Local expression of C-reactive protein is associated with deteriorating graft function in acute and chronic failure of kidney transplants.
BACKGROUND
C-reactive protein (CRP) is a key molecule in inflammation and tissue homeostasis and is produced locally by renal tubular epithelial cells. Its significance of expression in contrast to expression of cytotoxic T cell (CTL) markers remains to be elucidated.


METHODS
By means of real-time PCR, we determined mRNA levels of CRP in 66 renal allograft biopsies with acute allograft failure and in 34 biopsies with chronic dysfunction. Results were compared to expression of CTL components (perforin, granzyme B) and were correlated with histologic diagnoses and outcome.


RESULTS
CTL markers were found in most biopsies, and thus were not specific for particular histologies, although expression levels increased significantly with Banff rejection grades. Expression of CRP was highly specific for rejection episodes in acute failure (p < 0.0001) as well as for transplant glomerulopathy or de novo/recurrent glomerulonephritis in chronic failure (p < 0.005). Finally, the presence of CRP expression in renal allografts was associated with a deteriorating 1-year graft function in acute (p < 0.01) as well as chronic allograft dysfunction (p = 0.077).


CONCLUSIONS
Our data suggest local CRP expression of kidney transplants as an indicator for pathologic entities associated with unfavorable outcomes in the early and late course of kidney transplants.
Department of Medicine I, Division of Nephrology, School of Medicine, University of Lübeck, Lübeck, Germany.
Wolfram J
WJ
Jabs
Markus
M
Meier
Peter
P
Lamprecht
Juergen
J
Steinhoff
Martin
M
Nitschke
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000096:biosynthesis*; D002908:Chronic Disease; D005260:Female; D005786:Gene Expression Regulation; D006084:Graft Rejection / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D007668:Kidney / Q000378:metabolism*; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000096:biosynthesis; D014184:Transplantation, Homologous
D012333:RNA, Messenger; D002097:C-Reactive Protein