Clinical Study Of RBP-4in Peripheral Blood And Urine IP-10, Mig,OPG Content In Renal Allograft Function Recover And Acute Rejection

Part1Clinical significance of continuous monitoringperipheral blood retinol blinding protein-4in early stage afterrenal transplantationObjective: To investigate the correlation of early stage peripheral blood retinolbinding protein-4content in recipients and renal allograft function recovery.Methods: A retrospective nested case-control study,20cases of recipients whichwere clinical diagnosed acute rejection listed as the rejection group (AR group),20casesof delayed recovery of renal function recipients listed as DGF group,20cases of goodrecovery of renal function after renal transplantation recipients listed as the control group(Control group).3series of biomarkers-peripheral blood retinol binding protein-4(RBP-4) and serum creatinine (SCr), blood urea nitrogen(BUN) of all these60patientsindicators were dynamic monitoring by the immune turbidimetric method and sarcosineoxidase method operating platforms, then we carried out comparative analysis of the dataaspect.Results: RBP and Cr of the acute rejection group and the delayed graft functiongroup were significantly higher than those in the control group, no statistically significantdifference between the two two groups of BUN; these indexes except BUN of acuterejection group were significantly different between the rejection period of time andnon-rejection period of time; in delayed graft function group, RBP and Cr indexes weresignificantly different between renal dysfunction period and normal renal functionperiod;serum creatinine and BUN were positively correlated with Peripheral bloodretinol binding protein-4;anyhow,both in acute rejection group and delayed graft functiongroup,the time which Peripheral blood retinol binding protein-4appeared to change wasearlier than the time which Cr changed.There are certain advantages in pointing out whenrenal function changes.Conclusion:Peripheral blood retinol binding protein-4in the AR group, DGF groupand control group were positively correlated with serum creatinine;the clinical severity ofDGF and RBP-4contents were highly correlated, if the clinical DGF is more severe,peripheral RBP-4content is also higher;in AR group RBP-4increased earlier than serumcreatinine appeared to change, and in DGF group RBP-4decreased earlier than serum creatinine appeared to change. Finally through a series of sequential ongoing research inour center,we consider that RBP-4is a independent Biomarker index beside serumcreatinine which can be widely used in continue monitoring early renal function afterrenal transplantation in recipients. Part2Application of IP-10，Mig and OPG in urinedetection in acute renal allograft rejectionObjective: Detection of urine IP-10，Mig and OPG levels in patients, to discussthe significance in the diagnosis of acute rejection in renal transplantation.Methods:Rejection group and the control group have the same recipients from Part1，and Urine samples for the same period, the same batch of specimens.For everymorning urine samples on30consecutive days after operation in these two groups, usingLuminex100flow cytometry and fluorescence detector and Plexmark triple renal injurybiomarker kit to detection the level of urine IP-10, Mig and OPG.And the levels ofIP-10,Mig and OPG in the urine of two groups were compared and statistically analyzed,whether there is statistical significance in acute renal graft rejection.Results: Urinary IP-10and Mig levels were high expression in acute renal allograftrejection in patients with impaired renal function, no obvious difference between theexpression level of OPG in the two groups of patients.1,The peak urinary IP-10level ofrejection group was (317.10±61.99) pg/mL, significantly higher than that of the controlgroup (5.33±1.40) pg/mL (P<0.01). The peak Mig level of rejection group was (451±29.01) pg/mL, also significantly higher than that of the control group (22.16±5.96)pg/mL (P<0.01). The peak levels of urinary OPG was (375.55±28.22)pg/mL in rejectiongroup and (325±14.94) pg/mL in control group, but there were no significant differencesbetween the two groups (P>0.05).2, The rejection group of urinary IP-10and Mig levelsin different time and the concentration of blood creatinine were significantly correlated.The correlation between IP-10level and serum creatinine concentration has thedetermination coefficient R=0.7835,P<0.01;The correlation between Mig level andserum creatinine concentration has the determination coefficient R=0.7731, P<0.01;The correlation between OPG level and serum creatinine concentration has the determinationcoefficient R=0.0221, P>0.05.3,The rejection group in the rejection period of urinaryIP-10, Mig levels were significantly higher than those in non rejection period of urinaryIP-10, Mig levels,urinary OPG levels had no significant difference in rejection and nonrejection periods.4,The rejection group elevated urinary IP-10levels than serumcreatinine concentrations increased ahead of time (2.64±0.7426) days; increased urineMig levels increased earlier than serum creatinine concentration (2.6±0.7331) days.5,After the steroid impact treatment, urine IP-10, Mig from high expression decreasedsharply, earlier than serum creatinine concentrations fall time.Conclusion: Detection of urinary IP-10and Mig levels have significance for acuterenal allograft rejection, can advance indicate acute renal allograft rejection, and canearly show the treatment effect of steroid, can be used as a noninvasive, independentindex to predict the occurrence of acute rejection, and show the treatment effect of drugtherapy.