The use of NGAL and IP-10 in the prediction of early acute rejection in highly sensitized patients following HLA-incompatible renal transplantation.
Acute rejection is a significant problem for patients undergoing HLA-incompatible renal transplantation, affecting between 12 and 53% of patients. Any mechanism of detecting rejection in advance of current methods would offer significant benefit. This study aimed to evaluate whether serum biomarkers could predict rejection in HLAi transplants recipients. Sera from 94 HLAi transplant recipients from a single centre were analysed for a panel of biomarkers including: NGAL, KIM-1, IP-10, cystatin C, cathepsin L and VEGF. Biomarker levels pre-operatively, day 1 and at day 30 post-transplant were correlated with the development of early rejection. Significantly higher levels of IP-10 and NGAL were seen on day 1 following transplant in those patients who developed acute rejection (P < 0.001 and 0.005) and generated AUC of 0.73 and 0.67, respectively. No differences were seen for the other biomarkers or at the other time points. In this study cohort, IP-10 and NGAL have demonstrated good predictive ability for the development of acute rejection at a very early time point. They may have a role in identifying patients at higher risk for rejection and stratifying immunosuppression or surveillance.
Department of Renal Transplantation, University Hospital Birmingham Foundation Trust, Edgbaston, UK.
Melanie
M
Field
David
D
Lowe
Mark
M
Cobbold
Robert
R
Higgins
David
D
Briggs
Nicholas
N
Inston
Andrew R
AR
Ready
D000208:Acute Disease; D000209:Acute-Phase Proteins; D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D054357:Chemokine CXCL10 / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection / Q000097:blood* / Q000209:etiology*; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011518:Proto-Oncogene Proteins / Q000097:blood*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
D000209:Acute-Phase Proteins; D015415:Biomarkers; C114753:CXCL10 protein, human; D054357:Chemokine CXCL10; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins
HLA; IP-10; NGAL; kidney transplant; rejection