Fernández-Ruiz Mario, Parra Patricia, López-Medrano Francisco, Ruiz-Merlo Tamara, González Esther, Polanco Natalia, Origüen Julia, San Juan Rafael, Andrés Amado, Aguado José María
Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), School of Medicine, Universidad Complutense, Madrid, Spain.
Department of Nephrology, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre" (i+12), School of Medicine, Universidad Complutense, Madrid, Spain.
Transpl Infect Dis. 2017 Apr;19(2). doi: 10.1111/tid.12668. Epub 2017 Mar 21.
The transmembrane glycoprotein CD30 contributes to regulate the balance between Th and Th responses. Previous studies have reported conflicting results on the utility of its soluble form (sCD30) to predict post-transplant infection.
Serum sCD30 was measured by a commercial ELISA assay at baseline and post-transplant months 1, 3, and 6 in 100 kidney transplant (KT) recipients (279 monitoring points). The impact of sCD30 levels on the incidence of overall, bacterial and opportunistic infection during the first 12 months after transplantation was assessed by Cox regression.
There were no differences in serum sCD30 according to the occurrence of overall or opportunistic infection. However, sCD30 levels were higher in patients with bacterial infection compared to those without at baseline (P=.038) and months 1 (P<.0001), 3 (P=.043), and 6 after transplantation (P=.006). Patients with baseline sCD30 levels ≥13.5 ng/mL had lower 12-month bacterial infection-free survival (35.0% vs 80.0%; P<.0001). After adjusting for potential confounders, baseline sCD30 levels ≥13.5 ng/mL remained as an independent risk factor for bacterial infection (adjusted hazard ratio [aHR]: 4.65; 95% confidence interval [CI]: 2.05-10.53; <.001). Analogously, sCD30 levels ≥6.0 ng/mL at month 1 acted as a risk factor for subsequent bacterial infection (aHR: 5.29; 95% CI: 1.11-25.14; P=.036).
Higher serum sCD30 levels were associated with an increased risk of bacterial infection after KT. We hypothesize that this biomarker reflects a Th -polarized T-cell response, which exerts a detrimental effect on the immunity against bacterial pathogens.
跨膜糖蛋白CD30有助于调节Th和Th反应之间的平衡。先前的研究报告了其可溶性形式（sCD30）在预测移植后感染方面的效用存在相互矛盾的结果。
采用商业ELISA检测法，在100名肾移植（KT）受者的基线期以及移植后第1、3和6个月测定血清sCD30（共279个监测点）。通过Cox回归评估sCD30水平对移植后前12个月内总体感染、细菌感染和机会性感染发生率的影响。
根据总体感染或机会性感染的发生情况，血清sCD30无差异。然而，与未发生细菌感染的患者相比，发生细菌感染的患者在基线期（P = 0.038）、移植后第1个月（P < 0.0001）、第3个月（P = 0.043）和第6个月（P = 0.006）时的sCD30水平更高。基线sCD30水平≥13.5 ng/mL的患者12个月无细菌感染生存率较低（35.0%对80.0%；P < 0.0001）。在调整潜在混杂因素后，基线sCD30水平≥13.5 ng/mL仍然是细菌感染的独立危险因素（调整后风险比[aHR]：4.65；95%置信区间[CI]：2.05 - 10.53；P < 0.001）。类似地，第1个月时sCD30水平≥6.0 ng/mL是随后细菌感染的危险因素（aHR：5.29；95%CI：1.11 - 25.14；P = 0.036）。
较高的血清sCD30水平与KT后细菌感染风险增加相关。我们推测该生物标志物反映了Th极化的T细胞反应，这对抵抗细菌病原体的免疫力产生有害影响。
