Association of amino-terminal propeptide of type III procollagen and acute myocardial rejection in male patients receiving heart transplantation.
BACKGROUND
The amino-terminal propeptides of type I and III procollagens (PINP and PIIINP) are markers reflecting the status of collagen turnover. We hypothesized that measurement of these serum procollagen propeptides could be used to non-invasively assess acute rejection in heart transplant recipients.


METHODS
In heart transplant recipients, endomyocardial biopsy specimens taken at 6 and 12 months after surgery were used for study. PINP and PIIINP were measured postoperatively at 3, 6, and 12 months.


RESULTS
A total of 20 male heart transplant patients and seven male control subjects were enrolled. Five patients showed rejection 6 months after transplantation (group 1), while 15 patients showed no rejection (group 2). In group 2 patients, serum PINP and PIIINP levels decreased significantly 6 months after transplantation. In contrast, elevation of serum PINP and PIIINP levels persisted in group 1 patients 6 months after transplantation. At 6 months after transplantation, group 1 patients had significantly higher PIIINP levels than group 2 patients (p=0.025) and controls (p=0.003). After immunosuppressive therapy, all group 1 patients were free of rejection 12 months after transplantation and serial serum PIIINP levels decreased significantly in these patients.


CONCLUSIONS
Serum PIIINP levels represent a non-invasive method to reflect the occurrence and resolution of acute rejection.
Lin
Yen-Hung
YH
Department of Internal Medicine, Division of Cardiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Liu
Chung-Pin
CP
Hsu
Ron-Bin
RB
Lee
Chi-Ming
CM
Wang
Shoei-Shen
SS
Kao
Hsien-Li
HL
Chao
Chia-Lun
CL
Shiau
Yu-Chien
YC
Hung
Chi-Sheng
CS
Liao
Lin-Chu
LC
Ho
Yi-Lwun
YL
D006084:Graft Rejection / Q000175:diagnosis* / Q000188:drug therapy; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011347:Procollagen / Q000097:blood*; D011379:Prognosis
D007166:Immunosuppressive Agents; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide