Karahan Gonca E, Caliskan Yasar, Ozdilli Kursat, Kekik Cigdem, Bakkaloglu Huseyin, Caliskan Bahar, Turkmen Aydin, Sever Mehmet S, Oguz Fatma S
Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul - Turkey.
Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul - Turkey.
Int J Artif Organs. 2017 Jan 13;39(11):547-552. doi: 10.5301/ijao.5000537. Epub 2016 Dec 26.
Serum soluble CD30 (sCD30), a 120-kD glycoprotein that belongs to the tumor necrosis factor receptor family, has been suggested as a marker of rejection in kidney transplant patients. The aim of this study was to evaluate the relationship between sCD30 levels and anti-HLA antibodies, and to compare sCD30 levels in patients undergoing hemodialysis (HD) with and without failed renal allografts and transplant recipients with functioning grafts.
100 patients undergoing HD with failed grafts (group 1), 100 patients undergoing HD who had never undergone transplantation (group 2), and 100 kidney transplant recipients (group 3) were included in this study. Associations of serum sCD30 levels and anti-HLA antibody status were analyzed in these groups.
The sCD30 levels of group 1 and group 2 (154 ± 71 U/mL and 103 ± 55 U/mL, respectively) were significantly higher than those of the transplant recipients (group 3) (39 ± 21 U/mL) (p<0.001 and p<0.001). The serum sCD30 levels in group 1 (154 ± 71 U/mL) were also significantly higher than group 2 (103 ± 55 U/mL) (p<0.001). Anti-HLA antibodies were detected in 81 (81%) and 5 (5%) of patients in groups 1 and 2, respectively (p<0.001). When multiple regression analysis was performed to predict sCD30 levels, the independent variables in group 1 were the presence of class I anti-HLA antibodies (β = 0.295; p = 0.003) and age (β = -0.272; p = 0.005), and serum creatinine (β = 0.218; p = 0.027) and presence of class II anti-HLA antibodies (standardized β = 0.194; p = 0.046) in group 3.
Higher sCD30 levels and anti-HLA antibodies in patients undergoing HD with failed renal allografts may be related to higher inflammatory status in these patients.
血清可溶性CD30(sCD30)是一种属于肿瘤坏死因子受体家族的120-kD糖蛋白,已被认为是肾移植患者排斥反应的标志物。本研究的目的是评估sCD30水平与抗HLA抗体之间的关系,并比较有和没有移植肾失功的血液透析(HD)患者以及移植肾有功能的移植受者的sCD30水平。
本研究纳入了100例移植肾失功的HD患者(第1组)、100例从未接受过移植的HD患者(第2组)和100例肾移植受者(第3组)。分析了这些组中血清sCD30水平与抗HLA抗体状态的相关性。
第1组和第2组的sCD30水平(分别为154±71 U/mL和103±55 U/mL)显著高于移植受者(第3组)(39±21 U/mL)(p<0.001和p<0.001)。第1组的血清sCD30水平(154±71 U/mL)也显著高于第2组(103±55 U/mL)(p<0.001)。第1组和第2组分别有81例(81%)和5例(5%)患者检测到抗HLA抗体(p<0.001)。当进行多元回归分析以预测sCD30水平时,第1组的独立变量是I类抗HLA抗体的存在(β = 0.295;p = 0.003)和年龄(β = -0.272;p = 0.005),第3组的独立变量是血清肌酐(β = 0.218;p = 0.027)和II类抗HLA抗体的存在(标准化β = 0.194;p = 0.046)。
移植肾失功的HD患者中较高的sCD30水平和抗HLA抗体可能与这些患者较高的炎症状态有关。