title: Monocyte Chemoattractant Protein-1 (MCP-1/CCL2) Levels and Its Association with Renal Allograft Rejection.
abstract: BACKGROUND
  CCL2 is a chemoattractant for monocytes/macrophages, T cells, and natural killer cells. It is shown to be involved in the immunological responses against renal allograft. This study was conducted to access the role of urinary CCL2 expression in predicting the rejection episodes in renal transplant patients.
  
  
  METHODS
  A total of 409 urine samples included in this study. The samples were consisted of (a) biopsy-proven graft rejection (n = 165); (b) non-rejection (n = 93); (c) non-biopsy stable-graft (n = 42), and (d) healthy renal donors (n = 109). The samples were quantified for the CCL2 using the MCP-1/CCL2 ELISA kit. The data were analyzed using the Statistical Package for Social Sciences (SPSS®) and MedCalc®statistical software.
  
  
  RESULTS
  Results showed that the CCL2 levels were significantly increased in rejection group when compared with the non-rejection, stable-graft, and control, P < 0.05. The receiver operating curve's characteristics illustrated that the urinary CCL2 level is a good predictor for graft rejection, with an area under the curve of 0.81 ± 0.03 with optimum sensitivity and specificity of 87% and 62%, respectively, at a cut-off value of 198 pg/mL. Kaplan-Meier curve also showed better cumulative rejection-free graft survival time in group with less than 198 pg/mL of CCL2 as compared to those with expression levels of more than 198 pg/mL (30 weeks vs. 3 weeks; log-rank test, P < 0.001).
  
  
  CONCLUSIONS
  In our study, noninvasive investigation of CCL2 levels in urine has showed potential to predict rejection episodes. It is suggested that the CCL2, with others markers, may help in early detection and monitoring of graft rejection episodes.
authors.affiliation: a Centre for Human Genetics and Molecular Medicine , Sindh Institute of Urology and Transplantation , Karachi , Pakistan.
authors.forename: Ali
authors.initials: A
authors.lastname: Raza
authors.affiliation: a Centre for Human Genetics and Molecular Medicine , Sindh Institute of Urology and Transplantation , Karachi , Pakistan.
authors.forename: Sadaf
authors.initials: S
authors.lastname: Firasat
authors.affiliation: a Centre for Human Genetics and Molecular Medicine , Sindh Institute of Urology and Transplantation , Karachi , Pakistan.|b Department of Human Genetics , University of Health Sciences , Lahore , Pakistan.
authors.forename: Shagufta
authors.initials: S
authors.lastname: Khaliq
authors.affiliation: a Centre for Human Genetics and Molecular Medicine , Sindh Institute of Urology and Transplantation , Karachi , Pakistan.
authors.forename: Abdul Rafay
authors.initials: AR
authors.lastname: Khan
authors.affiliation: a Centre for Human Genetics and Molecular Medicine , Sindh Institute of Urology and Transplantation , Karachi , Pakistan.
authors.forename: Shafaq
authors.initials: S
authors.lastname: Mahmood
authors.affiliation: c Department of Urology , Sindh Institute of Urology and Transplantation , Karachi , Pakistan.
authors.forename: Tahir
authors.initials: T
authors.lastname: Aziz
authors.affiliation: d Department of Histopathology , Sindh Institute of Urology and Transplantation , Karachi , Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Mubarak
authors.affiliation: c Department of Urology , Sindh Institute of Urology and Transplantation , Karachi , Pakistan.
authors.forename: Syed Ali Anwar
authors.initials: SA
authors.lastname: Naqvi
authors.affiliation: c Department of Urology , Sindh Institute of Urology and Transplantation , Karachi , Pakistan.
authors.forename: Syed Adibul Hasan
authors.initials: SA
authors.lastname: Rizvi
authors.affiliation: a Centre for Human Genetics and Molecular Medicine , Sindh Institute of Urology and Transplantation , Karachi , Pakistan.
authors.forename: Aiysha
authors.initials: A
authors.lastname: Abid
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000652:urine*; D018932:Chemokine CCL2 / Q000652:urine*; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis* / Q000401:mortality; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2
keywords: Allograft rejection; CCL2; biomarkers; chemokines; kidney transplantation