Predictive Role of Pretransplant Serum CXCL10 for Cardiac Acute Rejection
Predictive Role of Pretransplant Serum CXCL10 for Cardiac Acute Rejection
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DOI：
10.1097/tp.0b013e3181919f5d
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发表时间：
2009-01-27
期刊：
影响因子：
6.2
通讯作者：
Maccherini, Massinio
中科院分区：
文献类型：
--
作者：
Crescioli, Clara;Buonamano, Andrea;Maccherini, Massinio
背景心脏移植中急性排斥反应的检测仍然是移植管理的重要特征，特别是在早期阶段。尽管内膜活检是一种侵入性操作，并具有一定的风险，但仍有必要经常进行监测。因此，能够预测急性排斥反应的非侵入性生物标志物可能是患者管理的进一步有用工具。干扰素-γ-诱导趋化因子CXCL 10是急性或慢性排斥反应引起的移植物衰竭发生和发展所必需的。据报道，CXCL 10血清水平可以预测肾移植受者的移植物丢失。在本研究中，我们研究了移植前CXCL 10血清水平是否可以作为心脏移植（HTx）受者的预测性非侵入性生物标志物。对143例原位心脏移植患者术前血清进行CXCL 10和CCL 22检测，并与健康对照组进行比较。我们发现HTx受体的基础CXCL 10血清水平显著高于健康受试者，而CCL 22水平无差异。在HTx接受者中，排斥者的CXCL 10血清水平显著高于非排斥者。我们的研究结果表明，CXCL 10是多个变量的显著独立危险因素，对早期急性心脏排斥反应的预测价值最高，临界值为160 pg/mL。在HTx受者中，移植前CXCL 10血清水平的测量可能是预测心脏急性排斥反应的临床有用工具，特别是在移植后早期。
Background. The detection Of acute rejection in heart transplantation remains an important feature of transplant management, especially in the early phase. Frequent surveillance with endoinyocardial biopsy is necessary, even though it is an invasive procedure and carries a certain risk. Hence, noninvasive biomarkers able to predict acute rejection could be a further helpful tool in patient management. The interferon-gamma-inducible chemokine CXCL10 is required for initiation and development of graft failure caused by acute or chronic rejection. It has been reported that CXCL10 serum level is predictive of graft loss in kidney graft recipients. In the present study, we investigated whether pretransplant CXCL10 serum level may be a predictive noninvasive biomarker in heart transplant (HTx) recipients, as well.Methods. Sera from 143 patients undergoing orthotopic heart transplantation were collected before surgery and tested for CXCL10 and CCL22 and compared with serum samples from healthy subjects.Results. We found that basal CXCL10 serum levels in HTx recipients were significantly higher than in healthy subjects, whereas no difference was seen in CCL22 levels. Among HTx recipients, CXCL10 serum levels of rejectors were significantly higher than in nonrejectors. Our results showed that CXCL10 was a significant independent risk factor of several variables and had the highest predictive value for early acute heart rejection, with 160 pg/mL cutoff value.Conclusions. In HTx recipients, measurement of pretransplant CXCL10 serum levels Could be a clinically useful tool for predicting cardiac acute rejection, especially in the early posttransplant period.