| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Rabant, Marion Amrouche, Lucile Lebreton, Xavier Aulagnon, Florence Benon, Aurélien Sauvaget, Virginia Bonifay, Raja Morin, Lise Scemla, Anne Delville, Marianne Martinez, Frank Timsit, Marc Olivier Duong Van Huyen, Jean-Paul Legendre, Christophe Terzi, Fabiola Anglicheau, Dany |
| Description |
Author Affiliation: Rabant M ( Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France); Amrouche L ( Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France); Lebreton X ( Department of Nephrology and Kidney Transplantation, Necker Hospital, and Centaure Foundation and Labex Transplantex, Necker Hospital, Paris, France.); Aulagnon F ( Department of Nephrology and Kidney Transplantation, Necker Hospital, and.); Benon A ( Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France); Sauvaget V ( Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France); Bonifay R ( Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France); Morin L ( Department of Nephrology and Kidney Transplantation, Necker Hospital, and.); Scemla A ( Department of Nephrology and Kidney Transplantation, Necker Hospital, and.); Delville M ( Department of Nephrology and Kidney Transplantation, Necker Hospital, and.); Martinez F ( Department of Nephrology and Kidney Transplantation, Necker Hospital, and.); Timsit MO ( Paris Descartes, Sorbonne Paris Cité University, Paris, France); Duong Van Huyen JP ( Paris Descartes, Sorbonne Paris Cité University, Paris, France); Legendre C ( Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France); Terzi F ( Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France); Anglicheau D ( Necker-Enfants Malades Institute, French National Institute of Health and Medical Research U1151, Paris, France) |
| Abstract |
Urinary levels of C-X-C motif chemokine 9 (CXCL9) and CXCL10 can noninvasively diagnose T cell-mediated rejection (TCMR) of renal allografts. However, performance of these molecules as diagnostic/prognostic markers of antibody-mediated rejection (ABMR) is unknown. We investigated urinary CXCL9 and CXCL10 levels in a highly sensitized cohort of 244 renal allograft recipients (67 with preformed donor-specific antibodies [DSAs]) with 281 indication biopsy samples. We assessed the benefit of adding these biomarkers to conventional models for diagnosing/prognosing ABMR. Urinary CXCL9 and CXCL10 levels, normalized to urine creatinine (Cr) levels (CXCL9:Cr and CXCL10:Cr) or not, correlated with the extent of tubulointerstitial (i+t score; all P<0.001) and microvascular (g+ptc score; all P<0.001) inflammation. CXCL10:Cr diagnosed TCMR (area under the curve [AUC]=0.80; 95% confidence interval [95% CI], 0.68 to 0.92; P<0.001) and ABMR (AUC=0.76; 95% CI, 0.69 to 0.82; P<0.001) with high accuracy, even in the absence of tubulointerstitial inflammation (AUC=0.70; 95% CI, 0.61 to 0.79; P<0.001). Although mean fluorescence intensity of the immunodominant DSA diagnosed ABMR (AUC=0.75; 95% CI, 0.68 to 0.82; P<0.001), combining urinary CXCL10:Cr with immunodominant DSA levels improved the diagnosis of ABMR (AUC=0.83; 95% CI, 0.77 to 0.89; P<0.001). At the time of ABMR, urinary CXCL10:Cr ratio was independently associated with an increased risk of graft loss. In conclusion, urinary CXCL10:Cr ratio associates with tubulointerstitial and microvascular inflammation of the renal allograft. Combining the urinary CXCL10:Cr ratio with DSA monitoring significantly improves the noninvasive diagnosis of ABMR and the stratification of patients at high risk for graft loss. |
| File Format |
HTM / HTML |
| ISSN |
10466673 |
| e-ISSN |
15333450 |
| Journal |
Journal of the American Society of Nephrology |
| Issue Number |
11 |
| Volume Number |
26 |
| Language |
English |
| Publisher |
American Society of Nephrology |
| Publisher Date |
2015-11-01 |
| Publisher Place |
United States |
| Access Restriction |
Open |
| Subject Keyword |
Discipline Nephrology Chemokine Cxcl10 Urine Graft Rejection Renal Insufficiency Diagnosis Immunology Antibodies Blood Area Under Curve Biological Markers Biopsy Chemokine Cxcl9 Cohort Studies Creatinine Inflammation Interferon-gamma Metabolism Kidney Transplantation Prognosis Proportional Hazards Models Roc Curve Reproducibility Of Results Transplantation, Homologous Research Support, Non-u.s. Gov't |
| Content Type |
Text |
| Resource Type |
Article |
| Subject |
Nephrology |
