Zhang Q, Liu Y-F, Su Z-X, Shi L-P, Chen Y-H
Department of Urinary Surgery, the First Affiliated Hospital of Jinan University Guangzhou, Guangdong, China.
Department of Urinary Surgery, the First Affiliated Hospital of Jinan University Guangzhou, Guangdong, China.
Transplant Proc. 2014 Jun;46(5):1420-5. doi: 10.1016/j.transproceed.2014.02.019.
The aims of this study were to determine if characterization of serum concentrations of interferon-gamma inducible protein-10 (IP-10), fractalkine, and their receptors (CXCR3 and CX3CR1) were predictive of acute allograft rejection in kidney transplant recipients.
Kidney transplant recipients (n = 52) were enrolled in this study and divide into either the acute rejection (AR, n = 15) or non-acute rejection (NAR, n = 35) groups. Serum samples from recipients were collected 1 day prior to transplantation and on days 1, 3, 5, 7, and 9 post-transplantation. The accuracy of chemokine concentrations for predicting acute rejection episodes was evaluated using receiver operator characteristic (ROC) curves.
AR was diagnosed in 15 patients based on histologic changes to renal biopsies. AR patients had significantly higher serum fractalkine, CXCR1, IP-10, and CXCR3 levels compared to levels observed in the NAR group and healthy controls. Fractalkine and IP-10 had the largest area under the ROC curve at 0.86 (95% confidence interval: 0.77-0.96). Following steroid therapy, chemokine levels decreased, which may serve to predict the therapeutic response to steroid therapy.
Measuring serum levels of fractalkine, IP-10, and their receptors (especially the fractalkine/IP-10 combination) may serve as a noninvasive approach for the early diagnosis of renal allograft rejection.
本研究旨在确定干扰素 - γ诱导蛋白10（IP - 10）、趋化因子及其受体（CXCR3和CX3CR1）的血清浓度特征是否可预测肾移植受者的急性移植物排斥反应。
52例肾移植受者纳入本研究，分为急性排斥反应组（AR，n = 15）和非急性排斥反应组（NAR，n = 35）。在移植前1天以及移植后第1、3、5、7和9天采集受者的血清样本。使用受试者工作特征（ROC）曲线评估趋化因子浓度预测急性排斥反应发作的准确性。
根据肾活检的组织学变化，15例患者被诊断为急性排斥反应。与非急性排斥反应组和健康对照组相比，急性排斥反应患者的血清趋化因子、CXCR1、IP - 10和CXCR3水平显著更高。趋化因子和IP - 10在ROC曲线下的面积最大，为0.86（95%置信区间：0.77 - 0.96）。类固醇治疗后，趋化因子水平下降，这可能有助于预测对类固醇治疗的反应。
检测血清趋化因子、IP - 10及其受体（尤其是趋化因子/IP - 10组合）的水平可能是早期诊断肾移植排斥反应的一种非侵入性方法。
