Meta-analysis Of The Influence Of Selective T-cell CD28-CD80/86 Co-stimulating Factor Blocker On CD4+CD25+Foxp3+Treg Cells Of Kidney Transplant Patients

Objective:To systematically evaluate the influence of selective T-cell CD28-CD80/ 86 co-stimulating blocker,Belatacept,on CD4+CD25+Foxp3+Treg cells of kidney transplant patients VS calcineurin inhibitors.To study whether belatacept could induce immune tolerance after kidney transplantation.Methods:By searching the Database of Medline、Embase、Cochrane Database of Systematic Reviews、EBSCO、OVID, all reports on randomized controlled trials ( RCTs) of T-cell CD28-CD80/86 co-stimulating blocker (belatacept) vs calcineurin inhibitors (CNI).We evaluated the acute rejection rate、peripheral blood Treg cells proportion、peripheral blood CD4+T cells proportion、peripheral blood CD8+T cells proportion、peripheral blood B cells proportion、biopsy Treg cells proportion by RevMan 5.3 Statistical software.Result:Six RCTs including 159 patients were finally selected for this study,including the Belatacept group(n=98)and the CNI group (n=61). The result of acute rejection rate is (RR=0.85,95%CI=[0.34,2.08], P>0.05), peripheral blood Treg cells prop-ortion is (WMD=0.10,95%CI=[-0.99,1.20],P>0.05), peripheral blood CD4+T cells proportion is (WMD=-0.63,95%CI=[-21.39,8.79], P>0.05),peripheral blood CD8+ T cells proportion is (WMD=4.49,95%CI=[-11.58,20.56], P>0.05),peripheral blood B cells proportion is (WMD=-3.15,95%CI=[-7.52,1.22], P>0.05).The special result is biopsy Treg cells proportion, (WMD=35.56,95%CI=[1.89,69.24], P<0.05).Conclusion:The influence of Belatacept on the acute rejection rate、peripheral blood Treg cells proportion、peripheral blood CD4+T cells proportion、peripheral blood CD8+T cells proportio、peripheral blood B cells proportion are same like CNI.But the biopsy Treg cells proportion is higher than CNI significantly, and this could help induce immune tolerance after kidney transplantation.