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肾移植后可溶性CD30水平与早期亚临床排斥反应相关。

Post-transplant soluble CD30 levels are associated with early subclinical rejection in kidney transplantation.

作者信息

Grenzi Patricia C, Campos Érika F, Silva Hélio T, Felipe Claudia R, Franco Marcelo F, Soares Maria F, Medina-Pestana José O, Gerbase-DeLima Maria

机构信息

Instituto de Imunogenética-AFIP, Rua Loefgreen 1235, 04040-031 São Paulo, SP, Brazil; Universidade Federal de São Paulo, Rua Sena Madureira 1500, 04021-001 São Paulo, SP, Brazil.

Hospital do Rim e Hipertensão, Rua Borges Lagoa 960, 04038-002 São Paulo, SP, Brazil.

出版信息

Transpl Immunol. 2015 Mar;32(2):61-5. doi: 10.1016/j.trim.2015.02.004. Epub 2015 Feb 17.

Abstract

Several studies have shown association of high pre- or post-transplant levels of soluble CD30 (sCD30) with acute rejection and poor late kidney transplant outcome. Our goal was to investigate whether sCD30 levels at month-3 post-transplant are associated with subclinical rejection, presence of CD30(+) cells within the graft, and expression of immune response genes in peripheral blood mononuclear cells. The study comprised 118 adult first kidney graft recipients, transplanted at a single center, receiving tacrolimus in low concentration. All were submitted to a protocol biopsy at month-3. Subclinical rejection was identified in 10 biopsies and sCD30 levels ≥ 61.88 ng/mL (P = 0.004), younger recipient age (P = 0.030) and non-Caucasian ethnicity (P = 0.011) were independently associated with this outcome. Rare CD30(+) cells were present in only two biopsies. There was a correlation between sCD30 levels and CD30 gene expression in peripheral blood mononuclear cells (r = 0.385, P = 0.043). These results show that high sCD30 levels are independent predictors of graft dysfunction and may contribute to patient selection protocols by indicating those who could benefit from a more thorough evaluation.

摘要

多项研究表明,移植前或移植后可溶性CD30(sCD30)水平升高与急性排斥反应及肾移植后期不良预后相关。我们的目标是调查移植后3个月时的sCD30水平是否与亚临床排斥反应、移植物内CD30(+)细胞的存在以及外周血单个核细胞中免疫反应基因的表达相关。该研究纳入了118名单中心接受低浓度他克莫司治疗的成年首次肾移植受者。所有患者在移植后3个月均接受了方案活检。在10份活检样本中发现了亚临床排斥反应,sCD30水平≥61.88 ng/mL(P = 0.004)、受者年龄较小(P = 0.030)和非白种人种族(P = 0.011)与这一结果独立相关。仅在两份活检样本中发现了罕见的CD30(+)细胞。外周血单个核细胞中的sCD30水平与CD30基因表达之间存在相关性(r = 0.385,P = 0.043)。这些结果表明,高sCD30水平是移植物功能障碍的独立预测指标,通过指出那些可能从更全面评估中受益的患者,可能有助于患者选择方案。

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