Urinary chemokines CXCL9 and CXCL10 are noninvasive markers of renal allograft rejection and BK viral infection.
Urinary chemokines CXCL9 and CXCL10 are noninvasive markers of renal allograft rejection and BK viral infection.
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DOI：
10.1111/j.1600-6143.2011.03680.x
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发表时间：
2011-10
期刊：
影响因子：
--
通讯作者：
Kirk AD
中科院分区：
文献类型：
--
作者：
Jackson JA;Kim EJ;Begley B;Cheeseman J;Harden T;Perez SD;Thomas S;Warshaw B;Kirk AD
肾移植受者需要定期监测免疫相关并发症，如排斥反应和感染。非侵入性监测方法是首选，特别是对于儿童，侵入性测试是有问题的。我们对成人和儿童移植受者进行了横断面分析，以确定基于尿的趋化因子检测是否可以在其他常见临床诊断中非侵入性地识别排斥反应患者。收集了110名成人和46名儿童的尿液，这些儿童具有明确的临床条件：健康志愿者，稳定的肾移植受者，临床或亚临床急性排斥反应（AR）或BK感染（BKI），钙调神经磷酸酶抑制剂（CNI）毒性或间质纤维化（IFTA）。采用固相微珠阵列法分析尿液中干扰素γ诱导的趋化因子CXCL9和CXCL10。我们发现，在经历AR或BKI的成人和儿童中，尿CXCL9和CXCL10显著升高（p=0.0002），但在稳定的同种异体移植受者或CNI毒性或IFTA的受者中没有。这些趋化因子检测的敏感性和特异性超过血清肌酐。两种趋化因子都不能区分AR和BKI。这些数据表明，尿液趋化因子监测识别患者肾移植炎症。该检测方法可用于非侵入性区分需要加强监测的同种异体移植受者和良性临床病程的受者。
Renal transplant recipients require periodic surveillance forimmune-based complications such as rejection and infection. Noninvasive monitoring methods are preferred, particularly for children, for whom invasive testing is problematic. We performed a cross-sectional analysis of adult and pediatric transplant recipients to determine whether a urine-based chemokine assay could non-invasively identify patients with rejection amongst other common clinical diagnoses. Urine was collected from 110 adults and 46 children with defined clinical conditions: healthy volunteers, stable renal transplant recipients, and recipients with clinical or subclinical acute rejection (AR) or BK infection (BKI), calcineurin inhibitor (CNI) toxicity, orinterstitial fibrosis (IFTA). Urine was analyzed using a solid-phase bead-array assay for the interferon gamma-induced chemokines CXCL9 and CXCL10. We found that urine CXCL9 and CXCL10 were markedly elevated in adults and children experiencing either AR or BKI (p=0.0002), but not in stable allograft recipients, or recipients with CNI toxicity or IFTA. The sensitivity and specificity of these chemokine assays exceeded that of serum creatinine. Neither chemokine distinguished between AR and BKI. These data show that urine chemokine monitoring identifies patients with renal allograft inflammation. This assay may be usefulfor non-invasively distinguishing those allograft recipients requiring more intensivesurveillance from those with benign clinical courses.
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