Slavcev Antonij, Lácha Jiri, Honsová Eva, Sajdlová Helena, Lodererová Alena, Vitko Stefan, Skibová Jelena, Striz Ilja
Department of Immunogenetics, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, Prague 140 21, Czech Republic.
Transpl Immunol. 2005 Jun;14(2):117-21. doi: 10.1016/j.trim.2005.03.014. Epub 2005 Apr 25.
Recent literary data suggest that high pre- and post-transplant serum levels of the soluble CD30 (sCD30) molecule may be a risk factor for acute rejection and worse prognosis of the transplanted kidney. The aim of our study was to correlate the concentrations of sCD30 and the presence of HLA antibodies as defined by flow cytometry and ELISA with the clinical course and graft prognosis after transplantation. One hundred and seventeen kidney transplant patients were included into the study. The incidence of rejection episodes, graft function and graft survival for up to 1 year post-transplant were evaluated. Soluble CD30 levels before transplantation were virtually the same in patients who experienced rejection and in non-rejecting patients. In both patient groups, a significant decrease of sCD30 was detected 2 weeks after transplantation (104.4 U/ml before vs. 37.0 U/ml post-transplant, P < 0.001). However, there was a substantial difference in the level of decrease of sCD30 between rejecting and non-rejecting patients. Patients without rejection had lower sCD30 values (31.2 U/ml post-transplant) compared to patients who experienced rejection episodes (62.9 U/ml), P < 0.04. Multifactorial analysis showed that antibodies to HLA class II antigens and elevated concentrations of sCD30 shortly after transplantation were associated with increased risk for acute rejection in the first post-transplant year. Measurement of soluble CD30 after transplantation, taken into consideration with the presence of HLA class II antibodies, might be helpful for evaluating the potential risk for acute rejection.
近期的文献数据表明，移植前后血清中可溶性CD30（sCD30）分子水平较高可能是急性排斥反应的危险因素，且会导致移植肾预后较差。我们研究的目的是将sCD30的浓度以及通过流式细胞术和酶联免疫吸附测定法确定的HLA抗体的存在情况与移植后的临床病程和移植物预后相关联。117名肾移植患者被纳入研究。评估了移植后长达1年的排斥反应发生率、移植物功能和移植物存活率。经历排斥反应的患者和未发生排斥反应的患者移植前的可溶性CD30水平几乎相同。在两组患者中，移植后2周均检测到sCD30显著下降（移植前为104.4 U/ml，移植后为37.0 U/ml，P < 0.001）。然而，发生排斥反应的患者和未发生排斥反应的患者之间sCD30的下降水平存在显著差异。未发生排斥反应的患者移植后的sCD30值（31.2 U/ml）低于经历排斥反应的患者（62.9 U/ml），P < 0.04。多因素分析表明，HLA II类抗原抗体以及移植后不久sCD30浓度升高与移植后第一年急性排斥反应风险增加相关。移植后测定可溶性CD30，并结合HLA II类抗体的存在情况，可能有助于评估急性排斥反应的潜在风险。
