Department of Hematology, Sichuan Academy of Medical Science, Chengdu, China.
Eur Rev Med Pharmacol Sci. 2013 Jul;17(13):1769-73.
Currently, it is important to identify a good biomarker to predict treatment-related complications in patients with transplantation. This study aimed to evaluate the significance of serum hepcidin-25 in predicting invasive fungal disease (IFD) after transplantation.
A total of 57 patients who underwent transplantation were included in this study, and their serum samples were obtained and stored at -80°C for analysis. The serum hepcidin-25 were assayed using enzyme-liked immunosorbent assay (ELISA), and hypersensitive C reactive protein (hsCRP) and 1,3-beta-D glucan were measured using standard laboratory techniques. These indices were monitored weekly, from one week before transplantation to four weeks after transplantation.
The median pretransplant serum hepcidin-25 level was 37.00 ng/mL which was higher than that of healthy volunteers (p < 0.001). Because the higher hepcidin-25 level of the third tertile among the patients was 39.855 ng/mL, we set a cutoff level of 40 ng/mL to divide them into low- and high-hepcidin-25 groups (n = 38 and 19, respectively). The prevalences of the documented infection in the two groups were 2.6% and 26%, respectively (p = 0.019). The high-hepcidin-25 group was monitored after transplantation. The hepcidin-25 level peaked one week after transplantation, followed by gradual decrease. The plasma (1-3)-beta-D-glucan reached the summit two week. The proven of IFD was delayed 10 days on average after hepcidin-25 had arrived summit and 5 days after (1-3)-beta-D-glucan peaked.
The pretransplant serum hepcidin-25 level would be a useful indicator for predicting the risk of infection after transplantation; and the dynamic changes of hepcidin-25 in patients with high-hepcidin-25 group would help to predict IFD after transplantation.
目前，识别一种良好的生物标志物来预测移植患者相关治疗并发症非常重要。本研究旨在评估血清铁调素-25 在预测移植后侵袭性真菌病（IFD）中的意义。
本研究共纳入 57 例接受移植的患者，采集其血清样本并在-80°C 下储存用于分析。采用酶联免疫吸附试验（ELISA）测定血清铁调素-25，采用标准实验室技术测定超敏 C 反应蛋白（hsCRP）和 1,3-β-D 葡聚糖。这些指标每周监测一次，从移植前一周到移植后四周。
患者移植前中位血清铁调素-25 水平为 37.00ng/ml，高于健康志愿者（p<0.001）。由于患者中第三 tertile 较高的铁调素-25 水平为 39.855ng/ml，我们将 40ng/ml 设定为截断值，将患者分为低铁调素-25 组和高铁调素-25 组（n=38 和 19）。两组的有记录感染发生率分别为 2.6%和 26%（p=0.019）。高铁调素-25 组在移植后进行监测。铁调素-25 水平在移植后一周达到峰值，随后逐渐下降。血浆（1-3）-β-D-葡聚糖在两周时达到高峰。在铁调素-25 达到峰值后平均延迟 10 天，在（1-3）-β-D-葡聚糖达到峰值后 5 天，才确诊 IFD。
移植前血清铁调素-25 水平可作为预测移植后感染风险的有用指标；高铁调素-25 组患者铁调素-25 的动态变化有助于预测移植后 IFD。
