Fuentes-Orozco Clotilde, Garcia-Salazar Sara Jazmín, Gómez-Navarro Benjamín, González-Espinoza Eduardo, Zepeda-González Alonso, Ramírez-Robles Juan Narciso, Castañeda-Espinoza Rafael, Yáñez-Sánchez Irinea, Gálvez-Gastelum Francisco Javier, Cervantes-Guevara Gabino, Cervantes-Cardona Guillermo Alonso, Contreras-Hernández Guadalupe Ivette, Pérez-Landeros Jacob Esau, García-Martinez David, González-Ojeda Alejandro
Biomedical Research Unit 02, Specialties Hospital, Western National Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico.
Health Sciences University Center, University of Guadalajara, Guadalajara, Jalisco, Mexico.
Ann Transplant. 2018 Jun 29;23:442-449. doi: 10.12659/AOT.908521.
BACKGROUND Recent studies have demonstrated that statins have anti-inflammatory and immunomodulatory properties, which could be considered beneficial in kidney transplantations. This study assesses the anti-inflammatory effect of atorvastatin on the kidney grafts of living donor transplants. MATERIAL AND METHODS In a randomized clinical trial, kidney donors were divided into 2 groups. The study group constituted 24 donors who received 40 mg atorvastatin, and 24 donors who received a placebo control, 4 weeks prior to transplantation. Serum C-reactive protein (CRP) levels were measured before and after atorvastatin administration. CRP and renal function of kidney recipients were measured at baseline and 1, 6, and 24 hours after transplantation. RESULTS After 4 weeks of treatment, the CRP level was 5.62±3.82 mg/dL in the control group and 3.27±0.62 mg/dL in the study group (P=0.007). Upon reperfusion, CRP levels in recipients at 1 hour were, 5.8±3.9 and 3.8±1.0 mg/dL, respectively (P=0.04). Twenty-four hours after the kidney transplantations, serum creatinine levels were 2.5±1.5 mg/dL in the study group and 3.7±2.4 mg/dL in the control group (P=0.04). CONCLUSIONS Our study suggests that the use of atorvastatin prior to allograft procurement of kidney transplant, reduces the acute kidney inflammatory burden profile, and promotes an improved kidney function recovery following transplantation.
背景 近期研究表明，他汀类药物具有抗炎和免疫调节特性，这在肾移植中可能被认为是有益的。本研究评估阿托伐他汀对活体供体肾移植受者肾脏移植物的抗炎作用。
材料与方法 在一项随机临床试验中，将肾供体分为2组。研究组由24名在移植前4周接受40毫克阿托伐他汀的供体和24名接受安慰剂对照的供体组成。在给予阿托伐他汀之前和之后测量血清C反应蛋白（CRP）水平。在基线以及移植后1、6和24小时测量肾移植受者的CRP和肾功能。
结果 治疗4周后，对照组的CRP水平为5.62±3.82毫克/分升，研究组为3.27±0.62毫克/分升（P = 0.007）。再灌注时，受者在1小时时的CRP水平分别为5.8±3.9和3.8±1.0毫克/分升（P = 0.04）。肾移植24小时后，研究组的血清肌酐水平为2.5±1.5毫克/分升，对照组为3.7±2.4毫克/分升（P = 0.04）。
结论 我们的研究表明，在肾移植的同种异体移植物获取之前使用阿托伐他汀，可减轻急性肾脏炎症负担，并促进移植后肾功能的改善恢复。
