Hosseinzadeh Morteza, Nafar Mohsen, Ahmadpoor Pedram, Noorbakhsh Farshid, Yekaninejad Mir Saeed, Niknam Mohammad Hossein, Amirzargar Aliakbar
Department of Immunology, School of Medicine, Ilam University of medical Sciences, Ilam, Iran.
Iran J Immunol. 2017 Mar;14(1):24-34.
The incidence of ischemic reperfusion injury (IRI) in early phase post-transplantation and activation of toll-like receptor (TLR-2) and TLR-4 remarkably impact the outcome of a renal allograft.
To investigate whether the expression of TLRs in peripheral blood mononuclear cells (PBMCs) can predict the clinical outcome of kidney allografts.
We obtained blood samples from 52 renal transplant patients before transplant, and 2, 90, and 180 days post-transplantation in order to analyze the surface expressions of TLR-2 and TLR-4 on peripheral blood monocytes. The expression patterns of TLR-2 and TLR-4 were compared between patients with graft dysfunction (GD) and those with well-functioning graft (WFG).
Significantly different mean dynamic changes in surface expression of TLR-2 according to percentage of TLR-2+ cells between (the GD and WFG) groups existed at most time-points before and after renal transplantation (p=0.007) with the exception of day 2 post-transplantation. We observed significantly higher mean fluorescence intensities of TLR-2 and TLR-4 on CD14+ cells in the GD group compared to the WFG group. This finding was particularly observed 180 days post-transplantation (p=0.001). Based on TLR-2 and TLR-4 protein expression for each step, multiple logistic regression and ROC curve analysis revealed that an increase in CD14+ TLR-2+ monocytes within the 90 days post-transplantaton was associated with increased risk of GD at 180 and 365 days post-transplantation [odds ratio (OR)=1.27, p=0.005)].
Sequential monitoring of TLR-2 and TLR-4 expression patterns in peripheral blood monocytes appear to be prognostic and predictive biomarkers for early and late kidney allograft outcomes.
移植早期缺血再灌注损伤（IRI）的发生率以及Toll样受体（TLR-2）和TLR-4的激活对同种异体肾移植的结果有显著影响。
探讨外周血单个核细胞（PBMC）中TLR的表达是否可预测同种异体肾移植的临床结局。
我们采集了52例肾移植患者移植前、移植后2天、90天和180天的血样，以分析外周血单核细胞上TLR-2和TLR-4的表面表达。比较移植肾功能障碍（GD）患者和移植肾功能良好（WFG）患者的TLR-2和TLR-4表达模式。
除移植后第2天外，肾移植前后大多数时间点，（GD组和WFG组）之间根据TLR-2 +细胞百分比计算的TLR-2表面表达的平均动态变化存在显著差异（p = 0.007）。我们观察到，与WFG组相比，GD组CD14 +细胞上TLR-2和TLR-4的平均荧光强度显著更高。这一发现尤其在移植后180天观察到（p = 0.001）。根据每个阶段的TLR-2和TLR-4蛋白表达，多因素logistic回归和ROC曲线分析显示，移植后90天内CD14 + TLR-2 +单核细胞增加与移植后180天和365天发生GD的风险增加相关[比值比（OR）= 1.27，p = 0.005]。
外周血单核细胞中TLR-2和TLR-4表达模式的连续监测似乎是同种异体肾移植早期和晚期结局的预后和预测生物标志物。
