Lack of correlation of soluble E-selectin level with renal transplant rejection.
E-Selectin is a 115-kDa cell surface glycoprotein transiently expressed on vascular endothelium in response to interleukin-1 and tumour necrosis factor-alpha with a peak in expression at four hours. Its distribution in transplant biopsies has been associated with inflammatory events such as allograft rejection. Recently, a soluble isoform of E-selectin has been detected in the culture medium of cytokine activated endothelial cells by an ELISA method. In this study soluble E-selectin levels in renal allograft recipients were compared with the incidence of rejection, acute tubular necrosis (ATN), cyclosporin A (CyA) toxicity, and use of orthoclone OKT3 (muromonab-CD3) to establish whether early endothelial activation and inflammatory damage could be detected. The mean soluble E-selectin level in normal volunteers was 89 ng/ml serum compared to 120 ng/ml for a group of chronic renal failure patients. Soluble E-selectin levels declined upon transplantation but this was not significant, nor was the difference in samples from patients experiencing rejection, ATN or CyA toxicity. A dramatic and sustained rise in soluble E-selectin levels was found within 24 hours of the first dose of OKT3 treatment. This study shows that soluble E-selectin does not provide early unequivocal indication of pathological sequelae in renal transplantation, although extensive endothelial activation can be demonstrated with OKT3 treatment.
Weston
S D
SD
Department of Surgery, Leicester General Hospital, UK.
Lycett
A E
AE
Edwards
C
C
Morgan
J D
JD
Horsburgh
T
T
Veitch
P S
PS
Bell
P R
PR
D015415:Biomarkers; D019040:E-Selectin / Q000097:blood*; D006084:Graft Rejection / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000276:immunology; D016030:Kidney Transplantation / Q000276:immunology*; D015166:Monitoring, Immunologic
D015415:Biomarkers; D019040:E-Selectin