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