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

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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.