Renal expression and urinary concentration of EGF and IL-6 in acutely dysfunctioning kidney transplanted patients |
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Authors: | Di Paolo S; Gesualdo L; Stallone G; Ranieri E; Schena F |
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Institution: | Institute of Nephrology, University of Bari, Polyclinic, Piazza Giulio Cesare, 11, I-70124 Bari, Italy |
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Abstract: | Background: Despite marked improvements in the success
of solid organ transplantation, a significant percentage of transplanted
organs is lost due to recurrent episodes of acute cellular rejection. The
mechanisms that govern allograft rejection likely include a complex
regulatory network of multiple cytokines and growth factors.
Design and Method: This study investigated the kidney
gene (in situ hybridization) and protein
(immunohistochemistry) expression and the urinary excretion rate of IL-6
and EGF in 29 renal transplant recipients: 16 with acute cellular rejection
(AR) and 13 with acute tubular damage/cyclosporine toxicity (ATD).
Results: AR patients displayed a 4-fold increase of
renal IL-6 expression, which localized chiefly to proximal tubular cells
and monocytes/macrophages, whereas EGF signal was extremely weak or even
absent. In ATD patients, EGF expression was markedly reduced, while IL-6
specific signal was unchanged. In all the patients examined the renal
expression of IL-6 and EGF strictly correlated with their urinary excretion
rate (r:0.459, P:0.001). Thus, urinary IL-6/EGF ratio was markedly
increased in the former group (>20-fold at day 1), where it
parallelled the modifications of plasma creatinine over time (r:0.603, P
<0.0001), and was only slightly increased in the latter group
(<3-fold). Conclusion: Kidney transplanted
patients with acute cellular rejection or acute tubular damage/CyA
nephrotoxicity exhibit a distinctly different pattern of intragraft
expression of IL-6 and EGF, which is closely reflected by their rate of
urinary excretion. |
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Keywords: | |
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