Hu Huaizhong, Aizenstein Brian D, Puchalski Alice, Burmania Jeanine A, Hamawy Majed M, Knechtle Stuart J
Renovar Incorporated, Madison, WI, USA.
Am J Transplant. 2004 Mar;4(3):432-7. doi: 10.1111/j.1600-6143.2004.00354.x.
A noninvasive urinary test that diagnoses acute renal allograft dysfunction would benefit renal transplant patients. We aimed to develop a rapid urinary diagnostic test by detecting chemokines. Seventy-three patients with renal allograft dysfunction prompting biopsy and 26 patients with stable graft function were recruited. Urinary levels of CXCR3-binding chemokines, monokine induced by IFN-gamma (Mig/CXCL9), IFN-gamma-induced protein of 10 kDa (IP-10/CXCL10), and IFN-inducible T-cell chemoattractant (I-TAC/CXCL11), were determined by a particle-based triplex assay. IP-10, Mig and I-TAC were significantly elevated in renal graft recipients with acute rejection, acute tubular injury and BK virus nephritis. Using 100 pg/mL as the threshold level, both IP-10 and Mig had diagnostic value (sensitivity 86.4%; specificity 91.3%) in differentiating acute graft dysfunction from other clinical conditions. In terms of monitoring the response to antirejection therapy, this urinary test is more sensitive and predictive than serum creatinine. These results indicate that this rapid test is clinically useful.
一种能够诊断急性肾移植功能障碍的非侵入性尿液检测方法将使肾移植患者受益。我们旨在通过检测趋化因子来开发一种快速尿液诊断检测方法。招募了73例因肾移植功能障碍而需要活检的患者以及26例移植肾功能稳定的患者。通过基于颗粒的三联检测法测定尿液中CXCR3结合趋化因子、γ干扰素诱导的单核因子（Mig/CXCL9）、10 kDa的γ干扰素诱导蛋白（IP-10/CXCL10）和干扰素诱导的T细胞趋化因子（I-TAC/CXCL11）的水平。在发生急性排斥反应、急性肾小管损伤和BK病毒肾炎的肾移植受者中，IP-10、Mig和I-TAC显著升高。以100 pg/mL作为阈值水平，IP-10和Mig在区分急性移植功能障碍与其他临床情况方面均具有诊断价值（敏感性86.4%；特异性91.3%）。在监测抗排斥治疗反应方面，这种尿液检测比血清肌酐更敏感且更具预测性。这些结果表明这种快速检测在临床上是有用的。
