Assessment of T lymphocyte activation and HIF-1α gene expression and protein levels in patients awaiting organ transplantation

Objective: This study aimed to determine the active T lymphocyte (% cell levels) associated with antibody development and the HIF-1α gene expression levels, which serve as metabolic regulators in these cells, in PRA-positive chronic kidney disease (CKD) patients awaiting transplantation. Additionally, the relationship between HIF-1α, T cell activation, immunological risks, and clinical outcomes was investigated in these patients. Method: The study sample consists of PRA-positive CKD patients (n=20), PRA-negative CKD patients (n=16), and control individuals (n=20). Peripheral blood samples from the subjects were analyzed for HIF-1α gene expression levels using Real-Time Quantitative PCR, and the expression (%) levels of active T lymphocytes were assessed using Flow Cytometry. Data analysis was performed using IBM SPSS 25.0 software to obtain statistical results. Results: According to the Flow Cytometry results, a statistically significant difference was found between the PRA positive CKD patients and the control groups in the percentages of CD3+CD25+CD69+HIF-1α+ cells (χ² (2) = 7.592, p = .022). When the PRA-positive CKD group was compared within itself, the cell percentages were significantly higher in the PRA Class I group compared to the PRA Class I & PRA Class II group (p=0.038). However, no statistically significant difference was observed in the HIF-1α gene expression levels between the study groups (χ²(2) = 4.513, p=0.105). Conclusion: The obtained data suggest that HIF-1α in CKD may be associated with T cell activation and the immune response developed against alloantigens. The observed increase in HIF-1α in CD3+CD25+CD69+ activated T cells may affect T cell function, leading to a more effective immune response against alloantigens. Therapeutic approaches targeting selective inhibition of HIF-1α to control its effect on antibody formation and rejection risk may be the subject of future research.