title: sCD30 and neopterin as risk factors of chronic renal transplant rejection: impact of cyclosporine A, tacrolimus, and mycophenolate mofetil.
abstract: High pretransplantation sCD30 levels have been shown to be associated with lower 5-year kidney graft survival in mainly Cyclosporine A (CsA)-treated recipients (Collaborative Transplant Study database). To analyze the effect of different immunosupressive regimens (CsA/Azathioprine [Aza], CsA/Mycophenolate Mofetil [MMF], Tacrolimus [Tacr]/Aza) on sCD30, we assessed serum sCD30 and neopterin together with in vitro cytokine responses in a prospective randomized study of 84 renal transplant recipients before, 4 months, and 1 year after transplantation. Panel-reactive antibody (PRA) formation, HLA matching, ATG induction therapy, and acute rejections had no impact on sCD30 levels, whereas cytomegalovirus (CMV) infections induced an up-regulation of sCD30 4 months posttransplantation (P = .003). Whereas MMF showed no effect on sCD30 compared with Aza therapy, we found a significant impact of Tacr versus CsA treatment (1-year sCD30 > or = 60 U/mL: 14/42 (33%), CsA; 1/38 (3%), Tacr; P < .0005). Chronic rejection 2 years posttransplantation was associated with elevated 1-year sCD30 (P = .001) and neopterin levels (P = .006). Our data indicate that the Th2 activation marker sCD30 provides a risk factor for chronic rejection independent of classical immunological risk factors and may be down-regulated using Tacr treatment.
authors.affiliation: Department of Internal Medicine, University of Giessen, Giessen, Germany. rolf.weimer@innere.med.uni-giessen.de
authors.forename: R
authors.initials: R
authors.lastname: Weimer
authors.forename: C
authors.initials: C
authors.lastname: Süsal
authors.forename: S
authors.initials: S
authors.lastname: Yildiz
authors.forename: S
authors.initials: S
authors.lastname: Streller
authors.forename: S
authors.initials: S
authors.lastname: Pelzl
authors.forename: A
authors.initials: A
authors.lastname: Staak
authors.forename: F
authors.initials: F
authors.lastname: Renner
authors.forename: H
authors.initials: H
authors.lastname: Dietrich
authors.forename: V
authors.initials: V
authors.lastname: Daniel
authors.forename: E
authors.initials: E
authors.lastname: Feuring
authors.forename: S
authors.initials: S
authors.lastname: Kamali-Ernst
authors.forename: W
authors.initials: W
authors.lastname: Ernst
authors.forename: W
authors.initials: W
authors.lastname: Padberg
authors.forename: G
authors.initials: G
authors.lastname: Opelz
mesh_terms: D015703:Antigens, CD / Q000097:blood; D002908:Chronic Disease; D016572:Cyclosporine / Q000627:therapeutic use*; D016207:Cytokines / Q000276:immunology; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology* / Q000276:immunology; D006085:Graft Survival / Q000187:drug effects / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017730:Ki-1 Antigen / Q000097:blood*; D016030:Kidney Transplantation / Q000276:immunology*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012307:Risk Factors; D016559:Tacrolimus / Q000627:therapeutic use*
chemical_list: D015703:Antigens, CD; D016207:Cytokines; D007166:Immunosuppressive Agents; D017730:Ki-1 Antigen; D016572:Cyclosporine; D009173:Mycophenolic Acid; D016559:Tacrolimus