Expression of decoy receptor 3 in kidneys is associated with allograft survival after kidney transplant rejection.
Decoy receptor 3 (DcR3) expression in kidneys has been shown to predict progression of chronic kidney disease. We prospectively investigated a cohort comprising 96 renal transplant recipients (RTRs) undergoing graft kidney biopsies. Computer-assisted quantitative immunohistochemical staining value of DcR3 in renal tubular epithelial cells (RTECs) was used to determine the predictive role of DcR3 in kidney disease progression. The primary end point was doubling of serum creatinine and/or graft failure. A multivariate Cox proportional hazards model was used to assess the risk of DcR3 expression in rejected kidney grafts toward the renal end point. In total, RTRs with kidney allograft rejection were evaluated and the median follow-up was 30.9 months. The greater expression of DcR3 immunoreactivity in RTECs was correlated with a higher rate of the histopathological concordance of acute T cell-mediated rejection. Compared with 65 non-progressors, 31 progressors had higher DcR3 expression (HDE) regardless of the traditional risk factors. Cox regression analysis showed HDE was significantly associated with the risk of renal end point with a hazard ratio of 3.19 (95% confidence interval, 1.40 to 7.27; P = 0.006) after adjusting for other variables. In repetitive biopsies, HDE in tissue showed rapid kidney disease progression due to persistent inflammation.
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.|Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Shuo-Chun
SC
Weng
Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Kuo-Hsiung
KH
Shu
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan.|School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Ming-Ju
MJ
Wu
School of Medicine, Chung Shan Medical University, Taichung, Taiwan.|Department of Pathology, Taichung Veterans General Hospital, Taichung, Taiwan.
Mei-Chin
MC
Wen
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Genomics Research Center, Academia Sinica, Taipei, Taiwan.
Shie-Liang
SL
Hsieh
Institute of Microbiology and Immunology, School of Life Sciences, National Yang-Ming University, Taipei, Taiwan.|Inflammation and Immunity Research Center, National Yang-Ming University, Taipei, Taiwan.
Nien-Jung
NJ
Chen
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Inflammation and Immunity Research Center, National Yang-Ming University, Taipei, Taiwan.|Department and Institute of Physiology, National Yang-Ming University, Taipei, Taiwan.|Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Der-Cherng
DC
Tarng
D015415:Biomarkers / Q000378:metabolism; D015897:Comorbidity; D005260:Female; D006084:Graft Rejection / Q000378:metabolism* / Q000401:mortality*; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000401:mortality* / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D053323:Receptors, Tumor Necrosis Factor, Member 6b / Q000378:metabolism*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology
D015415:Biomarkers; D053323:Receptors, Tumor Necrosis Factor, Member 6b