Mota Ana Pl, Menezes Cristiane A, Alpoim Patrícia N, Cardoso Carolina N, Martins Suellen R, Alves Lorraine V, de A Martins-Filho Olindo, Gomes Karina B, Dusse Luci Ms
Faculty of Pharmacy, Department of Clinical and Toxicological Analysis, Federal University of Minas Gerais - UFMG, Belo Horizonte, Minas Gerais, Brazil.
Laboratory of Diagnostic and Monitoring Biomarkers, Oswaldo Cruz Foundation - FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil.
Nephrology (Carlton). 2018 Sep;23(9):867-875. doi: 10.1111/nep.13114.
The maintenance of stable graft function in renal transplanted recipients (RTR) is a challenge for healthcare staff. The ideal biomarkers must have significant predictive values to monitor the intricate renal function response triggered after renal transplantation. The main purpose in this study was to evaluate the regulatory and pro-inflammatory cytokines as biomarkers of allograft function in living-related renal transplant patients.
Regulatory and pro-inflammatory cytokine plasma levels were measured by flow cytometry in 120 living-related renal transplanted patients categorized into three groups according to creatinine plasma levels: creatinine less than 1.4 mg/dL (C1), creatinine within 1.4-2.0 mg/dL (C2) and more than 2.0 mg/dL (C3). Patients were also classified as 'low' or 'high' cytokine producers. Clinical data were obtained from patients' medical record.
We have found a peak of regulatory cytokines in RTR with low creatinine levels as well as a peak of IL-6 pro-inflammatory cytokine in patients with high creatinine levels. C1 and C3 groups showed a mixed pro-inflammatory (IL-8, IL-6, IL-1β, TNF-α, IL-12 and IFN-γ) and regulatory (IL-4, IL-5 and IL-10) cytokine pattern and C2 had a predominant pro-inflammatory profile. C3 group showed a higher frequency of high pro-inflammatory cytokine producers compared to C1.
Our data suggest that regulatory cytokines IL-4, IL-5 and IL-10 could be good biomarkers associated with stable renal function, while pro-inflammatory cytokines seems to be potential markers in RTR related to high creatinine plasma levels, specially IL-6 despite of its borderline values.
维持肾移植受者(RTR)稳定的移植肾功能对医护人员来说是一项挑战。理想的生物标志物必须具有显著的预测价值,以监测肾移植后引发的复杂肾功能反应。本研究的主要目的是评估调节性细胞因子和促炎细胞因子作为亲属活体肾移植患者移植肾功能生物标志物的情况。
通过流式细胞术检测120例亲属活体肾移植患者血浆中调节性细胞因子和促炎细胞因子的水平,这些患者根据血肌酐水平分为三组:血肌酐低于1.4mg/dL(C1组)、血肌酐在1.4 - 2.0mg/dL之间(C2组)和血肌酐高于2.0mg/dL(C3组)。患者还被分为“低”或“高”细胞因子产生者。临床数据来自患者的病历。
我们发现血肌酐水平低的RTR中调节性细胞因子出现峰值,而血肌酐水平高的患者中促炎细胞因子IL-6出现峰值。C1组和C3组呈现促炎(IL-8、IL-6、IL-1β、TNF-α、IL-12和IFN-γ)和调节(IL-4、IL-5和IL-10)细胞因子混合模式,C2组以促炎特征为主。与C1组相比,C3组中高促炎细胞因子产生者的频率更高。
我们的数据表明,调节性细胞因子IL-4、IL-5和IL-10可能是与稳定肾功能相关的良好生物标志物,而促炎细胞因子似乎是RTR中与高血肌酐水平相关的潜在标志物,特别是IL-6,尽管其值处于临界值。