Urinary HLA-DR and CD54 expression - Indicators for inflammatory activity in decoy cell shedding patients

SeHoon Kim, Hyung Joon Ahn, YuSeun Kim, Soon Il Kim, Hyonsuk Kim, Hyeon Joo Jeong

Research output: Contribution to journalArticle

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Abstract

Background. Polyomavirus (PV) nephropathy may coexist with or follow acute renal transplant rejection. The aim of this study was to evaluate whether HLA-DR and CD54 are useful cellular markers for surveillance of acute rejection in PV-infected patients. Methods. A prospective study was conducted using 205 renal transplant patients. Urine samples were collected at a regular interval post-transplantation for routine cytology and immunocytochemistry. Urinary levels of tumour necrosis factor α, soluble interleukin-2 receptor and interleukin-6 were used as adjunctive markers for acute rejection. Results. Of the 699 total samples, decoy cells were identified in 100 samples of 50 patients. Patients with decoy cell-positive (DCP) samples had higher serum creatinine levels than decoy cell-negative (DCN) samples (1.55 vs 1.41 mg/dl, respectively; P = 0.006). DCP samples were also more likely to be HLA-DR positive (50.0 vs 32.4%; P = 0.029), as well as CD54 positive (17.4 vs 6.9%; P = 0.038). However, serum creatinine levels did not correlate with HLA-DR or CD54 positivity among DCP samples. Instead, CD54 positivity correlated with decoy cell grades. Immunosuppression decreased in 11 DCP patients, and HLA-DR was negatively converted in three of them. None of the patients developed acute clinical rejection. Urinary cytokine levels did not correlate with serum creatinine levels, nor did they correlate with HLA-DR or CD54 status among DCP patients. Conclusions. Urinary tubular HLA-DR and CD54 expression increased in decoy cell shedding patients but did not indicate a concomitant acute rejection. These markers may instead indicate renal inflammatory activity associated with viral reactivation, which has the potential to progress to PV interstitial nephritis.

Original languageEnglish
Pages (from-to)2601-2606
Number of pages6
JournalNephrology Dialysis Transplantation
Volume21
Issue number9
DOIs
Publication statusPublished - 2006 Sep 1

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HLA-DR Antigens
Polyomavirus
Creatinine
Kidney
Serum
Interstitial Nephritis
Interleukin-2 Receptors
Graft Rejection
Immunosuppression
Cell Biology
Interleukin-6
Tumor Necrosis Factor-alpha
Transplantation
Immunohistochemistry
Urine
Prospective Studies
Cytokines
Transplants

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

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title = "Urinary HLA-DR and CD54 expression - Indicators for inflammatory activity in decoy cell shedding patients",
abstract = "Background. Polyomavirus (PV) nephropathy may coexist with or follow acute renal transplant rejection. The aim of this study was to evaluate whether HLA-DR and CD54 are useful cellular markers for surveillance of acute rejection in PV-infected patients. Methods. A prospective study was conducted using 205 renal transplant patients. Urine samples were collected at a regular interval post-transplantation for routine cytology and immunocytochemistry. Urinary levels of tumour necrosis factor α, soluble interleukin-2 receptor and interleukin-6 were used as adjunctive markers for acute rejection. Results. Of the 699 total samples, decoy cells were identified in 100 samples of 50 patients. Patients with decoy cell-positive (DCP) samples had higher serum creatinine levels than decoy cell-negative (DCN) samples (1.55 vs 1.41 mg/dl, respectively; P = 0.006). DCP samples were also more likely to be HLA-DR positive (50.0 vs 32.4{\%}; P = 0.029), as well as CD54 positive (17.4 vs 6.9{\%}; P = 0.038). However, serum creatinine levels did not correlate with HLA-DR or CD54 positivity among DCP samples. Instead, CD54 positivity correlated with decoy cell grades. Immunosuppression decreased in 11 DCP patients, and HLA-DR was negatively converted in three of them. None of the patients developed acute clinical rejection. Urinary cytokine levels did not correlate with serum creatinine levels, nor did they correlate with HLA-DR or CD54 status among DCP patients. Conclusions. Urinary tubular HLA-DR and CD54 expression increased in decoy cell shedding patients but did not indicate a concomitant acute rejection. These markers may instead indicate renal inflammatory activity associated with viral reactivation, which has the potential to progress to PV interstitial nephritis.",
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Urinary HLA-DR and CD54 expression - Indicators for inflammatory activity in decoy cell shedding patients. / Kim, SeHoon; Ahn, Hyung Joon; Kim, YuSeun; Kim, Soon Il; Kim, Hyonsuk; Jeong, Hyeon Joo.

