Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand Is a Marker of Kidney Function and Inflammation in Heart and Kidney Transplant Recipients
Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand Is a Marker of Kidney Function and Inflammation in Heart and Kidney Transplant Recipients
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DOI：
10.1016/j.transproceed.2011.03.035
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发表时间：
2011-06-01
影响因子：
0.9
通讯作者：
Mysliwiec, M.
中科院分区：
文献类型：
--
作者：
Malyszko, J.;Przybylowski, P.;Mysliwiec, M.
背景肿瘤坏死因子相关凋亡诱导配体（tumor necrosis factor related apoptosis inducing ligand，TRAIL）是肿瘤坏死因子（tumor necrosis factor，TNF）超家族的第三个成员。TRAIL通常在包括肾脏在内的许多人体组织中表达。循环可溶性TRAIL是炎症的阴性标志物，与慢性肾病患者的死亡风险呈负相关。心脏移植受者中一种日益普遍的并发症似乎是慢性肾病。该研究的目的是评估136名心脏移植受者和80名普遍的肾移植受者的TRAIL浓度与肾功能的关系。检测全血细胞计数、尿素、血脂、空腹血糖、肌酐、NT-proBNP。用市售试剂盒检测可溶性TRAIL、hsCRP、白细胞介素-6（IL-6）、血管性血友病因子（vWF）。与对照组相比，心脏移植受者的血清肌酐、尿素、胆固醇、甘油三酯、空腹血糖、白色血细胞计数、血清TRAIL显著升高，估计肾小球滤过率降低。肾移植受者也获得了类似的结果。心脏移植患者血清TRAIL水平下降，肾小球滤过率下降。血清TRAIL与年龄、肾功能、红细胞计数、血红蛋白、NT-proBNP、纽约心脏协会分级、糖尿病、高密度脂蛋白（HDL）、IL-6和射血分数相关。年龄和HDL是心脏移植受者中TRAIL的预测因子。在肾移植受者中，在单变量分析中，TRAIL与年龄、NT-proBNP、移植后时间、肾功能和vWF相关。多元回归分析显示，vWF和移植后时间是TRAIL的预测因素。TRAIL可能代表内皮功能障碍和动脉粥样硬化的替代标志物，因为这些过程在心脏和肾脏功能障碍中加速。
Background. Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) was originally identified as the third member of the TNF superfamily to induce apoptosis. TRAIL is normally expressed in many human tissues including kidney. Circulating soluble TRAIL is a negative marker for inflammation and is inversely associated with the mortality risk in chronic kidney disease patients. One increasingly prevalent complication in heart transplant recipients appears to be chronic kidney disease.Materials and Methods. The aim of the study was to assess TRAIL concentration in 136 heart transplant recipients and 80 prevalent kidney allograft recipients in relation to kidney function. Complete blood count, urea, serum lipids, fasting glucose, creatinine, NT-proBNP were studied. Soluble TRAIL, hsCR P, interleukin-6 (IL-6), von willebrand factor (vWF) were assayed using commercially available kits.Results. Heart transplant recipients had significantly higher serum creatinine, urea, cholesterol, triglycerides, fasting glucose, white blood cell count, serum TRAIL and lower estimated glomerular filtration rate than the control group. Similar results were obtained for kidney allograft recipients. Serum TRAIL levels fell, together with decline in glomerular filtration rate in heart transplant patients. Serum TRAIL was related to age, kidney function, erythrocyte count, hemoglobin, NT-proBNP, New York Heart Association class, presence of diabetes, high-density lipoprotein (HDL), IL-6, and ejection fraction. Age and HDL turn out to be predictors of TRAIL in heart transplant recipients. In kidney transplant recipients, TRAIL was related, in univariate analysis, to age, NT-proBNP, time after transplantation, kidney function, and vWF. In multiple regression analysis, predictors of TRAIL were vWF and time after transplantation.Conclusion. TRAIL may represent a surrogate marker of endothelial dysfunction and atherosclerosis as these processes are accelerated in heart and kidney dysfunction.