 in NK cells in ITP patients was significantly lower than that in the control group (P<0. 01). In ITP patients, the serum IL-37 level and IL-18RαCD4T cells ratio both negatively correlated with Plt count (r=-0.58, r=-0.48) moreo-ver the serum IL-37 level also negatively correlated with amount of CD4 T cells and NK cells (r=-0.29, r=-0.28), but positively correlated with amount of CD8 T cells (r=0.329).
CONCLUSION
The IL-37 and its receptors may play an immunoregulatory role in CD4 T cells and NK cells, the IL-37 may be a therapeutic target for ITP patients.
CD8-Positive T-Lymphocytes
;
Flow Cytometry
;
Humans
;
Interleukin-1
;
immunology
;
Killer Cells, Natural
;
Leukocytes, Mononuclear
;
Purpura, Thrombocytopenic, Idiopathic
;
T-Lymphocyte Subsets
4.Single-cell Analysis of CAR-T Cell Activation Reveals A Mixed T1/T2 Response Independent of Differentiation.
Iva XHANGOLLI ; Burak DURA ; GeeHee LEE ; Dongjoo KIM ; Yang XIAO ; Rong FAN
Genomics, Proteomics & Bioinformatics 2019;17(2):129-139
The activation mechanism of chimeric antigen receptor (CAR)-engineered T cells may differ substantially from T cells carrying native T cell receptor, but this difference remains poorly understood. We present the first comprehensive portrait of single-cell level transcriptional and cytokine signatures of anti-CD19/4-1BB/CD28/CD3ζ CAR-T cells upon antigen-specific stimulation. Both CD4 helper T (T) cells and CD8 cytotoxic CAR-T cells are equally effective in directly killing target tumor cells and their cytotoxic activity is associated with the elevation of a range of T1 and T2 signature cytokines, e.g., interferon γ, tumor necrotic factor α, interleukin 5 (IL5), and IL13, as confirmed by the expression of master transcription factor genes TBX21 and GATA3. However, rather than conforming to stringent T1 or T2 subtypes, single-cell analysis reveals that the predominant response is a highly mixed T1/T2 function in the same cell. The regulatory T cell activity, although observed in a small fraction of activated cells, emerges from this hybrid T1/T2 population. Granulocyte-macrophage colony stimulating factor (GM-CSF) is produced from the majority of cells regardless of the polarization states, further contrasting CAR-T to classic T cells. Surprisingly, the cytokine response is minimally associated with differentiation status, although all major differentiation subsets such as naïve, central memory, effector memory, and effector are detected. All these suggest that the activation of CAR-engineered T cells is a canonical process that leads to a highly mixed response combining both type 1 and type 2 cytokines together with GM-CSF, supporting the notion that polyfunctional CAR-T cells correlate with objective response of patients in clinical trials. This work provides new insights into the mechanism of CAR activation and implies the necessity for cellular function assays to characterize the quality of CAR-T infusion products and monitor therapeutic responses in patients.
Antigens
;
metabolism
;
CTLA-4 Antigen
;
metabolism
;
Cell Differentiation
;
drug effects
;
Cell Line
;
Cytokines
;
metabolism
;
Cytotoxicity, Immunologic
;
drug effects
;
Granulocyte-Macrophage Colony-Stimulating Factor
;
pharmacology
;
Humans
;
Lymphocyte Activation
;
drug effects
;
immunology
;
Lymphocyte Subsets
;
drug effects
;
metabolism
;
Phenotype
;
Proteomics
;
Receptors, Chimeric Antigen
;
metabolism
;
Single-Cell Analysis
;
methods
;
T-Lymphocytes, Regulatory
;
drug effects
;
metabolism
;
Th1 Cells
;
cytology
;
drug effects
;
Th2 Cells
;
cytology
;
drug effects
;
Transcription, Genetic
;
drug effects
;
Up-Regulation
;
drug effects
5.Expression of PD1 and BTLA on the CD8+ T Cell and γδT Cell Subsets in Peripheral Blood of Non-Small Cell Lung Cancer Patients.
