Noro Daisuke, Yoneyama Tohru, Hatakeyama Shingo, Tobisawa Yuki, Mori Kazuyuki, Hashimoto Yasuhiro, Koie Takuya, Tanaka Masakazu, Nishimura Shin-Ichiro, Sasaki Hideo, Saito Mitsuru, Harada Hiroshi, Chikaraishi Tatsuya, Ishida Hideki, Tanabe Kazunari, Satoh Shigeru, Ohyama Chikara
Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan.
Int J Mol Sci. 2017 Aug 8;18(8):1731. doi: 10.3390/ijms18081731.
We determined if the serum -glycan profile can be used as a diagnostic marker of antibody-mediated rejection (ABMR) in living donor kidney transplant (LKTx) recipients. Glycoblotting, combined with mass spectrometry, was used to retrospectively examine -glycan levels in the postoperative sera of 197 LKTx recipients of whom 16 recipients had ABMR with or without T-cell-mediated rejection (TCMR), 40 recipients had TCMR, and 141 recipients had no adverse events. Multivariate discriminant analysis for prediction of ABMR was performed by inputting an ABMR event as an explanatory variable and sex, age, and serum N-glycan level as objective variables. The N-glycan score was calculated by multiplying the level of candidate objective variables by objective function values. The ABMR predictive performance of the N-glycan score was assessed by receiver operator characteristic curve and Kaplan-Meier curve analyses. The -glycan score discriminated ABMR with 81.25% sensitivity, 87.85% specificity, and an area under the curve (AUC) of 0.892 that was far superior to that of preformed donor-specific antibody status (AUC, 0.761). Recipients with N-glycan-positive scores >0.8770 had significantly shorter ABMR survival than that of recipients with N-glycan-negative scores. Although the limitations of our study includ its small sample size and retrospective nature, the serum N-glycan score may contribute to prediction of ABMR.
我们确定血清聚糖谱是否可作为活体供肾移植（LKTx）受者抗体介导排斥反应（ABMR）的诊断标志物。采用糖印迹法结合质谱法，回顾性检测了197例LKTx受者术后血清中的聚糖水平，其中16例受者发生了伴或不伴T细胞介导排斥反应（TCMR）的ABMR，40例受者发生了TCMR，141例受者未发生不良事件。通过将ABMR事件作为解释变量，性别、年龄和血清N聚糖水平作为客观变量，进行多变量判别分析以预测ABMR。N聚糖评分通过将候选客观变量的水平乘以目标函数值来计算。通过受试者操作特征曲线和Kaplan-Meier曲线分析评估N聚糖评分对ABMR的预测性能。聚糖评分对ABMR的判别灵敏度为81.25%，特异性为87.85%，曲线下面积（AUC）为0.892，远优于预先形成的供者特异性抗体状态（AUC，0.761）。N聚糖阳性评分>0.8770的受者ABMR存活时间明显短于N聚糖阴性评分的受者。尽管我们的研究存在样本量小和回顾性的局限性，但血清N聚糖评分可能有助于ABMR的预测。
