Evolution of immunoglobulin and mannose binding protein levels after renal transplantation: association with infectious complications
Evolution of immunoglobulin and mannose binding protein levels after renal transplantation: association with infectious complications
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DOI：
10.1111/j.1432-2277.2007.00556.x
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发表时间：
2008-01-01
影响因子：
3.1
通讯作者：
Abramowicz, Daniel
中科院分区：
文献类型：
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作者：
Broeders, Emine Nilufer;Wissing, Karl Martin;Abramowicz, Daniel
低丙种球蛋白血症（hypo-Ig）和低甘露糖结合蛋白（MBP）水平可能与肾移植术后感染的发生有关。在152例接受钙调磷酸酶抑制剂（CNI）和吗替麦考酚酯（MMF）治疗的肾移植受者中，我们前瞻性记录了第一年低丙种球蛋白血症和低MBP水平的发生率。在3个月和12个月（T3和T12）时，在92例患者中评价了它们对感染并发症的影响。低IgG组（T0组）、低MBP组（T3组）、低MBP组（T12组）分别为6%、45%、30%（P < 0.001），低MBP组分别为5%、11%、12%（P = 0.035）。T3时低IgG与第一年感染发生率增加无关。T3时合并低丙种球蛋白血症[IgG+（伊加和/或IgM）]和T0时单纯低IgG血症的患者发生感染的比例显著高于无这些缺陷的患者（P < 0.05）。T3时低MBP水平与更多败血症和病毒感染相关。在接受CNI和MMF治疗的患者中，肾移植后第一年内低丙种球蛋白血症很常见。T0时低IgG和T3时联合IgG缺陷与更多感染相关。MBP缺乏可能成为移植后感染风险的重要决定因素。
Hypogammaglobulinemia (hypo-Ig) and low mannose binding protein (MBP) levels might be involved in the infectious risk in renal transplantation. In 152 kidney transplant recipients treated with calcineurin inhibitors (CNI) and mycophenolate mofetil (MMF), during the first year, we prospectively recorded the incidence of hypogammaglobulinemia, and low MBP levels. Their influence on infectious complications was evaluated in 92 patients at 3 and 12 months (T3 and T12). The proportion of deficiency increased significantly: hypo-IgG: 6% (T0), 45% (T3), and 30% (T12) (P < 0.001); hypo-MBP: 5%, 11%, and 12% (P = 0.035). Hypo-IgG at T3 was not associated with an increased incidence of first-year infections. A significantly higher proportion of patients with combined hypogammaglobulinemia [IgG+ (IgA and/or IgM)] at T3 and with isolated hypo-IgG at T0 developed infections until T3 compared with patients free of these deficits (P < 0.05). Low MBP levels at T3 were associated with more sepsis and viral infections. Hypogammaglobulinemia is frequent during the first year after renal transplantation in patients treated with a CNI and MMF. Hypo-IgG at T0 and combined Igs deficts at T3 were associated with more infections. MBP deficiency might emerge as an important determinant of the post-transplant infectious risk.