Systemic inflammation in chronic renal allograft dysfunction
Abstract
Aim: the assessment of the systemic inflammation as a typical pathological process associated with chronic renal allograft dysfunction using a new integral criterion – scale of the chronic systemic inflammation. Patients and methods. Three groups of patients were studied: group 1 of patients with the end-stage renal disease who receive renal replacement therapy in the form of programmed hemodialysis; group 2 of patients with chronic renal allograft dysfunction; group 3 of patients with normal function of allograft. Control group was a cohort of 5 healthy persons. The systemic inflammation markers were in blood plasma interleukins (IL-6, IL-8, IL-10), tumor necrosis factor (TNF)a, C-reactivity protein (CRP), cortisol, myoglobin, troponin I, D-dimer using analyzer IMMULITE («SIEMENS», USA). On the basis of these markers we calculated integrated criterion – scale of chronic systemic inflammation, ranging 0 to 8. Point 0 meant the absence of systemic inflammatory response, 1–2 point meant availability of systemic inflammatory response, but the absence of chronic systemic inflammation, points ³3 proved chronic systemic inflammation. Results. Chronic systemic inflammation was detected in 82% patients of group 1, in 43,5% patients of group 2. Patients of group 3 had not chronic systemic inflammation. However, signs of systemic inflammatory response were registered in 90,9% patients of group 1, in 91,3% patients of group 2, in 41,7% patients of group 3. Conclusion: renal transplantation arrests systemic inflammation partially, but there is a strong possibility of chronic renal allograft dysfunction in recipients who have some criteria of chronic systemic inflammation.
About the Authors
E. Yu. Gusev
Institute of Immunology and Physiology, Ural branch Russian Academy of Sciences
Russian Federation
Russian Federation
L. V. Solomatina
Institute of Immunology and Physiology, Ural branch Russian Academy of Sciences
Russian Federation
Russian Federation
E. V. Panshina
ГУЗ «Свердловская областная клиническая больница № 1», г. Екатеринбург
Russian Federation
Russian Federation
J. A. Zhuravleva
Institute of Immunology and Physiology, Ural branch Russian Academy of Sciences
Russian Federation
Russian Federation
T. E. Zubova
Institute of Immunology and Physiology, Ural branch Russian Academy of Sciences
Russian Federation
Russian Federation
References
1. Багдасарян А.Р., Столяревич Е.С., Ким И.Г. и др. Влияние эналаприла на скорость прогрессирования хронической трансплантационной нефропатии // Нефрология и диализ. 2003. T. 5. № 1. С. 33–42.
2. Гусев Е.Ю., Соломатина Л.В., Журавлева Ю.А. и др. Сравнительный анализ показателей системной воспалительной реакции у больных с терминальной почечной недостаточностью // Нефрология и диализ. 2009. Т. 11. № 2. С. 123–128.
3. Гусев Е.Ю., Соломатина Л.В., Журавлева Ю.А. и др. Системная воспалительная реакция у больных с терминальной хронической почечной недостаточностью // Нефрология и диализ. 2008. T. 10. № 3–4. С. 248–253.
4. Гусев Е.Ю., Черешнев В.А., Журавлева Ю.А. и др. Варианты развития хронического системного воспаления // Медицинская иммунология. 2009. T. 11. № 2–3. С. 131–140.
5. Гусев Е.Ю., Черешнев В.А., Юрченко Л.Н. Системное воспаление с позиции теории типового патологического процесса // Цитокины и воспаление. 2007. Т. 6. № 4. С. 9–21.
6. Гусев Е.Ю., Юрченко Л.Н., Черешнев В.А. и др. Варианты развития острого системного воспаления // Цитокины и воспаление. 2008. Т. 7. № 2. С. 9–17.
7. Гусев Е.Ю., Юрченко Л.Н., Черешнев В.А. и др. Методология изучения системного воспаления // Цитокины и воспаление. 2008. Т. 7. № 1. С. 15–23.
8. Гусев Е.Ю., Юрченко Л.Н., Черешнев В.А. и др. Способ диагностики и прогноза системного воспаления с верификацией фаз и стадий // Патент на изобретение № 2335771 от 11.07.2006.
9. Гусев Е.Ю., Юрченко Л.Н., Черешнев В.А. и др. Хроническое системное воспаление как типовой патологический процесс // Цитокины и воспаление. 2008. Т. 7. № 4. С. 3–10.