Yi BAO ; Juan-Fen MO ; Jia-Yuan WU ; Chen-Xi CAO
Chinese Medical Sciences Journal 2019;34(4):248-255
Objective To investigate the expression and regulation of programmed cell death protein 1 (PD1), B lymphocyte and T lymphocyte attenuator (BTLA) in peripheral blood of patients with non-small cell lung cancer (NSCLC); to examine the correlation of the mRNA levels between PD and BTLA in NSCLC. Methods Flow cytometry was used to detect the expression of PD1 and BTLA on the surfaces of CD8+ T cells and γδ+ T cells in the peripheral blood samples collected from 32 in-patients with stage IV NSCLC and 30 healthy individuals. We compared the expression of PD1 and BTLA on the surfaces of γδ+ T cells in the NSCLC patients with bone metastasis before and after the treatment of zoledronic acid. The correlations of PD1 and BTLA, as well as their ligands were analyzed using Pearson correlation analysis with the cBioPortal data platform. Results The frequency of PD1 on the surfaces of CD8+ T cells was significantly higher than that of the γδT cells in both healthy controls (t=2.324, P=0.024) and NSCLC patients(t=2.498, P=0.015). The frequency of PD1 on CD8+ T cells, rather than on γδ+ T cells, was significantly upregulated in advanced NSCLC patients compared with that in healthy controls (t=4.829, P<0.001). The PD1+ BTLA+γδT cells of the healthy controls were significantly lower than that of the NSCLC patients (t=2.422, P=0.0185). No differences in percentage of PD1+γδ+ and BTLA+γδ+ T cells were observed in 7 NSCLC patients with bone metastasis before and after zoledronic acid treatment. PD1 was positively correlated with BTLA in both lung adenocarcinoma (r=0.54; P<0.05) and lung squamous cell carcinoma (r=0.78; P<0.05). Conclusions The upregulation of co-inhibitory molecules occurs on the surfaces of both CD8+ T cells and γδT cells in advanced NSCLC, suggesting that these molecules were involved in regulating the inactivation of CD8+ T cells and γδ+ T cells, immune escape and tumor invasion.
Bone Neoplasms/secondary*
;
CD8-Positive T-Lymphocytes
;
Carcinoma, Non-Small-Cell Lung/immunology*
;
Case-Control Studies
;
Female
;
Gene Expression Regulation, Neoplastic
;
Humans
;
Ligands
;
Lung Neoplasms/immunology*
;
Lymphocyte Subsets/immunology*
;
Male
;
Middle Aged
;
Programmed Cell Death 1 Receptor/metabolism*
;
RNA, Messenger/metabolism*
;
Receptors, Antigen, T-Cell, gamma-delta
;
Receptors, Immunologic/metabolism*
6.Changes in T helper lymphocytes and their subsets in children with tic disorders.
Xiao-Jun HOU ; Shan LIN ; Xiang-Quan LIN ; Lin-Juan HUANG ; Qiao-Yan HUANG
Chinese Journal of Contemporary Pediatrics 2018;20(7):519-523
OBJECTIVETo explore the changes in T helper lymphocytes and their subsets in children with tic disorders (TD) and their clinical significance.
METHODSFlow cytometry was used to measure the percentages of T helper lymphocytes and their subsets in the peripheral blood of children with TD and healthy children (controls).
RESULTSThe percentage of T helper lymphocytes was significantly lower in the TD group than in the control group (P<0.001). The abnormal rate of T helper lymphocytes in the TD group was significantly higher than that in the control group (68.7% vs 18.8%; P<0.001). The percentage of T helper lymphocytes was negatively correlated with Yale Global Tic Severity Scale score (r=-0.3945, P<0.001). As for the subsets of T helper lymphocytes, the TD group had a significantly higher percentage of Th1 cells and a significantly lower percentage of Th2 cells compared with the control group (P<0.001).
CONCLUSIONSThe abnormality of T helper lymphocytes and the imbalance of their subsets may be associated with the pathogenesis of TD in children. The percentage of T helper lymphocytes can be used as an indicator for assessing the severity of TD.
Child ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Lymphocyte Count ; Male ; T-Lymphocyte Subsets ; immunology ; T-Lymphocytes, Helper-Inducer ; immunology ; Th1 Cells ; immunology ; Th2 Cells ; immunology ; Tic Disorders ; genetics ; immunology
7.Clinical effect of pidotimod oral liquid as adjuvant therapy for infectious mononucleosis.
Hai-Tao LYU ; Teng-Teng SHEN ; Ji-Shan ZHENG ; Hui-Qing XU
Chinese Journal of Contemporary Pediatrics 2018;20(7):563-566
OBJECTIVETo study the clinical effect of pidotimod oral liquid as adjuvant therapy for infectious mononucleosis and its effect on T lymphocyte subsets.
METHODSA total of 76 children with infectious mononucleosis, who were admitted to the hospital between July 2016 and June 2017, were enrolled and randomly divided into two groups: conventional treatment and pidotimod treatment (n=38 each). The children in the conventional treatment group were given antiviral therapy with ganciclovir for injection and symptomatic treatment. Those in the pidotimod treatment group were given pidotimod oral liquid in addition to the treatment in the conventional treatment group. The course of treatment was two weeks for both groups. The two groups were compared in terms of the recovery of clinical indices and the changes in peripheral blood T lymphocyte subsets.
