title: Investigation of apoptosis-related gene expression levels in preimplantation biopsies as predictors of delayed kidney graft function.
abstract: BACKGROUND
  The purpose of this study was to investigate the expression of the gene coding for the antiapoptotic molecule Bcl-2, the proapoptotic molecule Bax, and the apoptosis executor enzyme caspase-3 in preimplantation renal biopsies (PIB) as markers for delayed graft function.
  
  
  METHODS
  In this prospective single-center study, gene expression levels were evaluated using real-time TaqMan polymerase chain reaction in PIB of kidneys from 72 deceased donors (DDs) and 18 living donors (LDs).
  
  
  RESULTS
  CASP3 and BAX expression levels were higher, whereas those of BCL2 were lower, in DD than in LD PIB. In biopsies from DD, BCL2 levels were lower in cases with DGF, whereas no differences were observed concerning CASP3 and BAX. The BAX/BCL2 gene expression ratio greater than 2.29 associated with DGF with an odds ratio of 2.00. A multiple regression analysis including data of TLR4 expression in the first day posttransplant PB from a previous study of our group conducted in the same patients revealed a very strong association of the combination of BAX/BCL2 greater than 2.3 in PIB and TLR4 of 0.95 uRE or lesser in PB with the occurrence of DGF, with OR of 120 and positive and negative predictive values of 91% and 92%, respectively.
  
  
  CONCLUSIONS
  The power to predict DGF of the combination of high BAX/BCL2 expression in PIB and low TLR4 expression in the first day posttransplant peripheral blood observed in the present study is extremely high, in comparison to any other marker or combinations of markers so far published in the literature.
authors: 1 Instituto de Imunogenética-AFIP, São Paulo, SP, Brazil. 2 Universidade Federal de São Paulo, São Paulo, SP, Brazil. 3 Hospital do Rim e Hipertensão, São Paulo, SP, Brazil. 4 Address correspondence to: Maria Gerbase-DeLima, MD, PhD, Rua Loefgreen 1235, 04040-031 São Paulo, SP, Brazil.
authors: Amador
authors: A
authors: Goncalves-Primo
authors: Tuíla B
authors: TB
authors: Mourão
authors: Vinícius
authors: V
authors: Andrade-Oliveira
authors: Erika F
authors: EF
authors: Campos
authors: José O
authors: JO
authors: Medina-Pestana
authors: Hélio
authors: H
authors: Tedesco-Silva
authors: Maria
authors: M
authors: Gerbase-DeLima
mesh_terms: D000328:Adult; D017209:Apoptosis / Q000235:genetics*; D051017:Apoptosis Regulatory Proteins / Q000235:genetics*; D001706:Biopsy; D001938:Brazil; D053148:Caspase 3 / Q000235:genetics; D051799:Delayed Graft Function / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D005260:Female; D005786:Gene Expression Regulation; D005819:Genetic Markers; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D051197:Toll-Like Receptor 4 / Q000235:genetics; D016896:Treatment Outcome; D051028:bcl-2-Associated X Protein / Q000235:genetics
chemical_list: D051017:Apoptosis Regulatory Proteins; C494826:BAX protein, human; D005819:Genetic Markers; D019253:Proto-Oncogene Proteins c-bcl-2; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4; D051028:bcl-2-Associated X Protein; C505407:CASP3 protein, human; D053148:Caspase 3