Serum periostin: a sentinel for malignancy risk in kidney transplant recipients

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Background Periostin (POSTN) is a matricellular protein involved in kidney fibrosis and inflammation but also linked to tumor progression and regulation of the local microenvironment.Aims This study aimed to evaluate the association between serum POSTN, transgelin (TAGLN) and highly sensitive interleukin 6 (hsIL-6) and de novo malignancy occurrence post kidney transplant (KTx).Methods Serum concentrations of POSTN, TAGLN, and hsIL-6 were measured in 127 KTRs and compared with 32 healthy controls. Patients were followed for a median (IQR) of 29 (25–32) months.Results Log-transformed serum POSTN concentrations were lower in the KTx group (mean [SD]: 6.80[0.53] vs. 7.06[0.33] pmol/l), whereas transgelin (4.62[0.34] vs. 4.30[0.29] ng/mL) and hsIL-6 (1.51[0.50] vs. 0.99[0.37] pg/mL) were elevated (p < 0.001 for all). Final model showed satisfactory discrimination (AUC 0.83; 95% CI 0.74–0.91). Patients in the moderate POSTN zone were characterized higher odds of malignancy (OR 4.40; 95% CI 1.21–16.91, p = 0.011). Higher POSTN levels were independently associated with time post-KTx (β = 0.20; p < 0.001). Lower TAGLN levels were observed in older patients (β = −0.005; p = 0.011), those with CV disease (β = −0.200; p = 0.008) and among smokers (β = −0.19; p = 0.026).Conclusions In patients post-KTx, elevated serum POSTN is an independent predictor of new-onset malignancy. Further prospective evaluation is warranted.

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