Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 30130-100, Brazil.
Int Urol Nephrol. 2012 Oct;44(5):1539-48. doi: 10.1007/s11255-012-0176-2. Epub 2012 Apr 28.
Clinical- and histopathology-based scores are the limited predictors of allograft outcome. Thus, predictors of allograft survival still remain a challenge. This study aimed to evaluate the urinary levels of chemokines and anti-inflammatory molecules at 30, 90, and 300 days after renal transplantation and to further correlate these measurements to graft function.
Glomerular filtration rate (GFR) and urinary levels of MCP-1/CCL2, MIP-1α/CCL3, RANTES/CCL5, IL-8/CXCL8, IP-10/CXCL10, interleukin-1 receptor antagonist, soluble tumor necrosis factor receptor-1, and receptor-2 were determined at 30, 90, and 300 days after renal transplantation in 22 patients. Transplanted patients were also divided according to the type of donor (living donor, LD, n = 13 or deceased donor, DD, n = 9).
Urinary levels of all molecules, except MIP-1α/CCL3, remained unchanged at 30, 90, and 300 days after transplantation in our 22 patients. MIP-1α/CCL3 levels significantly reduced from 30 to 300 days and showed a negative correlation with GFR at 30 days. The comparison between LD and DD groups showed similar levels of all markers, except for MCP-1/CCL2, which presented higher values in LD than in DD at 30 days. sTNFR1 and MCP-1/CCL2 significantly reduced from 30 to 300 days in LD group, but only sTNFR2 concentrations at 30 days were negatively correlated with GFR at 300 days. On the other hand, in DD group, IL-1Ra concentrations at 30 and at 90 days were positively correlated with GFR at 300 days.
Urinary chemokine and anti-inflammatory molecules measurements may be a promising tool in the follow-up of renal transplanted patients.
基于临床和组织病理学的评分是同种异体移植物结局的有限预测因子。因此，同种异体移植物存活的预测因子仍然是一个挑战。本研究旨在评估肾移植后 30、90 和 300 天时尿液中趋化因子和抗炎分子的水平，并进一步将这些测量值与移植物功能相关联。
在 22 例患者中，分别于肾移植后 30、90 和 300 天测定肾小球滤过率（GFR）以及尿液中 MCP-1/CCL2、MIP-1α/CCL3、RANTES/CCL5、IL-8/CXCL8、IP-10/CXCL10、白细胞介素-1 受体拮抗剂、可溶性肿瘤坏死因子受体-1 和受体-2 的水平。移植患者还根据供体类型（活体供体，LD，n=13 或已故供体，DD，n=9）进行了分组。
在我们的 22 例患者中，除 MIP-1α/CCL3 外，所有分子的尿液水平在移植后 30、90 和 300 天均保持不变。MIP-1α/CCL3 水平从 30 天到 300 天显著降低，并且与 30 天的 GFR 呈负相关。LD 和 DD 组之间的比较显示，除 30 天时 LD 组的 MCP-1/CCL2 水平高于 DD 组外，所有标志物的水平相似。LD 组中 sTNFR1 和 MCP-1/CCL2 从 30 天到 300 天显著降低，但只有 sTNFR2 浓度在 30 天与 300 天的 GFR 呈负相关。另一方面，在 DD 组中，30 天和 90 天的 IL-1Ra 浓度与 300 天的 GFR 呈正相关。
尿液趋化因子和抗炎分子的测定可能是监测肾移植患者的一种有前途的工具。
