title: Urinary fractalkine is a marker of acute rejection.
abstract: Chemokines and their receptors play an important role in the development of allograft rejection through directing mononuclear cell invasion of the graft. To study whether chemokine assays in the urine could prove to be predictive of acute rejection, we measured the urinary excretion of several chemokines, including fractalkine, chemokine monokine induced by interferon-gamma, interferon-gamma-inducible protein 10, macrophage inflammatory protein-3 alpha, granzyme B, and perforin in 215 allograft recipients and in 80 healthy control subjects. The 67 patients with acute rejection had significantly higher levels of all urinary chemokines compared to the healthy controls or patients having chronic allograft nephropathy but with stable renal function. Only changes in urinary fractalkine differentiated patients with acute rejection from those with acute tubular necrosis. The 7 patients who lost their grafts had greater urinary fractalkine, interferon-gamma, and macrophage inflammatory protein-3 alpha concentrations than those patients with reversible acute rejection. The area under the receiver operating characteristic curve for fractalkine was the best indicator among all of the markers differentiating 39 patients diagnosed with steroid-resistant from the 28 patients with steroid-sensitive acute rejection and in predicting graft loss. Our study shows that measuring urinary fractalkine levels is a noninvasive approach for detecting acute rejection where high levels were associated with steroid-resistance and poor outcome.
authors.affiliation: Kidney Disease Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China.
authors.forename: Wenhan
authors.initials: W
authors.lastname: Peng
authors.forename: Jianghua
authors.initials: J
authors.lastname: Chen
authors.forename: Yuguang
authors.initials: Y
authors.lastname: Jiang
authors.forename: Jianyong
authors.initials: J
authors.lastname: Wu
authors.forename: Zhangfei
authors.initials: Z
authors.lastname: Shou
authors.forename: Qiang
authors.initials: Q
authors.lastname: He
authors.forename: Yiming
authors.initials: Y
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.forename: Huiping
authors.initials: H
authors.lastname: Wang
mesh_terms: D000208:Acute Disease; D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine; D016022:Case-Control Studies; D054428:Chemokine CX3CL1 / Q000652:urine*; D018925:Chemokines / Q000276:immunology / Q000652:urine; D004351:Drug Resistance; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D013256:Steroids / Q000493:pharmacokinetics; D014184:Transplantation, Homologous
chemical_list: D015415:Biomarkers; D054428:Chemokine CX3CL1; D018925:Chemokines; D013256:Steroids