title: Low serum mannose-binding lectin levels are associated with inflammation and apoptosis in early surveillance allograft biopsies.
abstract: BACKGROUND
  Mannose-binding lectin (MBL) is a protein of the innate immune system that participates in host defense and the tissue injury/repair process, enhancing the clearance of apoptotic cells by macrophages. The aim is to characterize the relationship between pre-transplant MBL levels, histological lesions and number of apoptotic cells in early surveillance renal allograft biopsies.
  
  
  METHODS
  Consecutive renal transplant recipients were recruited and MBL levels were classified into tertiles. The first tertile was considered the low MBL group. Surveillance biopsies were done during the first 6 months and were evaluated according to Banff criteria. Renal inflammatory infiltrates were studied by immunohistochemical techniques. Apoptosis was studied using morphological methods in renal tubular cells and was expressed as the number of apoptotic cells/mm(2).
  
  
  RESULTS
  MBL was determined in 126 patients and a surveillance biopsy with sufficient tissue was obtained in 41 of them. Patients with low pre-transplant MBL levels showed a higher acute Banff index (3.14 ± 1.96 vs. 1.88 ± 1.56, p = 0.044) and an increased proportion of biopsies with tubular cell apoptosis The proportion of biopsies with tubular cell apoptosis was higher in patients with low pre-transplant MBL levels in comparison with patients with high MBL levels (4.3 ± 3.6 versus 0.2 ± 0.9 p = 0.012) and increased interstitial number of inflammatory cells and significantly the macrophages/mm(2) (109 ± 118 vs. 32 ± 46; p = 0.04).
  
  
  CONCLUSIONS
  Low pre-transplant serum MBL levels are associated with more severe inflammation and increased apoptosis in early surveillance renal allograft biopsies suggesting that MBL modulates renal inflammation after transplantation.
authors: Nephrology Department, Hospital Universitari Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain. Electronic address: mibernon@vhebron.net.
authors: M
authors: M
authors: Ibernon
authors: Nephrology Department, Hospital Universitari Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.
authors: F
authors: F
authors: Moreso
authors: Pathology Department and Institute of Biopathology and Regenerative Medicine (IBIMER), Hospital San Cecilio, Granada, Spain.
authors: F
authors: F
authors: O'Valle
authors: Nephrology Department, Hospital Universitari de Bellvitge, Barcelona, Spain.
authors: J M
authors: JM
authors: Grinyo
authors: UGC Provincial Intercentros de Anatomía Patológica, Granada, Spain.
authors: R G
authors: RG
authors: Moral
authors: Nephrology Department, Hospital Universitari Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.
authors: D
authors: D
authors: Seron
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts / Q000276:immunology*; D017209:Apoptosis / Q000276:immunology; D001706:Biopsy; D002478:Cells, Cultured; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000276:immunology; D016030:Kidney Transplantation; D007684:Kidney Tubules / Q000473:pathology; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood*; D008875:Middle Aged; D015166:Monitoring, Immunologic / Q000379:methods
chemical_list: D037601:Mannose-Binding Lectin
keywords: Apoptosis; Inflammation; Mannose-binding lectin; Renal transplantation; Surveillance allograft biopsy