RESULTSCompared with the conventional treatment group, the pidotimod treatment group had significantly shorter fever clearance time, time to the disappearance of isthmopyra, time to the relief of lymph node enlargement, time to the relief of hepatosplenomegaly, and length of hospital stay (P<0.05). After treatment, the pidotimod treatment group had significant reductions in the percentages of CD3 and CD8 T cells and had significantly lower percentages of CD3 and CD8 T cells than the conventional treatment group (P<0.001). The pidotimod treatment group had significant increases in the percentage of CD4 T cells and CD4/CD8 ratio after treatment, which was significantly higher than those in the conventional treatment group (P<0.001). The conventional treatment group had no significant changes in T lymphocyte subsets after treatment (P>0.05).
CONCLUSIONSPidotimod oral liquid has a good clinical effect as the adjuvant therapy for infectious mononucleosis and can improve cellular immune function, so it holds promise for clinical application.
Adjuvants, Immunologic ; administration & dosage ; Administration, Oral ; Antiviral Agents ; administration & dosage ; CD4-CD8 Ratio ; Drug Therapy, Combination ; Female ; Ganciclovir ; administration & dosage ; Humans ; Infectious Mononucleosis ; drug therapy ; immunology ; Male ; Pyrrolidonecarboxylic Acid ; administration & dosage ; analogs & derivatives ; T-Lymphocyte Subsets ; drug effects ; immunology ; Thiazolidines ; administration & dosage ; Treatment Outcome
8.Effect of electro-acupuncture at Zusanli acupoint on postoperative T cell immune function in rats.
Jianxing ZHANG ; Yan WANG ; Yuanbo GUO ; Xuexia JI ; Sheng WANG
Journal of Southern Medical University 2018;38(11):1384-1388
OBJECTIVE:
To study the effect of electro- acupuncture at Zusanli acupoint in regulating perioperative cell immune functions in rats.
METHODS:
Forty-two SD rats were divided into blank control group (=6), model group (=18), and electroacupuncture group (=18). The rats in the latter two groups underwent thigh incision and femoral dissection under anesthesia; the rats in electro-acupuncture group received electro-acupuncture at bilateral Zusanli acupoint for 15 min before anesthesia and 1 h after the surgery. The rats in the model group and electro-acupuncture group were sacrificed at 6 h, 24 h, and 72 h after the operation and blood samples were taken from the ventricle for analyzing CD3, CD4, and CD8 T cell subpopulations and calculation of CD4/CD8 using flow cytometry. ELISA was used to detect the levels of interleukin-1 (IL-1) and IL-6.
RESULTS:
The CD3 T cell subpopulation was significantly lower in the model group and electro-acupuncture group than in the blank group at 6 h and 24 h after the operation. At 72 h after the operation, CD3 subpopulation levels still remained low in the model group, but recovered the control level in electro-acupuncture group. At each time point of measurement, CD3 level was significantly lower in the model group than in the electro-acupuncture group. CD4 level in the model group was significantly lowered at 6 h and 24 h after the operation, and recovered the control level at 72 h. In the electro-acupuncture group, CD4 level was significantly lowered at 6 h after the operation, but recovered the control level at 24 h. At 24 h and 72 h, the levels of CD4 were significantly lower in the model group than in the electro-acupuncture group. CD8 level underwent no significant changes after the operation in either the model group or electro-acupuncture group. CD4/CD8 was significantly lowered at 24 h and 72 h after the operation in the model group but showed no significant variation in the electro-acupuncture group. Compared with that in the control group, IL-1 level was significantly lowered in both the model group and electroacupuncture group at 6 h, 24 h, and 72 h after the operation, and was significantly lower in the model group than in the electroacupuncture group at these time points. IL-6 level increased significantly in the model group and the electro- acupuncture group at 6 h and 24 h. at 72 h, IL-6 level was obviously lowered in the electro-acupuncture group but remained elevated in the model group.
CONCLUSIONS
Electro-acupuncture alleviates postoperative immune suppression and promotes recovery of the immune function in rats, suggesting a protective effect of electro-acupuncture at Zusanli acupoint on cellular immune function after surgery.
Acupuncture Points
;
Animals
;
CD4-Positive T-Lymphocytes
;
cytology
;
immunology
;
CD8-Positive T-Lymphocytes
;
cytology
;
immunology
;
Electroacupuncture
;
methods
;
Femur
;
surgery
;
Flow Cytometry
;
Humans
;
Immunity, Cellular
;
Perioperative Period
;
Rats
;
Rats, Sprague-Dawley
;
T-Lymphocyte Subsets
;
cytology
;
immunology
9.Effects of Huaiqihuang granules on immune function in children with severe Mycoplasma pneumoniae pneumonia.
Jin LIU ; Hong YAN ; Xiao-Geng CHEN ; Ya-Ping MU
Chinese Journal of Contemporary Pediatrics 2017;19(7):759-762
OBJECTIVETo observe the effects of Huaiqihuang granules on the immune function in children with severe Mycoplasma pneumoniae pneumonia.