In: Nephrology Dialysis Transplantation, Vol. 21, No. 9, 01.09.2006, p. 2601-2606.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Urinary HLA-DR and CD54 expression - Indicators for inflammatory activity in decoy cell shedding patients

AU - Kim, SeHoon

AU - Ahn, Hyung Joon

AU - Kim, YuSeun

AU - Kim, Soon Il

AU - Kim, Hyonsuk

AU - Jeong, Hyeon Joo

PY - 2006/9/1

Y1 - 2006/9/1

N2 - Background. Polyomavirus (PV) nephropathy may coexist with or follow acute renal transplant rejection. The aim of this study was to evaluate whether HLA-DR and CD54 are useful cellular markers for surveillance of acute rejection in PV-infected patients. Methods. A prospective study was conducted using 205 renal transplant patients. Urine samples were collected at a regular interval post-transplantation for routine cytology and immunocytochemistry. Urinary levels of tumour necrosis factor α, soluble interleukin-2 receptor and interleukin-6 were used as adjunctive markers for acute rejection. Results. Of the 699 total samples, decoy cells were identified in 100 samples of 50 patients. Patients with decoy cell-positive (DCP) samples had higher serum creatinine levels than decoy cell-negative (DCN) samples (1.55 vs 1.41 mg/dl, respectively; P = 0.006). DCP samples were also more likely to be HLA-DR positive (50.0 vs 32.4%; P = 0.029), as well as CD54 positive (17.4 vs 6.9%; P = 0.038). However, serum creatinine levels did not correlate with HLA-DR or CD54 positivity among DCP samples. Instead, CD54 positivity correlated with decoy cell grades. Immunosuppression decreased in 11 DCP patients, and HLA-DR was negatively converted in three of them. None of the patients developed acute clinical rejection. Urinary cytokine levels did not correlate with serum creatinine levels, nor did they correlate with HLA-DR or CD54 status among DCP patients. Conclusions. Urinary tubular HLA-DR and CD54 expression increased in decoy cell shedding patients but did not indicate a concomitant acute rejection. These markers may instead indicate renal inflammatory activity associated with viral reactivation, which has the potential to progress to PV interstitial nephritis.

AB - Background. Polyomavirus (PV) nephropathy may coexist with or follow acute renal transplant rejection. The aim of this study was to evaluate whether HLA-DR and CD54 are useful cellular markers for surveillance of acute rejection in PV-infected patients. Methods. A prospective study was conducted using 205 renal transplant patients. Urine samples were collected at a regular interval post-transplantation for routine cytology and immunocytochemistry. Urinary levels of tumour necrosis factor α, soluble interleukin-2 receptor and interleukin-6 were used as adjunctive markers for acute rejection. Results. Of the 699 total samples, decoy cells were identified in 100 samples of 50 patients. Patients with decoy cell-positive (DCP) samples had higher serum creatinine levels than decoy cell-negative (DCN) samples (1.55 vs 1.41 mg/dl, respectively; P = 0.006). DCP samples were also more likely to be HLA-DR positive (50.0 vs 32.4%; P = 0.029), as well as CD54 positive (17.4 vs 6.9%; P = 0.038). However, serum creatinine levels did not correlate with HLA-DR or CD54 positivity among DCP samples. Instead, CD54 positivity correlated with decoy cell grades. Immunosuppression decreased in 11 DCP patients, and HLA-DR was negatively converted in three of them. None of the patients developed acute clinical rejection. Urinary cytokine levels did not correlate with serum creatinine levels, nor did they correlate with HLA-DR or CD54 status among DCP patients. Conclusions. Urinary tubular HLA-DR and CD54 expression increased in decoy cell shedding patients but did not indicate a concomitant acute rejection. These markers may instead indicate renal inflammatory activity associated with viral reactivation, which has the potential to progress to PV interstitial nephritis.

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