title: Plasma proteomics for the assessment of acute renal transplant rejection.
abstract: Renal transplant is the best treatment for patients with chronical kidney disease however acute graft rejection is the major impediment to success in renal transplantation leading to loss of the organ the first year after transplantation. The aim of this study was to identify plasma proteins that may be early biomarkers of acute rejection of renal allograft, developing a diagnostic model that avoids the loss of the transplanted organ. Shotgun proteomics (LC-MS/MS) method was used to analyze a set of thirty-one plasma samples, including 06 from patients with acute graft rejection after transplantation (rejection group/Rej-group) and twenty-five from renal transplant patients with stable renal graft function (control group/Ct-group). As results nineteen proteins were upregulated in the rejection group compared to the control group, and two proteins were downregulated; and three were present exclusively in the rejection group. After analysis, we selected four proteins that were related to the acute phase response and that were strongly associated with each other: they are alpha-1 antitrypsin (A1AT), alpha-2 antiplasmin (A2AP), serum amyloid A (SAA) and apolipoprotein CIII (APOC3). We think that simultaneous monitoring of SAA and APOC3 can provide insights into a broad profile of signaling proteins and is highly valuable for the early detection of a possible acute renal graft rejection.
  
  
  CONCLUSIONS
  In this study we did plasma shotgun patients with and without acute rejection of renal allograft. In a clinical setting an acute rejection is typically suspected upon an increase in plasma creatinine and renal biopsy. But these methods are late and unspecific; sometimes the rejection process is already advanced when there is an increase in serum creatinine. Therefore, it is necessary to find proteins that can predict the allograft rejection process. In our study were able to identify changes in the concentration of plasma protein belonging to a network of protein interaction processes the acute phase response. We believe, therefore, that development of a routine diagnosis of these proteins can detect early acute rejection of renal allograft process, thus preventing its loss.
authors.affiliation: Department of Medicine, Division of Nephrology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Juliana D
authors.initials: JD
authors.lastname: Perez
authors.affiliation: Department of Medicine, Division of Nephrology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Maísa M
authors.initials: MM
authors.lastname: Sakata
authors.affiliation: Universidade de Santo Amaro, Programa em Medicina Populacional, São Paulo, Brazil.
authors.forename: Juliana A
authors.initials: JA
authors.lastname: Colucci
authors.affiliation: Nephrology Division, Hospital do Rim e Hipertensão, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Gláucio A
authors.initials: GA
authors.lastname: Spinelli
authors.affiliation: Nephrology Division, Hospital do Rim e Hipertensão, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Claudia R
authors.initials: CR
authors.lastname: Felipe
authors.affiliation: Fleury Group, São Paulo, Brazil.
authors.forename: Valdemir M
authors.initials: VM
authors.lastname: Carvalho
authors.affiliation: Fleury Group, São Paulo, Brazil.
authors.forename: Karina Helena M
authors.initials: KH
authors.lastname: Cardozo
authors.affiliation: Nephrology Division, Hospital do Rim e Hipertensão, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: José O
authors.initials: JO
authors.lastname: Medina-Pestana
authors.affiliation: Nephrology Division, Hospital do Rim e Hipertensão, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Hélio
authors.initials: H
authors.lastname: Tedesco-Silva
authors.affiliation: Department of Medicine, Division of Nephrology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Nestor
authors.initials: N
authors.lastname: Schor
authors.affiliation: Department of Medicine, Division of Nephrology, Universidade Federal de São Paulo, São Paulo, Brazil. Electronic address: casarini.elena@unifesp.br.
authors.forename: Dulce E
authors.initials: DE
authors.lastname: Casarini
mesh_terms: D001798:Blood Proteins / Q000378:metabolism*; D002853:Chromatography, Liquid; D005260:Female; D006084:Graft Rejection / Q000097:blood*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D021241:Spectrometry, Mass, Electrospray Ionization; D053719:Tandem Mass Spectrometry
chemical_list: D001798:Blood Proteins
keywords: Biomarker; Mass spectrometry; Plasma proteomics; Serum amyloid A