It is known at the present time that immunological biomarkers may become more sensitive, non-invasive methods of graft rejection diagnosis than those currently used. A growing amount of studies in animal models shows that chemokines, as active participants in the immune process, may be used to this purpose. Our earlier studies have shown an important prognostic significance of IL-6, IL-2, 17A and IL-1RA increase in pre-operative period as markers of acute kidney allograft rejection. When assessing changes in studied peripheral blood growth factors, we concluded that a sharp decrease in BDNF content is a diagnostically significant early sign of kidney allograft rejection. The aim of this study was to identify the prognostic role of serum chemokine levels at the preoperative stage, taking into account the production of anti-HLA antibodies during the post-transplant period as a risk factor of kidney allograft rejection. A comparative analysis of chemokine serum concentrations was performed in the patients with terminal-stage chronic kidney disease (CKD). In the patients from main clinical groups, the blood cytokine levels were measured 6 hours before transplantation, i.e., Eotaxin (CCL11), GRO-α (CXCL1), IL-8 (CXCL8), IP-10 (CXCL10), MCP-1 (CCL2), MIP-1α (CCL3), MIP-1β (CCL4), SDF-1α (CXCL12), RANTES (CCL5), MIG (CXCL9) by means of multiplex immunological assays, using appropriate test systems. The studies have shown significant changes in several chemokines in the CKD patients compared to age-matched controls. However, the following diagnostically significant biomarkers associated with early rejection of transplanted kidney should be considered: increased concentration of CCL2 and CCL4 chemokines, as well as an acute decrease in CCL11. Significantly decreased CXCL12 concentration in peripheral blood could be considered a marker of favorable posttransplant clinical course. Occurence of HLA antibodies in recipients is also associated with elevated serum levels of CXCL8, CXCL10, CCL4, and CCL5.
Association of preoperative non-HLA antibodies with kidney allograft rejection
