Development of biomarkers for the elucidation of pathophysiology and early diagnosis of chronic allograft nephropathy

慢性移植肾肾病（CAN）是移植肾功能衰竭的主要原因。我们以前报道过活化的巨噬细胞（Mφ）在肾组织损伤和纤维化中起主要作用，并表明Mφ亚型之一的CD 163阳性Mφ可能参与慢性病变的形成。我们检测了尿CD 163抗原水平，并研究了它们与组织学和临床表现的相关性。在肾活检标本中，间质CD 163阳性Mφ的数量与纤维化的严重程度呈正相关。尿CD 163水平与急性期后稳定期移植肾功能相关，并可反映移植肾纤维化的进展程度，提示CD 163阳性的Mφ参与了CAN的进展，尿CD 163可作为CAN早期诊断的无创性指标。

Chronic allograft nephropathy(CAN) is the major cause of failure of renal graft function. It has posed diagnostic challenge and there have been no non-invasive diagnostic procedures of CAN that is also safe for pediatric patients.We have previously reported that activated macrophages(Mφ) play a major role in renal tissue impairment and fibrosis and shown that CD163-positive Mφ, one of Mφsubtypes, may be involved in the formation of chronic lesions.In this study, we measured urinary CD163 antigen levels and investigated their correlation with histological and clinical findings. In renal biopsy specimens, the number of interstitial CD163-positive Mφwas positively correlated with severity of fibrosis. The urinary CD163 levels were also correlated with renal graft function in the stable phase after the acute phase and may indicate the degree of progression of renal graft fibrosis.These results suggest that CD163-positive Mφis deeply involved in the progression of CAN and the urinary CD163 can be used as a non-invasive marker for the early diagnosis of CAN.