Immune Monitoring (Videos Available)

Tuesday July 03, 2018 from 09:45 to 11:15

Room: N-106

420.6 Urinary C-X-C motif chemokines 13 is a noninvasive biomarker of antibody-mediated renal allograft rejection

Dajin Chen, P.R. China

THE FIRST AFFILIATED HOSPITAL ZHEJIANG UNIVERCITY

Abstract

Urinary C-X-C Motif Chemokines 13 is a Noninvasive Biomarker of Antibody-Mediated Renal Allograft Rejection

Dajin Chen1, Jianghua Chen1.

1Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Key Laboratory of Multiple Organ Transplantation, Ministry ofHealth, Hangzhou, P.R. China

Key Laboratory of Nephropathy, Zhejiang Province.

Background:Since acute rejection remains one of the major complications which necessitate periodic surveillance, noninvasive diagnostic/prognostic methods are preferred by renal transplant recipients. Here we explored whether urinary C-X-C motif chemokines 13(CXCL13) could be apotential candidate to reflect ongoing immune processes within the renal graft. Methods: We investigated urinary CXCL13 levels by a cross-sectional analysisof 146 renal allograft recipients and 40 healthy controls. Besides, a subset of patients (n = 57) were followed-up for kinetic monitoring of immune status. Results:Urinary CXCL13/Cr was lower in normal transplants compared to those withacute tubular necrosis (ATN, P = 0.001), chronic allograft nephropathy (CAN, P = 0.01) andacute rejection (AR, P < 0.0001), which yielded a good diagnosis performance of urinary CXCL13 for AR (AUC = 0.818, P< 0.0001). Interestingly, urinary CXCL13 furtherdistinguished acute antibody mediated rejection (ABMR)from acute cellular rejection, with an AUC of 0.856. Besides,patients with steroid-resistant acute rejection had distinctly greater urinary CXCL13/Cr levels than patients with reversible acute rejection, P =0.001. Follow-up data revealed that urinary CXCL13/Cr varied in line with the occurrence of ABMR. Furthermore, elevated levels of urinary CXCL13/Cr within the first monthwas predictive of graft function at 3, 6 months, P=0.044 and 0.4. Conclusion:This study demonstrated that monitoring of urinary CXCL13/Cr might be a valuable noninvasive approach for the detection of AR, especially ABMR. Additionally, high urinary CXCL13/Cr levels related to the poor response to steroid treatment and predicted a compromised graft function after AR. Key Words:C-X-C motif chemokines 13; kidney transplantation; rejection; urine

Key Laboratory of Multiple Organ Transplantation, Ministry ofHealth.



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