RESUMO
AIM: This study was aimed at investigating platelet-derived microparticles (PMP), endothelium cell-derived microparticles (EMP) and von Willebrand factor (VWF) according to renal function and time post-transplant. We found this study relevant because unusual biomarkers seem to be a promising tool to evaluate chronic renal disease and post-transplant monitoring. METHODS: Ninety-one renal transplant recipients (RTx) were allocated into groups according to creatinine plasma levels (C1 < 1.4 and C2 ≥ 1.4 mg/dL), estimated glomerular filtration rates (R1 < 60 and R2 ≥ 60 mL/min per 1.73 m2 ) and time post-transplant (T1: 3-24; T2: 25-60; T3: 61-120; and T4 > 120 months). EMP and PMP levels were assessed by flow cytometry and VWF levels were evaluated by enzyme-linked immunosorbent assay. RESULTS: Platelet-derived microparticle levels were higher in C1 group compared with C2 (P = 0.00). According to diameter, small PMP and EMP (≤0.7 µm) were also higher in C1 group, all values of P less than 0.05. T1 and T2 groups have shown high EMP levels and a predominance of big microparticle (>0.7 µm) compared with T4 group, all values of P less than 0.05. Higher VWF levels were observed among RTx with creatinine ≥1.4 mg/dL compared with other RTx, P = 0.01. CONCLUSION: The results showed that PMP, EMP and VWF are promising markers to evaluate endothelial function in RTx. These biomarkers could play a major role in monitoring patients after renal transplant.
Assuntos
Micropartículas Derivadas de Células , Transplante de Rim , Monitorização Fisiológica/métodos , Complicações Pós-Operatórias , Insuficiência Renal Crônica , Fator de von Willebrand/análise , Biomarcadores/sangue , Plaquetas , Brasil , Células Endoteliais , Feminino , Sobrevivência de Enxerto , Humanos , Testes de Função Renal/métodos , Transplante de Rim/efeitos adversos , Transplante de Rim/métodos , Masculino , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/prevenção & controle , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/cirurgia , Reprodutibilidade dos TestesRESUMO
AIM: The maintenance of stable graft function in renal transplanted recipients (RTR) is a challenge for healthcare staff. The ideal biomarkers must have significant predictive values to monitor the intricate renal function response triggered after renal transplantation. The main purpose in this study was to evaluate the regulatory and pro-inflammatory cytokines as biomarkers of allograft function in living-related renal transplant patients. METHODS: Regulatory and pro-inflammatory cytokine plasma levels were measured by flow cytometry in 120 living-related renal transplanted patients categorized into three groups according to creatinine plasma levels: creatinine less than 1.4 mg/dL (C1), creatinine within 1.4-2.0 mg/dL (C2) and more than 2.0 mg/dL (C3). Patients were also classified as 'low' or 'high' cytokine producers. Clinical data were obtained from patients' medical record. RESULTS: We have found a peak of regulatory cytokines in RTR with low creatinine levels as well as a peak of IL-6 pro-inflammatory cytokine in patients with high creatinine levels. C1 and C3 groups showed a mixed pro-inflammatory (IL-8, IL-6, IL-1ß, TNF-α, IL-12 and IFN-γ) and regulatory (IL-4, IL-5 and IL-10) cytokine pattern and C2 had a predominant pro-inflammatory profile. C3 group showed a higher frequency of high pro-inflammatory cytokine producers compared to C1. CONCLUSION: Our data suggest that regulatory cytokines IL-4, IL-5 and IL-10 could be good biomarkers associated with stable renal function, while pro-inflammatory cytokines seems to be potential markers in RTR related to high creatinine plasma levels, specially IL-6 despite of its borderline values.