Toll-like 4 receptor (TLR4) expression on peripheral blood mononuclear cells in renal transplant recipients with pre-transplant chronic interstitial nephritis indicates patients at risk of graft deterioration.

Zmonarski, SC ; Banasik, M ; et al.

In: Transplant immunology, Jg. 62 (2020-10-01), S. 101319

academicJournal

Data binding the expression of Toll-like 4 receptor (TLR4ex), transplanted kidney function, and the cause of pre-transplant end-stage renal disease are scarcely available.

Objective: To investigate the relationship between pre-transplant chronic interstitial nephritis (CIN), TLR4ex and transplanted kidney function.

Materials and Methods: TLR4ex was measured in peripheral blood mononuclear cells of 43 CIN kidney transplant recipients. We compared TLR4ex among 33 patients with pre-transplant chronic non-infectious interstitial nephritis (NIN) and 10 patients with pre-transplant chronic pyelonephritis (Py). At the beginning (Day-0) TLR4ex, as well as concentrations of cyclosporin A (CyA) and tacrolimus (TAC) were determined. Both CIN and NIN patients were divided according to the respective median of TLR4ex into groups of low-TLR4 expression (L-TLR4ex) and high-TLR4 expression (H-TLR4ex). Serum creatinine/glomerular filtration rate (sCr/EGFR) was assessed on Day-0 and after the follow-up (F-up). The magnitudes of sCr/EGFR change (ΔsCr/ΔEGFR) were evaluated. The treatment was maintained stable along the F-up period (median 11.9 months).

Results: Day-0: in CIN with L-TLR4ex TAC was lower but sCr/EGFR were not different from H-TLR4ex; in Py TLR4ex and TAC were lower than in NIN with no difference in sCR/eGFR. After F-up: in CIN with L-TLR4ex sCR/EGFR and ΔsCr/ΔEGFR were worse than in H-TLR4ex; in Py sCR/EGFR and ΔsCr/ΔEGFR were worse than in NIN. The regression analysis points out prospective impact of Py and TLR4ex on sCR/eGFR and ΔsCr/ΔeGFR.

Conclusion: In CIN, both TLR4ex and Tac appear to be a useful positive predictor of the effectiveness of immunosuppression. Chronic pyelonephritis indirectly promotes faster progression of chronic transplanted kidney disease.

Titel:	Toll-like 4 receptor (TLR4) expression on peripheral blood mononuclear cells in renal transplant recipients with pre-transplant chronic interstitial nephritis indicates patients at risk of graft deterioration.
Autor/in / Beteiligte Person:	Zmonarski, SC ; Banasik, M ; Golebiowski, T ; Madziarska, K ; Mazanowska, O ; Myszka, M ; Zmonarska, J ; Letachowicz, K ; Dawiskiba, T ; Krajewska, M
Zeitschrift:	Transplant immunology, Jg. 62 (2020-10-01), S. 101319
Veröffentlichung:	Amsterdam : Elsevier ; <i>Original Publication</i>: Dunton Green, Sevenoaks, Kent, UK : Edward Arnold, c1993-, 2020
Medientyp:	academicJournal
ISSN:	1878-5492 (electronic)
DOI:	10.1016/j.trim.2020.101319
Schlagwort:	Adult Chronic Disease Female Gene Expression Regulation Graft Rejection epidemiology Humans Male Middle Aged Poland epidemiology Risk Toll-Like Receptor 4 genetics Young Adult Graft Rejection diagnosis Kidney Transplantation Leukocytes, Mononuclear metabolism Nephritis, Interstitial therapy Toll-Like Receptor 4 metabolism Transplant Recipients
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Research Support, Non-U.S. Gov't Language: English [Transpl Immunol] 2020 Oct; Vol. 62, pp. 101319. <i>Date of Electronic Publication: </i>2020 Jul 18. MeSH Terms: Kidney Transplantation* ; Transplant Recipients* ; Graft Rejection / diagnosis ; Leukocytes, Mononuclear / metabolism ; Nephritis, Interstitial / therapy ; Toll-Like Receptor 4 / metabolism ; Adult ; Chronic Disease ; Female ; Gene Expression Regulation ; Graft Rejection / epidemiology ; Humans ; Male ; Middle Aged ; Poland / epidemiology ; Risk ; Toll-Like Receptor 4 / genetics ; Young Adult Contributed Indexing: Keywords: Chronic interstitial nephritis; Cyclosporine-A; Pyelonephritis; Tacrolimus; Toll-like 4 receptor; Transplanted kidney Substance Nomenclature: 0 (Toll-Like Receptor 4) Entry Date(s): Date Created: 20200722 Date Completed: 20210401 Latest Revision: 20210401 Update Code: 20240513

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