Alcalde G, Merino J, Sanz S, Zubimendi J A, Ruiz J C, Torrijos J, de Francisco A L, Cotorruelo J G, López-Hoyos M, Novo M J
Nephrology Services, University Hospital Marqués de Valdecilla, Santander, Spain.
Transplantation. 1995 Jun 27;59(12):1695-9. doi: 10.1097/00007890-199506270-00009.
Adhesion molecules appear on leukocytes and endothelial cells mediating the localization and migration of leukocytes to sites of inflammation. Rejecting kidney grafts have shown an increased expression of these molecules. Recent reports have detected in serum soluble forms of adhesion molecules that could play a role in regulating inflammation. We have measured by ELISA the circulating serum levels of ICAM-1, VCAM-1 and E-selectin in: 23 controls, 33 chronic renal failure patients (CRF), 20 hemodialysis patients (HD), 17 samples from 6 patients with stable kidney graft function (STx), 25 samples from 8 patients with steroid-responsive rejection proven by biopsy, and 28 samples from 9 patients with steroid-resistant rejection and good response to OKT3. There was not a rise in cICAM-1 or cE-selectin levels during rejection compared with the steady phase before and after rejection. In the case of cVCAM-1, only the OKT3 group showed increased rejection levels (P < 0.05) that were maintained after rejection. For ICAM-1, CRF and HD groups had higher levels than the remaining groups. cVCAM-1 levels were elevated in all groups when compared with control, furthermore, OKT3 and HD groups had higher levels than the STx, CRF, or steroid-responsive groups. For cE-selectin, we only found differences between the CRF and both rejection groups. Serum creatinine correlated significantly with c-ICAM-1 and cVCAM-1 R = 0.30 and R = 0.22), but not with cE-selectin. We conclude that soluble adhesion molecules levels are not valuable markers for rejection. Patients with chronic renal failure have increased levels of adhesion molecules, which could reflect an impaired elimination.
黏附分子出现在白细胞和内皮细胞上，介导白细胞向炎症部位的定位和迁移。移植肾排斥反应中这些分子的表达增加。最近的报告在血清中检测到可溶性黏附分子形式，其可能在调节炎症中发挥作用。我们通过酶联免疫吸附测定法（ELISA）测量了以下人群血清中细胞间黏附分子-1（ICAM-1）、血管细胞黏附分子-1（VCAM-1）和E-选择素的循环水平：23名对照组、33名慢性肾衰竭患者（CRF）、20名血液透析患者（HD）、来自6名移植肾功能稳定患者（STx）的17份样本、来自8名经活检证实为类固醇反应性排斥患者的25份样本，以及来自9名类固醇抵抗性排斥且对OKT3反应良好患者的28份样本。与排斥反应前后的稳定期相比，排斥反应期间循环ICAM-1或循环E-选择素水平没有升高。对于循环VCAM-1，只有OKT3组在排斥反应期间显示水平升高（P<0.05），且在排斥反应后仍维持升高。对于ICAM-1，CRF组和HD组的水平高于其他组。与对照组相比，所有组的循环VCAM-1水平均升高，此外，OKT3组和HD组的水平高于STx组、CRF组或类固醇反应性组。对于循环E-选择素，我们仅发现CRF组与两个排斥组之间存在差异。血清肌酐与循环ICAM-1和循环VCAM-1显著相关（R = 0.30和R = 0.22），但与循环E-选择素无关。我们得出结论，可溶性黏附分子水平不是排斥反应的有价值标志物。慢性肾衰竭患者的黏附分子水平升高，这可能反映了清除功能受损。
