Prediction of acute renal allograft rejection by urinary monokine induced by IFN-γ (MIG)

Prediction of acute renal allograft rejection by urinary monokine induced by IFN-γ (MIG)

Early diagnosis of acute allograft rejection (AR) is still decisive for long-term renal allograft survival. The aim of this study was to define the role of the chemokine monokine induced by IFN-gamma (MIG) (CXCL9) and IFN-gamma-inducible protein 10 (IP-10) (CXCL10) as early markers of AR in renal tr...

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Bibliographic Details
Published in:Journal of the American Society of Nephrology Vol. 16; no. 6; pp. 1849 - 1858
Main Authors: HAUSER, Ingeborg A, SPIEGLER, Sandra, RADEKE, Heinfried H, KISS, Eva, GAUER, Stefan, SICHLER, Olaf, SCHEUERMANN, Ernst H, ACKERMANN, Hanns, PFEILSCHIFTER, Josef M, GEIGER, Helmut, GRÖNE, Hermann-Josef
Format: Journal Article
Language:English
Published: Hagerstown, MD Lippincott Williams & Wilkins 01-06-2005
Subjects:
Acute Disease
Adult
Aged
Biological and medical sciences
Biomarkers - urine
Chemokine CXCL10
Chemokine CXCL9
Chemokines, CXC - urine
Female
Graft Rejection - drug therapy
Graft Rejection - etiology
Graft Rejection - urine
Humans
Immunosuppressive Agents - therapeutic use
Intercellular Signaling Peptides and Proteins - urine
Kidney Transplantation - adverse effects
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Predictive Value of Tests
Prospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Human
Urine
Nephrology
Acute
Cytokine
Prediction
Monokine
Transplantation
Homotransplantation
Kidney
Urology
Rejection
CXCL9 chemokine
Urinary system
Surgery
Graft
CXC chemokine
Gamma interferon
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Summary:Early diagnosis of acute allograft rejection (AR) is still decisive for long-term renal allograft survival. The aim of this study was to define the role of the chemokine monokine induced by IFN-gamma (MIG) (CXCL9) and IFN-gamma-inducible protein 10 (IP-10) (CXCL10) as early markers of AR in renal transplantation (NTX). In a prospective study, 69 de novo renal transplant recipients were monitored and urine samples were collected after NTX for a median of 29 d. In pH-adjusted urine, MIG and IP-10 were determined by modified ELISA. AR was clinically diagnosed in 15 of 69 recipients and confirmed by biopsy in 14 of 15 AR patients (Banff classification). Corresponding to CXCR3-positive infiltrates in renal tissue, urinary MIG was elevated in 14 of 15 AR patients with a median of 2809 pg/ml (quartile 25% and 75% = 870 and 13,000; n = 15), being significantly (P < 0.0001) different from both nonrejecting allograft patients (NO-AR) (median, 25%, and 75%: 96, 1.0, and 161, n = 54) and healthy controls (median, 25%, and 75%: 144, 19, and 208, n = 13). Urinary MIG predicted AR with a sensitivity of 93% and a specificity of 89%. In AR and NO-AR groups, MIG values correlated well with IP-10 (P < 0.001). MIG values indicated both imminent rejection and response to successful antirejection therapy. MIG was not related to intercurrent infections or other causes for impairment of renal function. In a multivariate analysis, MIG correlated best (P < 0.001) with AR from all AR-associated parameters. In conclusion, urinary MIG serves as a very sensitive and specific predictor for AR, mirrors response to antirejection therapy, and thus may contribute to improved long-term renal allograft survival.
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ISSN:1046-6673
1533-3450
DOI:10.1681/ASN.2004100836