Background: Despite the long history of ATG use, the exact in vivo mechanism of action remains unclear. In the present study, we analyzed the effect of ATG‐induction therapy on expression of 10 immunologically relevant genes in the early post‐transplant period. Methods: Eight renal allograft recipients received post‐transplant prophylactic ATG treatment on 10 consecutive days and an additional three patients received treatment on 5, 6, or 7 consecutive days, respectively. Gene expression was measured at the beginning and the end of therapy and normalized to a control gene using Taqman real‐time PCR methodology. Results were compared with those of matched control patients. No patients were diagnosed with rejection. Results: ATG‐treated patients showed decreases in the expression of cytotoxic T cell genes perforin (−56%, p = 0.03) and granzyme B (−45%, p = 0.01) and cytokine gene IFN‐ γ (−75%, p = 0.005), and significant increases in the expression of cytokine genes IL‐7 (550%, p = 0.04), IL‐10 (275%, p = 0.01), IL‐15 (417%, p = 0.03), TNF‐ α (615%, p = 0.01), and TGF‐ β (235%, p = 0.02). No significant changes were observed in the control group, with the exception of a decrease in IL‐10 expression (−42%, p = 0.01). There were no significant changes in IL‐12 or Fas‐L expression in either group. Conclusion: ATG‐induced decreases in the expression of IFN‐ γ , perforin, and granzyme B and increases in IL‐10 and TGF‐ β might be considered beneficial to the recipient, whereas increases in the expression of IL‐7, IL‐15, and TNF‐ α genes might be involved in immunological processes not effected by ATG that may harm the transplant in the long term.
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Simon et al. (2003) studied this question.