Kidney injury molecule-1 and osteopontin: New markers for prediction of early kidney transplant rejection

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• 作者：Zhan-Kui Jin^a ; ^b ; ¹ ; Pu-Xun Tian^a ; ^c ; ¹ ; ^{ttibrg@126.com} ; Xu-Zhen Wang^a ; ¹ ; Wu-Jun Xue^a ; ^c ; Xiao-Ming Ding^a ; ^c ; Jin Zheng^a ; ^c ; Cheng-Guang Ding^a ; Tian-Ci Mao^a ; Wan-Li Duan^a ; Min Xi^a
• 关键词：ARG ; acute rejection group ; AUC ; area under ROC curve ; CI ; confidence interval ; HC ; healthy controls ; KIM-1 ; kidney injury molecule-1 ; KTx ; kidney transplantation ; LDKT ; living-related donor kidney transplant ; NK ; natural killer ; NRG ; non-rejection group
• 刊名：Molecular Immunology
• 出版年：2013
• 出版时间：July, 2013
• 年：2013
• 卷：54
• 期：3-4
• 页码：457-464
• 全文大小：1317 K

文摘

Background

Kidney injury molecule-1 (KIM-1) and osteopontin (OPN) play important roles in immune regulation. We hypothesized that serum KIM-1 and OPN might serve as biomarkers for predicting early acute rejection after kidney transplantation (KTx).

Methods

We conducted a single-center study of 155 subjects, who were classified into acute rejection group (ARG, n = 32), non-rejection group (NRG, n = 45) and healthy controls (HC, n = 78). Serum KIM-1 and OPN levels were measured by Luminex.

Results

The pre-transplant levels of serum KIM-1 and OPN in all KTx recipients were higher than those of HC (P < 0.01). Compared with NRG, ARG showed significantly high serum levels of KIM-1 on day 0 (pre-KTx) and on the 1st, 4th, and 7th post-KTx days, and significantly high OPN levels on day 0 and the 7th day. Kaplan-Meier survival analysis showed that the higher levels of KIM-1 on day 0, the 1st and 4th days and OPN on day 0 and the 7th day were significantly associated with the lower probabilities of rejection-free survival. ROC analyses highlight the superiority of KIM-1 on the 1st day and OPN on the 7th day over those on other post-KTx days in prediction of acute rejection episodes. Multivariate logistic analysis revealed that the serum KIM-1 levels on the 1st post-KTx day and the OPN level on the 7th day were independent and powerful predictors of acute rejection episodes. An optimal predictive model was built by combining KIM-1 on the 1st day and OPN on the 7th day, and this model had the highest AUC (0.922).

Conclusions

This study was the first to demonstrate that serum KIM-1 and OPN may be the promising and elegant markers for prediction of early acute kidney allograft rejection.