247.4: TGF- β1 and galectin-3 diagnostic and predictive value in kidney transplant recipients with graft rejection.

Le résumé fourni par la source

Introduction: Minimally invasive technologies for diagnostic or prediction early signs of complications is one of the key areas in current research of kidney transplantation (KT). The possibilities for the practical use of molecular and genetic biomarkers are being studied. Transforming growth factor beta 1 (TGF-β1), which has multiple effects in the body, and galectin-3 (gal-3), which is highly expressed in fibrosis of transplanted organs, seem promising in this role. The aim of the study is to determine the diagnostic and predictive value of TGF-β1 and gal-3 levels for post-transplant complications in kidney transplant recipients. Methods: The study included 129 kidney transplant recipients (62 men and 67 women aged 17 to 68 years) were followed up to 10 years after KT and 35 healthy individuals. TGF-β1 and gal-3 concentrations were measured in serum by ELISA. Graft rejection was verified through morphological analysis of biopsies. Results: 95 kidney recipients with laboratory and clinical signs of graft dysfunction were identified and biopsied; 34 recipients had normal graft function. The causes of kidney graft dysfunction included: AMR (n=35), ACR (n=26), acute tubular necrosis (n=11), CNI nephrotoxicity (n=13), and chronic graft rejection (n=10). TGF-β1 and gal-3 levels didn’t correlate with the glomerular filtration rate and most blood test parameters, including tacrolimus concentration. The recipients with kidney graft dysfunction had significantly higher TGF-β1 levels than in healthy individuals (p=0.00001) or recipients without it (p=0.018). The recipients with immune-mediated kidney graft injury (ACR, AMR and chronic rejection) had higher TGF-β1 levels than recipients with kidney graft dysfunction caused by other mechanisms (p=0.007). The diagnostic value of TGF-β1 was found: the kidney recipients with serum level of TGF-β1 above the threshold concentration had a higher risk of graft rejection than other recipients (RR=2.2±0.2 [95% CI 1.5–3.5]) with Se=77.5% test and Sp=60.3%. Among the recipients with graft dysfunction, 26 returned to hemodialysis a year or more after КТ, their gal-3 levels were significantly higher, than in other recipients. The predicting value of gal-3 test was found: RR=2.2±0.4 [95% CI 1.1–4.8], Se=73.1%, Sp=52.3%. Conclusion: The complex measurement of serum levels of TGF-β1 and galectin-3 in kidney transplant recipients can be used to monitor the risk of acute and chronic graft rejection and predict a return to hemodialysis.

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