title: Association of soluble human leukocyte antigen-G with acute tubular necrosis in kidney transplant recipients.
abstract: BACKGROUND
  Human leukocyte antigen (HLA)-G is a nonclassical HLA class I molecule that displays strong immune-inhibitory properties and has been associated with allograft acceptance. However, there are conflicting data on the correlation of soluble HLA-G (sHLA-G) and acute rejection and no data on the correlation with acute tubular necrosis in kidney transplantation.
  
  
  OBJECTIVE
  To evaluate the association of sHLA-G level in early post-transplant period and allograft rejection/ and acute tubular necrosis (ATN) in kidney transplant recipients.
  
  
  METHODS
  The sera procured before transplantation and serially on day 3 and day 7 after transplantation from 76 kidney transplant recipients were analyzed for the level of sHLA-G by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  The levels of sHLA-G from three serial sera did not differ between patients with acute rejection and patients without rejection. However, the sHLA-G levels on day 3 post-transplant and day 7 post-transplant in patients with ATN were significantly higher than that in patients without ATN (16.3 vs 9.85 U/ml, p = 0.018, for day 3 post-transplant and 12.47 vs 5.42 U/ml, p = 0.044, for day 7 post-transplant). In addition, the ROC analysis of sHLA-G for identifying patients with ATN showed that the area under curve was 0.67 (95% confidence interval 0.54-0.80).
  
  
  CONCLUSIONS
  There was no significant difference for sHLA-G levels between patients with acute rejection and without rejection. Interestingly, high levels of sHLA-G in day 3 and day 7 after transplantation were associated with acute tubular necrosis. Our findings raise the question whether the increased levels of sHLA-G in patients with acute tubular necrosis after transplantation might be a result of ischemia and reperfusion injury.
authors.affiliation: Histocompatibility and Immunogenetics Laboratory, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Jatupon
authors.initials: J
authors.lastname: Krongvorakul
authors.forename: Surasak
authors.initials: S
authors.lastname: Kantachuvesiri
authors.forename: Atiporn
authors.initials: A
authors.lastname: Ingsathit
authors.forename: Sasivimol
authors.initials: S
authors.lastname: Rattanasiri
authors.forename: Tasanee
authors.initials: T
authors.lastname: Mongkolsuk
authors.forename: Pimpun
authors.initials: P
authors.lastname: Kitpoka
authors.forename: Duangtawan
authors.initials: D
authors.lastname: Thammanichanond
mesh_terms: D000328:Adult; D064591:Allografts; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006084:Graft Rejection / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D059951:HLA-G Antigens / Q000097:blood / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D007683:Kidney Tubular Necrosis, Acute / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012995:Solubility; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D059951:HLA-G Antigens