title: Pre-transplant angiotensin receptor II type 1 antibodies and risk of post-transplant focal segmental glomerulosclerosis recurrence.
abstract: Post-kidney transplant recurrence of focal segmental glomerulosclerosis (FSGS) is a major problem. AT1R is expressed on podocyte; its expression is elevated in the proteinuric state. Using an ELISA, we tested pre-transplant sera of 28 patients with history of idiopathic FSGS for anti-AT1R levels and serum soluble urokinase-type plasminogen activator receptor (suPAR) as a biomarker for risk of recurrence of FSGS. Sera from 11 patients with polycystic kidney disease (PKD) were used as controls. Twelve patients had biopsy proven post-transplant FSGS recurrence at 1.5 months. No difference was found in the pre-transplant suPAR levels of FSGS patients (5993 ± 2292 pg/mL) vs. PKD (7334 ± 4538 pg/mL) (p = 0.23). Serum suPAR levels in patients with FSGS recurrence (5786 ± 1899 pg/mL) vs. no FSGS recurrence (6149 ± 2598 pg/mL) (p = 0.69) were not different. Anti-AT1R levels in patients with FSGS were 12.66 ± 11.85 U/mL vs. 8.69 ± 6.52 U/mL in PKD (p = 0.32); however, a difference was found in patients with and without FSGS recurrence 20.41 ± 14.36 U/mL 6.84 ± 4.181 U/mL, respectively (p < 0.01). Area under curve for suPAR and anti-AT1R to predict post-transplant FSGS recurrence was 0.51 and 0.84, respectively. Pre-transplant anti-AT1R levels appear to be a helpful biomarker in identifying patients at high risk of post-transplant FSGS recurrence.
authors.affiliation: Division of Nephrology, University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Mujtaba
authors.affiliation: Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Asif A
authors.initials: AA
authors.lastname: Sharfuddin
authors.affiliation: Division of Transplant Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Benita L
authors.initials: BL
authors.lastname: Book
authors.affiliation: Division of Transplant Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Goggins
authors.affiliation: Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Khalil
authors.affiliation: Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Dennis P
authors.initials: DP
authors.lastname: Mishler
authors.affiliation: Division of Transplant Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Johnathan A
authors.initials: JA
authors.lastname: Fridell
authors.affiliation: Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Yaqub
authors.affiliation: Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Tim E
authors.initials: TE
authors.lastname: Taber
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005923:Glomerulosclerosis, Focal Segmental / Q000175:diagnosis* / Q000276:immunology; D006084:Graft Rejection / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D044140:Receptor, Angiotensin, Type 1 / Q000276:immunology*; D012008:Recurrence; D012307:Risk Factors
chemical_list: D001323:Autoantibodies; D044140:Receptor, Angiotensin, Type 1
keywords: anti-AT1R; focal segmental glomerulosclerosis; recurrence; transplant