There is evidence that non-invasive immunological monitoring may be useful in the early period after renal transplantion, particularly with regard to predicting acute rejection. It is less clear whether chronic allograft dysfunction (CAD) is associated with changes in urinary cells. We evaluated gene expression levels of cytokines, chemokines, growth factors and their receptors in urinary sediment of kidney transplant recipients with different post-transplantion times as a tool for non-invasive monitoring of graft function. From a total of 630 kidney transplant recipients at our transplant clinic, 107 urine samples were evaluated. These patients were divided as within six months (n=30) and until three years after kidney transplantation (n=77). All patients were on calcineurin-based protocols consisting of cyclosporine/mycophenolate mofetil (MMF)/steroids (n=47) or tacrolimus/MMF/steroids (n=30). Patients with biopsy proven CAD and creatinine levels of ≥2mg/dl (n=24) were compared with patients with SGF, creatinine <2mg/dl, n=39) and with those with stable graft function (SGF) and proteinuria >500mg/24h (n=14). Gene expression levels of a set of 32 markers were evaluated in urine samples of the kidney transplant patients using real time PCR analysis (qPCR). In kidney patients with less than six months post KTx TGF-ß1, IFN-gamma as well as IL-10 expression was significantly decreased. TGF-ß1 mRNA levels were significantly higher in CAD patients compared with SGF patients. Interestingly, TGF-ß1 levels were higher in patients with SGF and proteinuria than in CAD patients suggesting that molecules involved in fibrosis development are higher in those patients. EGFR and AGT were downregulated in CAD when compared with SGF patients. In contrast TSP-1 mRNA levels were higher in CAD patients. Moreover, significantly upregulated urinary IP-10 mRNA levels were detectable in CAD patients and those with SGF and proteinuria compared to SGF patients. These data reveal a potential utility of TGF-ß1, AGT, EGFR, and IP-10 mRNA levels in urine samples of kidney transplant patients as early markers of CAD progression.
To cite this abstract in AMA style:Gasser M, Tsaur I, Lopau K, Germer C, Chandraker A, Waaga-Gasser A. Urinary Transcript Expression Profile in Kidney Transplant Recipients Is Predictive for Post-Transplant Graft Function [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/urinary-transcript-expression-profile-in-kidney-transplant-recipients-is-predictive-for-post-transplant-graft-function/. Accessed May 7, 2021.
« Back to 2013 American Transplant Congress