Impact of immunosuppressive treatment on endothelial biomarkers after kidney transplantation
Impact of immunosuppressive treatment on endothelial biomarkers after kidney transplantation
复制标题
DOI：
10.1111/j.1600-6143.2008.02399.x
复制
发表时间：
2008-11-01
影响因子：
8.8
通讯作者：
Camoin-Jau, L.
中科院分区：
文献类型：
--
作者：
Al-Massarani, G.;Vacher-Coponat, H.;Camoin-Jau, L.
内皮功能障碍发生于血液透析和肾移植患者，可通过免疫抑制治疗增强。循环内皮细胞（CEC）、内皮微粒（EMP）和sVCAM-1提供内皮活化和损伤的信息。我们比较了两种免疫抑制方案（CsA/Aza vs. Tac/MMF）对52例患者CEC、EMP和sVCAM-1水平动力学的影响，包括移植前和移植后3、6、9和12个月，以50名健康对照为参考。与移植前相比，移植后1年（M12） CEC、EMP和sVCAM-1水平显著降低。在M12时，CEC和sVCAM-1水平显著高于对照组，而EMP达到正常水平。移植后9个月，与他克莫司/霉酚酸酯（Tac/MMF）治疗的患者相比，接受环孢素微乳/硫唑嘌呤（CsA/Aza）治疗的患者CEC和EMP正常化水平较低。多因素分析表明，M12时CEC与心血管病史、EMP与巨细胞病毒感染呈正相关。总之，我们对内皮损伤标志物的综合分析证实了肾移植对内皮的有利影响，并表明CEC水平区分了治疗相关的内皮毒性。这些结果启发了这些非侵入性血液生物标志物在索引血管损伤和优化治疗方案方面的潜力。
Endothelial dysfunction occurs in hemodialysis and kidney-transplanted patients and can be enhanced by immunosuppressive therapy. Circulating endothelial cells (CEC), endothelial microparticles (EMP) and sVCAM-1 provide information on endothelium activation and damage.We compared the impact of two immunosuppressive regimens (CsA/Aza vs. Tac/MMF) on the kinetics of CEC, EMP and sVCAM-1 levels in 52 patients, both before graft and 3, 6, 9 and 12 months after graft, in reference to 50 healthy controls.CEC, EMP and sVCAM-1 levels were significantly decreased 1 year after transplantation (M12) as compared to pretransplant values. At M12, CEC and sVCAM-1 levels were significantly higher than those of controls whereas EMP reached normal values. Nine months postgraft, lower CEC and normalized EMP levels were found in patients receiving cyclosporine microemulsion/ azathioprine (CsA/Aza) when compared to patients treated with tacrolimus/ mycophenolate mofetil (Tac/MMF). Multivariate analysis evidenced positive correlations between CEC and history of cardiovascular diseases and between EMP and cytomegalovirus infection at M12.In conclusion, our combined analysis of endothelial injury markers confirms the favorable impact of renal transplantation on endothelium, and show that CEC levels discriminate treatment-associated endothelial toxicity. These results enlighten the potential of these noninvasive blood biomarkers in indexing vascular injury and optimize therapeutic options.