title: Early-onset coronary artery disease after pediatric kidney transplantation: implicating the angiogenesis inhibitor, endostatin.
abstract: Pediatric kidney transplant recipients have a higher rate of coronary artery disease (CAD) as adults. The angiogenesis inhibitor, endostatin, has been implicated in the development of atherosclerosis. Endostatin levels will vary between adult patients who received a kidney transplant as a child. We conducted a study in young adult patients who had undergone pediatric kidney (n = 12) or liver transplantation (n = 8). Coronary arterial calcification was measured using electron beam CT. Values were compared with age-matched control subjects from an epidemiologic database. Serum endostatin levels were measured using enzyme-linked immunosorbent assay. Risk factors for atherosclerosis were assessed. Kidney transplant recipients had a higher rate of CAD compared with liver transplant recipients (33 vs 0%, P = 0.03). Mean (± standard error of mean) serum endostatin levels were higher in kidney transplant recipients compared with liver transplant recipients (26 ± 7 vs 14 ± 3 ng/mL, P = 0.04) and control subjects (26 ± 7 vs 11 ± 1 ng/mL, P = 0.01). Pediatric kidney transplantation is associated with a higher rate of adult-onset CAD compared with liver transplantation. Endostatin levels were greater in kidney transplant recipients compared with liver transplant recipients and healthy control subjects. Endostatin may play a role in the development of atherosclerosis after kidney transplantation and may serve as a biomarker for atherosclerotic disease.
authors.affiliation: Department of Surgery, Children’s Mercy Hospitals and Clinics, Kansas City, Missouri, USA. cwiqbal@yahoo.com
authors.forename: Corey W
authors.initials: CW
authors.lastname: Iqbal
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Dean
authors.forename: Michael B
authors.initials: MB
authors.lastname: Ishitani
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D020533:Angiogenesis Inhibitors / Q000097:blood; D050197:Atherosclerosis / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000503:physiopathology*; D043169:Endostatins / Q000097:blood / Q000502:physiology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D017741:Survivors; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors; D015415:Biomarkers; D043169:Endostatins