Gastroenterology, Nephrourology and Surgery Clinic, Faculty of Medicine, Vilnius University, LT03101 Vilnius, Lithuania.
Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, LT44307 Kaunas, Lithuania.
Medicina (Kaunas). 2024 Jun 20;60(6):1016. doi: 10.3390/medicina60061016.
: Endobiogeny is a global systems approach to human biology based on the concept that the endocrine system manages the metabolism. Biology of function (BoF) indices are diagnostic tools in endobiogenic medicine that reflect the action of the endocrine system on the cells and the metabolic activity of an organism. Kidney transplant recipients are a very specific patient population due to their constant use of immunosuppressive agents such as steroids and anamnesis of chronic kidney disease. The aim of this study was to assess the tendencies of endobiogenic BoF indices in a kidney transplant recipient population and to determine the relationship between BoF index values and histology-proven kidney transplant rejection. : A total of 117 kidney transplant recipients undergoing surveillance or indication allograft biopsy were included in this study. Endobiogenic BoF indices were calculated from complete blood count tests taken before the kidney biopsy. Histology samples were evaluated by an experienced pathologist according to the Banff classification system. Clinical and follow-up data were collected from an electronic patient medical record system. : Overall, <35% of the patients had BoF index values assumed to be normal, according to the general population data. Additionally, >50% of the patients had lower-than-normal adaptation, leucocyte mobilization, genital, and adjusted genital ratio indices, while the Cata-Ana, genito-thyroid ratio, adrenal gland, and cortisol indices were increased in >50% of the transplant recipients. The adaptation index was significantly higher in patients with biopsy-proven transplant rejection and demonstrated an AUC value of 0.649 (95%CI 0.540-0.759) for discriminating rejectors from patients without transplant rejection. : Most of the kidney transplant recipients had abnormal BoF index values, reflecting increased corticotropic effects on their cells. The adaptation index distinguished patients with biopsy-proven transplant rejection from those without it.
: 内发生物学是一种基于内分泌系统管理新陈代谢的概念的全球系统方法，用于研究人类生物学。功能生物学 (BoF) 指数是内发生物医学中的诊断工具，反映了内分泌系统对细胞的作用和生物体的代谢活性。由于肾移植受者持续使用免疫抑制剂（如类固醇）并且有慢性肾病病史，因此他们是一个非常特殊的患者群体。本研究旨在评估肾移植受者群体中内发生物 BoF 指数的趋势，并确定 BoF 指数值与组织学证实的肾移植排斥之间的关系。 : 本研究共纳入 117 名接受监测或指征性同种异体肾活检的肾移植受者。从肾活检前进行的全血细胞计数测试中计算出内发生物 BoF 指数。组织学样本由一位经验丰富的病理学家根据 Banff 分类系统进行评估。临床和随访数据从电子患者病历系统中收集。 : 总体而言，根据一般人群数据，<35%的患者的 BoF 指数值被认为正常。此外，>50%的患者的白细胞动员、生殖和调整生殖比指数低于正常，而 Cata-Ana、生殖-甲状腺比、肾上腺和皮质醇指数在>50%的移植受者中增加。在组织学证实的移植排斥患者中，适应指数显著更高，其 AUC 值为 0.649（95%CI 0.540-0.759），可区分排斥者和无移植排斥者。 : 大多数肾移植受者的 BoF 指数值异常，反映了细胞的促皮质激素作用增加。适应指数可区分组织学证实的移植排斥患者和无移植排斥患者。
