Myeloperoxidase and carbonyl proteins: Promising markers for non-invasive monitoring of graft rejection after heart transplantation

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• 作者：Sonja Koestenbauer ; Philipp Stiegler ; Vanessa Stadlbauer ; Ursula Mayrhauser ; Bettina Leber ; Martin Schweiger ; Andrae Wasler ; Gü ; nther Prenner ; Michael Sereinigg ; Sieglinde Zelzer ; Tatjana Stojakov
• 关键词：myeloperoxidase ; carbonyl proteins ; non-invasive rejection monitoring ; heart transplantation
• 刊名：The Journal of Heart and Lung Transplantation
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：29
• 期：12
• 页码：1352-1357
• 全文大小：706 K

文摘

Background

After heart transplantation (HTx), endomyocardial biopsy (EMB) is currently the standard method to diagnose acute graft rejection. A non-invasive marker of rejection would be desirable as an alternative or to permit more selective use of the costly and invasive EMB.

Methods

In this retrospective study, outcomes of routinely taken EMBs were used to select 28 patients after HTx EMB Grade 0R (8 patients), 1R (9 patients) or 2R (11 patients). For these patients, myeloperoxidase (MPO) and carbonyl proteins (CP) in serum were measured using enzyme-linked immunoassay (ELISA).

Results

MPO and CP levels in post-HTx patients with Grade 2R rejection were significantly (MPO: p < 0.01; CP: p < 0.001) elevated at the time of rejection compared with levels 1 month earlier. MPO and CP levels predicted Grade 2R rejection and the best cut-off point was 237.5 μg/l for MPO and 222.5 pmol/mg for CP, respectively. Clinically most important was the marked increase (doubling of basic values within 1 month) of MPO and CP levels in cases of Grade 2R rejection in post-HTx patients.

Conclusions

MPO and CP seem to be appropriate parameters to monitor rejection events non-invasively and to minimize the application of EMBs after HTx.