- Circulating endothelial microparticles and von willebrand factor in renal antibody-mediated allograft rejection
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SHUBHI KAMTHAN,VINITA AGRAWAL,SNIGDHA SINGH,NARAYAN PRASAD,VIKAS AGARWAL
2022 ; 2022(1):
- 논문분류 :
- 춘계학술대회 초록집
Objectives: Endothelial activation and injury in renal allografts due to antibody-mediated rejection can cause detachment of endothelial cells and release of various cytokines including vWF. It may also result in the release of microparticles known as endothelial microparticles (EnMPs). EnMPs and vWF levels can be used as non-invasive biomarkers for diagnosis and follow up of antibody-mediated rejection (ABMR). We performed this study to evaluate serum and urine vWF and circulating EnMPs in ABMR and correlated it with clinical and histological parameters.
Methods: The study included sixteen patients with a for-cause renal graft biopsy, eight diagnosed as ABMR and eight with no evidence of rejection (NER) from Jan 2021 to Dec 2021. Two age and sex-matched healthy controls were included. ELISA (R&D) for vWF was done in serum and urine samples as per manufacturer’s protocol. Total MPs isolated from blood plasma were defined as EnMPs using CD31+/CD42a- markers and quantified by flow cytometer.
Results: All the participants were males with a mean age of 37.6±6. years. Mean of Serum creatinine in patients with ABMR was 2.78 ±1.0 mg/dl,NER 1.27±0.4 mg/dl and HC 0.93±0.3 mg/dl .Patients with ABMR had significantly elevated levels of serum and urine vWF with a mean of 51.66±40.26ng/ml and 0.25ng/ml±.45ng/ml respectively as compared to NER (serum vWF:23.1±14.62ng/ml, urine vWF: 0.22ng/ml±0.58ng/ml) and healthy controls (serum vWF:8.50±1.06ng/ml, urine vWF: 0.20ng/ml±0.31ng/ml). EnMPs were also elevated in ABMR with a mean of 19% as compared to NER 14% and healthy controls 11% of total MPs. Serum vWF correlated with S.Cr (r=0.459, p=0.045). Urine vWF significantly correlated with degree of peritubular capillaritis (r=0.738, p=.036).
Conclusions: The biomarkers of endothelial injury including EnMPs and vWF were found to be elevated in renal allografts with ABMR. Further studies may elucidate their potential as non-invasive biomarkers for ABMR.