Hospital of Nephropathy, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, China.
Acta Biochim Biophys Sin (Shanghai). 2012 Sep;44(9):730-6. doi: 10.1093/abbs/gms056. Epub 2012 Jul 3.
Acute rejection (AR) is a strong risk factor for chronic rejection in renal transplant recipients. Accurate and timely diagnosis of AR episodes is very important for disease control and prognosis. Therefore, objectively evaluated the immune status of patients is essential in the field of post-transplantation treatment. This longitudinal study investigated the usefulness of five biomarkers, human leukocyte antigen (HLA)-G5 and sCD30 level in sera, intracellular adenosine triphosphate (iATP) release level of CD4(+) T cells, and granzyme B/perforin expression in peripheral blood mononuclear cells (PBMCs) and biopsies, to detect AR and the resolution of biomarkers in a total of 84 cases of renal transplantation. The data demonstrated that recipients with clinical or biopsy proven rejection significantly increased iATP release level of CD4(+) T cells, and elevated sCD30 but lowered HLA-G5 level in sera compared with individuals with stable graft function. Expression levels of granzyme B and perforin were also elevated in PBMCs and graft biopsies of AR patients. Taken together, we identified that upregulation of sCD30, iATP, granzyme B, perforin, and downregulation of HLA-G5 could provide valuable diagnostic standards to identify those recipients in the risk of AR. And iATP may be a better biomarker than others for predicting the graft rejection episode.
急性排斥反应（AR）是肾移植受者发生慢性排斥反应的一个强烈危险因素。准确、及时地诊断 AR 发作对疾病控制和预后非常重要。因此，客观评估患者的免疫状态对于移植后治疗领域至关重要。本纵向研究调查了五种生物标志物（人类白细胞抗原（HLA）-G5 和血清中 sCD30 水平、CD4+T 细胞内三磷酸腺苷（iATP）释放水平以及外周血单个核细胞（PBMC）和活检中的颗粒酶 B/穿孔素表达）在总共 84 例肾移植中的诊断价值。数据表明，与具有稳定移植物功能的个体相比，临床或活检证实排斥的受者的 CD4+T 细胞 iATP 释放水平显著升高，血清中 sCD30 升高但 HLA-G5 水平降低。AR 患者的 PBMC 和移植物活检中颗粒酶 B 和穿孔素的表达水平也升高。总之，我们发现 sCD30、iATP、颗粒酶 B、穿孔素上调和 HLA-G5 下调可以为识别那些处于 AR 风险中的受者提供有价值的诊断标准。而且 iATP 可能是比其他标志物更好的预测移植物排斥发作的生物标志物。