METHODSPediatric inpatients with severe Mycoplasma pneumoniae pneumonia were randomly divided into Huaiqihuang granule treatment group (n=51) and conventional treatment group (n=47). The Huaiqihuang granule treatment group was orally administered Huaiqihuang granules in addition to the conventional treatment, while the conventional treatment group received conventional treatment only. Levels of serum IgA, IgG, and IgM, percentages of CD4and CD8 T lymphocyte subsets, and CD4/CD8ratio were examined in the two groups. The incidence rate of respiratory tract re-infection within three months following treatment was compared between the two groups.
RESULTSThe levels of serum IgA, IgG, and IgM, the percentage of CD4 T lymphocytes, and the CD4/CD8ratio were significantly higher in the Huaiqihuang granule treatment group than in the conventional treatment group three months after treatment (P<0.05). In contrast, the percentage of CD8T lymphocytes was significantly lower in the Huaiqihuang granule treatment group than in the conventional treatment group (P<0.05). In addition, the incidence rate of respiratory tract re-infection within three months following treatment was significantly lower in the Huaiqihuang granule treatment group than in the conventional treatment group (P<0.05).
CONCLUSIONSHuaiqihuang granules can regulate immune functions and reduce the incidence of short-term respiratory tract re-infection in children with severe Mycoplasma pneumoniae pneumonia.
Adolescent ; CD4-CD8 Ratio ; Child ; Child, Preschool ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunoglobulins ; analysis ; Male ; Pneumonia, Mycoplasma ; drug therapy ; immunology ; T-Lymphocyte Subsets ; drug effects ; immunology
10.Individualized Immunosuppressive Protocol of Liver Transplant Recipient Should be Made Based on Splenic Function Status.
Ji-Yong SONG ; Guo-Sheng DU ; Li XIAO ; Wen CHEN ; Long-Long SUO ; Yu GAO ; Li-Kui FENG ; Bing-Yi SHI
Chinese Medical Journal 2016;129(11):1340-1346
BACKGROUNDLymphocyte subsets play important roles in rejection in liver transplant recipients, and the effect of splenic function on these roles remains unknown. The aim of this study was to explore the feasibility to adjust immunosuppressive agents based on splenic function status through detecting the lymphocyte subsets in liver transplantBeijing recipients.
METHODSThe lymphocyte subsets of 49 liver transplant recipients were assessed in the 309th Hospital of Chinese People's Liberation Army between June 2014 and August 2015. The patients were divided into splenectomy group (n = 9), normal splenic function group (n = 24), and hypersplenism group (n = 16). The percentages and counts of CD4+ T, CD8+ T, natural killer (NK) cell, B-cell, regulatory B-cell (Breg), and regulatory T-cell (Treg) were detected by flow cytometer. In addition, the immunosuppressive agents, histories of rejection and infection, and postoperative time of the patients were compared among the three groups.
RESULTSThere was no significant difference of clinical characteristics among the three groups. The percentage of CD19+CD24+CD38+ Breg was significantly higher in hypersplenism group than normal splenic function group and splenectomy group (3.29 ± 0.97% vs. 2.12 ± 1.08% and 1.90 ± 0.99%, P = 0.001). The same result was found in CD4+CD25+FoxP3+ Treg percentage (0.97 ± 0.39% vs. 0.54 ± 0.31% and 0.56 ± 0.28%, P = 0.001). The counts of CD8+ T-cell, CD4+ T-cell, and NK cell were significantly lower in hypersplenism group than normal splenic function group (254.25 ± 149.08 vs. 476.96 ± 225.52, P= 0.002; 301.69 ± 154.39 vs. 532.50 ± 194.42, P= 0.000; and 88.56 ± 63.15 vs. 188.33 ± 134.51, P = 0.048). Moreover, the counts of CD4+ T-cell and NK cell were significantly lower in hypersplenism group than splenectomy group (301.69 ± 154.39 vs. 491.89 ± 132.31, P= 0.033; and 88.56 ± 63.15 vs. 226.00 ± 168.85, P = 0.032).
CONCLUSIONSplenic function status might affect the immunity of liver transplant recipients, that should be considered when we make immunosuppressive protocols.
CD4-Positive T-Lymphocytes ; drug effects ; immunology ; Female ; Humans ; Hypersplenism ; immunology ; Immunosuppressive Agents ; administration & dosage ; therapeutic use ; Killer Cells, Natural ; drug effects ; immunology ; Liver Transplantation ; methods ; Lymphocyte Subsets ; drug effects ; immunology ; Male ; Middle Aged ; Retrospective Studies ; Sirolimus ; administration & dosage ; therapeutic use ; Spleen ; drug effects ; immunology ; T-Lymphocytes, Regulatory ; drug effects ; immunology

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