Quimiocinas e citocinas urinárias no transplante renal

Abstract

Background: Nowadays, renal transplantion is considered the best treatment for patients with end stage renal disease. To extend the renal allograft survival remains to be a challenge. Sometimes the diagnosis of an injured graft is made only with the biopsy. Harmless diagnosis tools to monitor the renal allograft are necessary. Aims: To study the renal function and urinary cytokines and chemokines of renal transplanted patients at 30, 90 and 300 days after the transplant Methods: We evaluate 22 renal transplanted patients and 9 gender and agematchedhealthy controls. We measured renal function and urinary levels RANTES/CCL5, MIP-1á/CCL3, MCP-1/CCL2, IL1-Ra, sTNFR1, sTNFR2, IP-10/CXCL10 and IL-8/CXCL8 in the transplanted patients at 30, 90 and 300 days after the transplant, and in the controls at one time. Evaluations were based on the type of donor, and the presence of rejection orcytomegalovirus (CMV) infection. Ethics issues: The study was approved by the ethic committee of our institution. Informed consent was obtained from all participants. Results: In the total group of transplanted patients (GT), MIP-1á/CCL3 levels reduced from 30 to 300 days (p: 0,0248). In the living donors group (Gdv), sTNFR1 (p: 0,0445) and MCP-1/CCL2 (p: 0,0452) levels were smaller in 300 days than in 30 days. Those patients with acute rejection or CMV infection (G1) showed lower levels of MIP-1á/CCL3 at 300 days than at 90 days (p:0,048). MIP-1á/CCL3 (r:-0,46 p:0,0284) and IL-8/CXCL8 (r:-0,66 p:0,0008) levels showed a significant correlation with renal function at 30 days after transplant, in the GT. The renal function at 90 days correlated with MIP-1á/CCL3 levels at 300 days (r:-0,72 p:0,026) in G1. In the group without acute rejection and CMV infection (G2), MIP-1á/CCL3 levels showed significant correlation with renal function at 90 days (r:-0,6 p:0,0302). The Gdv showed significant correlation of sTNFR2 levels with renal function at 30 and at 300 days (r:-0,57 p:0,039). In the Gdf, IL-1Ra levels at 30 days (r:0,84 p:0,0043) and at 90 days (r:0,77 e p:0,0133) correlated with renal function at 300 days. MCP- 1/CCL2 levels at 30 days were higher in the Gdv than in the Gdf (p:0,0390). MIP-1á/CCL3 levels at 90 days were higher in the G2 than in the G1. Conclusion: MIP-1á/CCL3, IL-8/CXCL8, sTNFR2 and IL-1Ra correlated with renal function after transplant. MIP-1á/CCL3, MCP-1/CCL2 and sTNFR1 reduced during the follow up of the transplanted patients in different way according to presence of RA, CMV infections and type of donor. RANTES and IP-10/CXCL10 levels remained stable in thesepatients. Urinary chemokines and cytokines could be a good urinary biomarker for renal transplantation in the future.