Serum Endocan Correlated With Stage of Chronic Kidney Disease and Deterioration in Renal Transplant Recipients

• Published in: Transplantation proceedings Vol. 46; no. 2; pp. 323 - 327
• Main Authors: Su, Y.-H, Shu, K.-H, Hu, C.-P, Cheng, C.-H, Wu, M.-J, Yu, T.-M, Chuang, Y.-W, Huang, S.-T, Chen, C.-H
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2014
• Subjects: Adult; Female; Glomerular Filtration Rate; Human Umbilical Vein Endothelial Cells; Humans; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - surgery; Kidney Transplantation; Male; Middle Aged; Neoplasm Proteins - blood; Proteoglycans - blood; Surgery; Tumor Necrosis Factor-alpha - metabolism
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2013.10.057

Abstract Earlier detection and intervention for chronic renal allograft injury (CRAI) remain major challenges for transplantation physicians. Endocan plays a key role in the regulation of cell adhesion, inflammatory disorders, and tumor progression. We conducted this cross-sectional study of 97 renal transplant (RT) recipients with mean RT duration of 7.0 ± 5.7 years to determine whether Endocan could be a diagnostic and prognostic marker. The patients' mean age was 43.6 ± 13.2 years, and 55.7% (54/97) were male. Higher Endocan levels were found in more advanced chronic kidney disease (CKD) stages in a dose-dependent manner. Interestingly, the Endocan ≥643.19 pg/mL group had higher creatinine (Cr; 1.2 ± 0.4 vs 1.6 ± 1.1 mg/dL; P  = .029) and lower estimated glomerular filtration rate (eGFR; 67.8 ± 23.8 mL/min vs 54.4 ± 22.0; P  = .006) than the Endocan <643.19 pg/mL group after 3 months of follow-up, respectively. Linear regression analysis found tumor necrosis factor (TNF)-α correlated well with Endocan. To elucidate the response of endothelium activation, we stimulated human umbilical vein endothelial cells (HUVECs) with TNF-α in vitro, and found the levels of Endocan ( P  = .022) and transforming growth factor (TGF)-β1 ( P  = .034) increased with time, but interleukin (IL)-10 decreased ( P  = .013). In summary, Endocan may reflect the degree of endothelial cell injury in renal allografts, and showed a trend of elevation in late-stage CKD. An in vitro study demonstrated TNF-α–activated HUVECs secreted high levels of Endocan and TGF-β1, which could lead to a better understanding of the role of endothelium in immune balance. In conclusion, Endocan may have potential as a useful long-term indicator of CRAI in RT recipients, but further study is needed to verify our findings.