10. Столяр А.Г., Бердюгина О.В., Борецкая Е.И. и др. Иммунологический подбор при трансплантации почки – сохраняющаяся актуальность проблемы // Вестник трансплантологии и искусственных органов. 2010. Т. 12 (приложение). С. 94–95.
11. Столяревич Е.С. Хроническая дисфункция трансплантированной почки: морфологическая картина, особенности течения, подходы к профилактике и лечению // Автореферат диссертации на соискание ученой степени доктора медицинских наук / Москва, 2010. 50 с.
12. Alachkar N., Ugarte R., Huang E. et al. Stem cell factor, interleukin-16, and interleukin-2 receptor alpha are predictive biomarkers for delayed and slow graft function // Transplant. Proc. 2010. Vol. 42 (9). P. 3399–3405.
13. Burgos P.I., Perkins L.E., Pons-Estel G.J. et al. Risk factors and impact of recurrent lupus nephritis in patients with systemic lupus erythematosus undergoing renal transplantation: data from a single US institution // Arthritis Rheum. 2009. Vol. 60 (9). P. 2757–2766.
14. Cottone S., Palermo A., Vaccaro F. et al. In renal transplanted patients inflammation and oxidative stress are interrelated // Transplant. Proc. 2006. Vol. 38 (4). P. 1026–1030.
15. Fletcher J.T., Nankivell B.J., Alexander S.I. Chronic allograft nephropathy // Pediatr. Nephrol. 2009. Vol. 24 (8). P. 1465–1471.
16. Freidrich B., Alexander D., Janessa A. et al. Acute effects of hemodialysis on cytokine transcription profiles: Evidence for C-reactive protein-dependency of mediator induction // Kidney International. 2006. Vol. 70. P. 2124–2130.
17. Halloran P., Melk A., Barth C. Rethinking allograft nephropathy: The concept of accelerated senescence // J. Am. Soc. Nephrol. 1999. Vol. 10. P. 167–181.
18. Jabs W.J., Meier M., Lamprecht P. et al. Local expression of C-reactive protein is associated with deteriorating graft function in acute and chronic failure of kidney transplants // Nephron. Clin. Pract. 2010. Vol. 117 (4). P. 390–397.
19. Joosten S.A., van Kooten C., Paul L.C. Pathogenesis of chronic allograft rejection // Transpl. Int. 2003. Vol. 16 (3). P. 137–145.
20. Kasiske B.L. Clinical correlates to chronic renal allograft rejection // Kidney Int. 1997. Vol. 52. Suppl. 63. P. 71–74.
21. Krueger N.R., Becker B.N., Heisey D.M. et al. Chronic allograft nephropathy uniformly affects recipients of cadaveric, non-identical living-related and living-unrelated grafts // Transplantation. 2003. Vol. 75 (10). P. 1677–1682.
22. Lattanzio R.M., Kypyt D.N. Acute kidney injury: New concepts in definition, diagnosis, pathophysiology and treatment // J. Am. Osteopath. Assoc. 2009. Vol. 109 (1). P. 13–19.
23. Ortega L.M., Schultz D.R., Lenz O. et al. Review: Lupus nephritis: pathologic features, epidemiology and a guide to therapeutic decisions // Lupus. 2010. Vol. 19 (5). P. 557–574.
24. Ponticelli C. Progression of renal damage in chronic rejection // Kidney Int. 2000. Vol. 57. Suppl. 75. P. 62–70.
25. Ricci Z., Ronco C. Pathogenesis of acute kidney injury during sepsis // Current Drug Targets. 2009. Vol. 10 (12). P. 1179–1183.
26. Sepsis and Non-infectious systemic inflammation / Edited by Cavaillon J.M., Adrie C. Wieley BlackWell. 2009. 66 р.
27. van Ree R.M., Oterdoom L.H., de Vries A.P. et al. Elevated levels of C-reactive protein independently predict accelerated deterioration of graft function in renal transplant recipients // Nephrology Dialysis Transplantation. 2007. Vol. 22. P. 246–253.
28. Yao Q., Axellson J., Heimburger O. et al. Systemic inflammation in dialysis patients with end-stage renal disease: causes and consequences // Minerva Urol. Nephrol. 2004. Vol. 56. P. 237–248.
Review
For citations:
Gusev E.Yu., Solomatina L.V., Panshina E.V., Zhuravleva J.A., Zubova T.E. Systemic inflammation in chronic renal allograft dysfunction. Nephrology and Dialysis. 2011;13(2):082-088. (In Russ.)
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