可溶性 Tim-3/Gal-9 作为肾移植后不良结局的预测因子：一项队列研究。
Soluble Tim-3/Gal-9 as predictors of adverse outcomes after kidney transplantation: A cohort study.
机构信息
Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Wuhou District, Chengdu, Sichuan, China.
Department of Urology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Wuhou District, Chengdu, Sichuan, China.
出版信息
Clin Biochem. 2022 Apr;102:19-25. doi: 10.1016/j.clinbiochem.2021.12.010. Epub 2021 Dec 27.
BACKGROUND
In our previous study, serum soluble T-cell immunoglobulin and mucin structure-3 (sTim-3) and galactosin-9 (sGal-9) were found to be associated with renal function after kidney transplantation. However, it is unclear whether these two indicators can predict adverse outcomes after transplantation.
METHODS
Ninety-one recipients of kidney transplantation were enrolled and divided into a stable group and an adverse outcome group (consisting of biopsy-proven rejection, graft loss, death and clinically diagnosed rejection). The expression levels of sTim-3 and sGal-9 before (pre-Tim-3 and pre-Gal-9) and one month after transplantation (post-Tim-3 and post-Gal-9) were measured by ELISA.
RESULTS
The level of pre-Tim-3 was significantly higher in the stable group than in the adverse outcome group [median (range), 2275 (840-4236) pg/mL vs. 1589 (353-3094) pg/mL, P = 0.002]. The level of post-Gal-9 was significantly lower in the stable group than in the adverse outcome group [median (range), 4869 (1418-13080) pg/mL vs. 6852: (4128-10760) pg/mL, P = 0.003]. The areas under the curve (AUCs) for pre-Tim-3 and post-Gal-9 were 0.737 (P = 0.002) and 0.751 (P = 0.003), respectively, better than AUC of post-eGFR (0.633) (P = 0.071), according to the receiver operating characteristic (ROC) curve. Through Cox regression analysis, including pre-Tim-3, post-Gal-9, post-eGFR, sex, age, BMI of recipients and donors, pre-Tim-3 and post-Gal-9 were independent risk factors for adverse outcomes after kidney transplantation (P = 0.016, P = 0.033, respectively).
CONCLUSION
Serum sTim-3 and sGal-9 can predict adverse outcomes within two years after kidney transplantation.
背景
在我们之前的研究中，发现血清可溶性 T 细胞免疫球蛋白和粘蛋白结构域 3（sTim-3）和半乳糖凝集素-9（sGal-9）与肾移植后的肾功能有关。然而，目前尚不清楚这两个指标是否可以预测移植后的不良结局。
方法
本研究纳入 91 例肾移植受者，分为稳定组和不良结局组（包括活检证实的排斥反应、移植物丢失、死亡和临床诊断的排斥反应）。采用 ELISA 法检测移植前（pre-Tim-3 和 pre-Gal-9）和移植后 1 个月（post-Tim-3 和 post-Gal-9）血清 sTim-3 和 sGal-9 的表达水平。
结果
稳定组患者的 pre-Tim-3 水平明显高于不良结局组[中位数（范围），2275（840-4236）pg/ml 比 1589（353-3094）pg/ml，P=0.002]。稳定组患者的 post-Gal-9 水平明显低于不良结局组[中位数（范围），4869（1418-13080）pg/ml 比 6852（4128-10760）pg/ml，P=0.003]。根据受试者工作特征（ROC）曲线，pre-Tim-3 和 post-Gal-9 的 AUC 分别为 0.737（P=0.002）和 0.751（P=0.003），优于 post-eGFR 的 AUC（0.633）（P=0.071）。通过 Cox 回归分析，包括 pre-Tim-3、post-Gal-9、post-eGFR、受者和供者的性别、年龄、BMI 等，pre-Tim-3 和 post-Gal-9 是肾移植后不良结局的独立危险因素（P=0.016、P=0.033）。
结论
血清 sTim-3 和 sGal-9 可预测肾移植后 2 年内的不良结局。
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