Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland; Laboratory of Centre for Preclinical Research, Department of Experimental and Clinical Physiology, Medical University of Warsaw, Warsaw, Poland
Pol Arch Intern Med. 2019 Sep 30;129(9):592-597. doi: 10.20452/pamw.14926. Epub 2019 Aug 7.
Early prognostic markers that identify high‑risk kidney transplant recipients may lead to optimization of immunosuppressive therapy and improved long‑term outcomes.
The aim of this study was to assess whether the measurement of urinary concentrations of CCL2 and CXCL10 chemokines can be a valuable noninvasive tool for identifying ongoing pathological processes in a kidney allograft.
The study included 40 patients who underwent a protocol biopsy within 1‑year post kidney transplant. The urinary concentrations of CCL2 and CXCL10 with reference to creatinine in urine were assayed in all patients. On the basis of biopsy results, a study group was selected (n = 25), including patients with a diagnosis of interstitial fibrosis and tubular atrophy grades II to III (n = 16), BK virus (BKV) nephropathy (n = 4), or mild inflammatory lesions fulfilling the criteria for mild rejection processes or borderline lesions (n = 11). Patients with normal biopsy results were included in a control group (n = 15).
The ratio of CCL2 to creatinine (CCL2:Cr) was a significant independent predictor of BKV ephropathy (odds ratio, 1.1; 95% CI, 1.0-1.2; P = 0.04). The CXCL10:Cr ratio was not found to be an independent predictor of BKV nephropathy (odds ratio, 1.3; 95% CI, 0.99-1.71; P = 0.06).
The CCL2:Cr and CXCL10:Cr ratios may predict BKV nephropathy. The diagnostic value of CCL2 and CXCL10 in BKV infection should be further evaluated.
早期能够预测风险的移植肾标志物可以指导免疫抑制剂的优化使用，改善长期预后。
本研究旨在评估尿趋化因子 CCL2 和 CXCL10 浓度能否作为一种有价值的非侵入性工具，用于识别移植肾中的持续病理过程。
本研究纳入了 40 例在肾移植后 1 年内接受方案活检的患者。所有患者均检测了尿 CCL2 和 CXCL10 与肌酐的比值。根据活检结果选择研究组（n = 25），包括间质纤维化和肾小管萎缩 Ⅱ-Ⅲ级（n = 16）、BK 病毒（BKV）肾病（n = 4）或轻度炎症病变符合轻度排斥反应过程或边界病变标准（n = 11）的患者。将活检结果正常的患者纳入对照组（n = 15）。
CCL2 与肌酐的比值（CCL2:Cr）是 BKV 肾病的独立预测因子（比值比，1.1；95%置信区间，1.0-1.2；P = 0.04）。CXCL10:Cr 比值不是 BKV 肾病的独立预测因子（比值比，1.3；95%置信区间，0.99-1.71；P = 0.06）。
CCL2:Cr 和 CXCL10:Cr 比值可能预测 BKV 肾病。CCL2 和 CXCL10 在 BKV 感染中的诊断价值需要进一步评估。
