Decreasing plasma soluble IL-1 receptor antagonist and increasing monocyte activation early post-transplant may be involved in pathogenesis of delayed graft function in renal transplant recipients.
Delayed graft function (DGF) increases the risk of acute allograft rejection and may affect long-term graft survival. We compared pre-transplant, early post-transplant, and late post-transplant serum creatinine (Cr) and plasma levels of neopterin, cytokines, and cytokine receptors/antagonists in patients with DGF (n = 39), slow graft function (SGF) (n = 43), or immediate graft function (IGF) (n = 30). Three and eight days post-transplant, plasma neopterin (p < 0.001; p < 0.001), Soluble Interleukin-6 (IL-6) receptor (R) (p = 0.002; p = 0.001), and IL-10 (p = 0.003; p = 0.001) were higher in DGF than IGF patients. One month post-transplant, plasma neopterin (p < 0.001) and IL-10 (p < 0.001) were higher in DGF than IGF patients. Three days post-transplant, the results indicated reduced sIL-1 receptor antognist (RA) production in DGF patients (p = 0.001). Simultaneously, plasma sIL-6R and IL-10 increased in DGF (p < 0.001; p = 0.003) and SGF (p = 0.007; p = 0.030) patients, indicating increased production of sIL-6R and IL-10. Lower sIL-1 production in DGF than IGF patients early post-transplant might promote the increased production of monocyte-derived neopterin, sIL-6R, and IL-10. This monocyte/macrophage activation might induce inflammation in the graft and subsequently cause an impairment of graft function. Blocking of monocyte activity after renal transplantation may be considered a potential approach for improving graft outcome.
Sadeghi
Mahmoud
M
Department of Transplantation Immunology, University of Heidelberg, D-69120 Heidelberg, Germany. Mahmoud.Sadeghi@med.uni-heidelberg.de
Daniel
Volker
V
Naujokat
Cord
C
Schmidt
Jan
J
Mehrabi
Arianeb
A
Zeier
Martin
M
Opelz
Gerhard
G
D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function / Q000097:blood* / Q000209:etiology; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000097:blood*; D007375:Interleukin-1 / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D011184:Postoperative Period; D057234:Preoperative Period; D017472:Receptors, Interleukin-1 / Q000097:blood; D019947:Receptors, Interleukin-6 / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D053590:Interleukin 1 Receptor Antagonist Protein; D007375:Interleukin-1; D015850:Interleukin-6; D017472:Receptors, Interleukin-1; D019947:Receptors, Interleukin-6; D016753:Interleukin-10; D003404:Creatinine