Cueto-Manzano Alfonso M, Morales-Buenrostro Luis E, González-Espinoza Liliana, González-Tableros Norma, Martín-del-Campo Fabiola, Correa-Rotter Ricardo, Valera Isela, Alberú Josefina
Unidad de Investigación Médica en Epidemiología Clínica, Hospital de Especialidades, CMNO, Guadalajara, Mexico.
Transplantation. 2005 Jul 15;80(1):47-51. doi: 10.1097/01.tp.0000164348.16689.03.
This study aims to compare serum C-reactive protein (CRP), interleukin (IL-6), and tumor necrosis factor (TNF)-alpha in end-stage renal disease (ESRD) patients before versus after receiving renal transplantation (RT) and versus donors.
Serum samples from 37 ESRD patients (24 male, age 34+/-13 years) were collected before and after RT; in addition, samples from 31 donors were obtained at transplantation. CRP concentrations were measured using nephelometry, and TNF-alpha and IL-6 were measured by enzyme-linked immunoadsorbent assay.
Ninety-two percent of recipients had a living donor, 73% received cyclosporine A, 27% tacrolimus, and 70% induction with daclizumab. Thirteen percent had acute rejection and 16% chronic allograft nephropathy. All inflammation markers decreased 6 months after RT, but only CRP was below baseline values (baseline: 5.0+/-3.5; 6 months: 3.0+/-0; 12 months: 3.2+/-0.7; 18 months: 3.2+/-0.6; donors: 3.6+/-1.5 mg/L; P<0.05), whereas median TNF-alpha (baseline: 0.1 [0.03-0.2]; 6 months: 0 [0-0.1]; 12 months: 0.3 [0.1-2.6]; 18 months: 0.6 [0.1-1.9]; donors: 0 [0-0.1] pg/mL; P<0.05) and IL-6 (baseline: 1.9 [1.2-7.1]; 6 months: 1.2 [0.6-28.3]; 12 months: 2.6 [1.3-3.4]; 18 months: 2.7 [1.7-4.2]; donors: 1.1 [0.6-1.9] pg/mL; P<0.05) significantly increased up to the end of follow-up. Before RT, CRP correlated with age (r 0.45, P=0.006) and albumin (r -0.36, P=0.04). TNF-alpha and IL-6 were correlated before (r 0.34, P=0.04) and after (r 0.55, P=0.02) RT. Inflammation markers were not different in patients who had acute rejection episodes or chronic nephropathy.
Compared with controls, patients displayed an inflammatory phenomenon before receiving RT. Serum CRP decreased significantly after RT, whereas TNFalpha and IL-6 increased.
本研究旨在比较终末期肾病（ESRD）患者肾移植（RT）前后以及与供体之间血清C反应蛋白（CRP）、白细胞介素（IL-6）和肿瘤坏死因子（TNF）-α的水平。
收集37例ESRD患者（24例男性，年龄34±13岁）RT前后的血清样本；此外，还获取了31例供体在移植时的样本。采用散射比浊法测定CRP浓度，通过酶联免疫吸附测定法测定TNF-α和IL-6。
92%的受者有活体供体，73%接受环孢素A治疗，27%接受他克莫司治疗，70%使用达利珠单抗诱导治疗。13%的患者发生急性排斥反应，16%患有慢性移植肾肾病。所有炎症标志物在RT后6个月均下降，但只有CRP低于基线值（基线：5.0±3.5；6个月：3.0±0；12个月：3.2±0.7；18个月：3.2±0.6；供体：3.6±1.5mg/L；P<0.05），而TNF-α中位数（基线：0.1[0.03 - 0.2]；6个月：0[0 - 0.1]；12个月：0.3[0.1 - 2.6]；18个月：0.6[0.1 - 1.9]；供体：0[0 - 0.1]pg/mL；P<0.05）和IL-6（基线：1.9[1.2 - 7.1]；6个月：1.2[0.6 - 28.3]；12个月：2.6[1.3 - 3.4]；18个月：2.7[1.7 - 4.2]；供体：1.1[0.6 - 1.9]pg/mL；P<0.05）在随访结束时显著升高。RT前，CRP与年龄相关（r = 0.45，P = 0.006）和白蛋白相关（r = -0.36，P = 0.04）。TNF-α和IL-6在RT前后均相关（RT前：r = 0.34，P = 0.04；RT后：r = 0.55，P = 0.02）。发生急性排斥反应或慢性肾病的患者炎症标志物无差异。
与对照组相比，患者在接受RT前表现出炎症现象。RT后血清CRP显著下降，而TNF-α和IL-6升高。
