Lack of Association Between Elevated Urinary Levels of Interleukin-10 and Interferon Gamma With the Presence of Inflammation in Kidney Transplant Recipients.
BACKGROUND
A lot of evidence has demonstrated the importance of different cytokines in acute renal rejection. Previous studies have examined the presence or absence of interleukin (IL)-10 in related immunopathologic rejection grafts as well as other interleukins. Studies in human transplantation show elevated levels of IL-10 and gamma interferon (INF-γ) in inflammation and rejection.


OBJECTIVE
The objective of this study was to demonstrate the lack of association of elevated urinary levels of IL-10 and IFN in the presence of active inflammation.


METHODS
An observational, descriptive, cross-sectional study conducted in transplant recipients at 12 months of follow-up after renal transplantation. In those who were held biopsy after renal transplantation at one year follow-up, or allograft dysfunction, we also measured IL-10 and INF-γ in the urine. The following were considered as variables: age, body mass index (BMI), gender, transplant type, creatinine, chronic kidney disease epidemiology collaboration equation, (CKD-EPI), modification of diet in renal disease study equation (MDRD), Banff classification, and levels of IL-10 and INF-γ. Statistical analysis was performed calculating a sample size of 25 patients, with an alpha bias of 0.05%, yielding measures of central tendency and determining no association between levels of IL-10 and INF-γ with the presence of rejection using SPSS 21.0 program.


RESULTS
A total of 50 patients, 34 (68%) males, 16 (32%) females, with an average 31.7 ± 9.9 years, weight of 64.91 ± 13.84 kg, size 1.60 ± 0.10 m and 24.97 ± 4.07 BMI were included,39 (78%) living donor and 11 (22%) cadaveric. Twenty-six (52%) showed inflammation in the biopsy and 24 (48%) showed none. Mean creatinine was 1.81 ± 1.5, and the estimated glomerular filtration rate (eGFR) was 55.27 ± 22.46, 65.76 ± 26.7. (MDRD and CKD-EPI, respectively). No statistical difference was found in the levels of IL-10 and IFN-γ using analysis of variance. (ANOVA; P = .467 and P = .063, respectively) Based on Banff, the inflammation on biopsy score was 2.78 ± 2.84. There was statistical significance (P < .05) with respect to the Cr and eGFR by different equations. There were no significant interactions between cytokine levels and more than 1 factor. (as indicated by P < .2).


CONCLUSIONS
No significant differences were observed in the level of interleukins in patients with and without inflammation, denoting an adequate immunosuppression in most of these patients. Determination of inflammatory cytokines in urine could be used as a determinant of a good immunosuppression status, rather than as an early marker of rejection.
Department of Transplantation, Mexico's General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico; Mexican Institute of Social Security, Mexico City, Mexico. Electronic address: asfa@live.com.mx.
L
L
García-Covarrubias
Department of Transplantation, Mexico's General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico.
E
E
Ventura
Department of Pathology, Mexico's General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico.
V
V
Soto
Laboratory of Immunology, Unit of Experimental Medicine, Universidad Nacional Autonoma de Mexico, Mexico's General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico.
E
E
González
Department of Transplantation, Mexico's General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico.
A
A
García
Department of Transplantation, Mexico's General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico.
J C
JC
Aguilar
Department of Transplantation, Mexico's General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico.
J M
JM
Torres
Department of Transplantation, Mexico's General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico; Mexican Institute of Social Security, Mexico City, Mexico.
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H
Hinojosa
Department of Transplantation, Mexico's General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico.
P
P
Fragoso
Department of Transplantation, Mexico's General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico.
J
J
De Los Santos
Mexican Institute of Social Security, Mexico City, Mexico.
D
D
Ortuño
Department of Transplantation, Mexico's General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico.
P
P
San Cristóbal
Department of Transplantation, Mexico's General Hospital Dr. Eduardo Liceaga, Mexico City, Mexico.
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H
Díliz
D000328:Adult; D015415:Biomarkers / Q000652:urine; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006084:Graft Rejection / Q000175:diagnosis / Q000652:urine*; D006801:Humans; D007249:Inflammation / Q000652:urine*; D007371:Interferon-gamma / Q000652:urine*; D016753:Interleukin-10 / Q000652:urine*; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology; D013997:Time Factors; D066027:Transplant Recipients; D014184:Transplantation, Homologous
D015415:Biomarkers; C508609:IL10 protein, human; D016753:Interleukin-10; D007371:Interferon-gamma