Critical Care Medicine, First Affiliated Hospital of Nanchang University, Nanchang, China.
Department of General Surgery, First Affiliated Hospital of Nanchang University, Nanchang, China.
Front Immunol. 2019 May 15;10:1046. doi: 10.3389/fimmu.2019.01046. eCollection 2019.
B cell activating factor (BAFF) belonging to TNF family is a cytokine that enhances B-cell proliferation and differentiation. Recently, It has been suggested that BAFF might be a potential therapeutic target for treating autoimmune disease. However, the relationship between BAFF and allograft rejection is controversial, and the clinical significance of BAFF in predicting allograft rejection need to be further explored. We conducted 6-month follow-up study to confirm the hypothesis that BAFF might be a risk factor for predicting acute rejection in kidney transplant recipients. At the end of the study, a total of 155 kidney transplant recipients were recruited from October 2015 to October 2017, and classified into acute rejection group ( = 34) and stable renal function group ( = 121) according to their clinical course. We demonstrate that the serum BAFF levels when acute rejection occurred was significantly higher than that in the stable renal function group (2426.19 ± 892.19 vs. 988.17 ± 485.63 pg/mL, < 0.05). BAFF expression was significantly enhanced in the membrane and cytoplasm of renal tubule epithelial cells in the transplant kidney tissue with acute rejection, and a positive correlation between BAFF and C4d expression was also observed ( = 0.880, = 0.001). ROC analyses highlight the superiority of serum BAFF level before transplant over those on other post-transplant days in prediction of acute rejection episodes. The sensitivity, specificity and AUC (area under curve) were 83.3, 89.5, and 0.886%, respectively. Kaplan-Meier survival analysis showed that recipients with higher pretransplant BAFF levels had higher acute rejection incidence ( = 0.003). In conclusion, we have identified that BAFF levels are associated with the acute rejection and could be a promising biomarker to predict kidney transplant rejection risks.
B 细胞激活因子（BAFF）属于 TNF 家族，是一种细胞因子，可增强 B 细胞的增殖和分化。最近，有人提出 BAFF 可能是治疗自身免疫性疾病的潜在治疗靶点。然而，BAFF 与同种异体移植排斥反应的关系存在争议，BAFF 预测同种异体移植排斥反应的临床意义需要进一步探讨。我们进行了为期 6 个月的随访研究，以证实 BAFF 可能是预测肾移植受者急性排斥反应的危险因素这一假设。研究结束时，我们从 2015 年 10 月至 2017 年 10 月共招募了 155 例肾移植受者，根据临床病程将其分为急性排斥反应组（n = 34）和肾功能稳定组（n = 121）。我们发现，发生急性排斥反应时的血清 BAFF 水平明显高于肾功能稳定组（2426.19 ± 892.19 比 988.17 ± 485.63 pg/ml， < 0.05）。急性排斥反应移植肾组织中肾小管上皮细胞的膜和细胞质中 BAFF 表达明显增强，且 BAFF 与 C4d 表达呈正相关（ = 0.880， = 0.001）。ROC 分析突出了移植前血清 BAFF 水平在预测急性排斥反应发作方面优于其他移植后天数的优势。敏感性、特异性和 AUC（曲线下面积）分别为 83.3%、89.5%和 0.886%。Kaplan-Meier 生存分析表明，移植前 BAFF 水平较高的受者急性排斥发生率较高（ = 0.003）。总之，我们已经确定 BAFF 水平与急性排斥反应有关，可能是预测肾移植排斥反应风险的有前途的生物标志物。
