AIM: The purpose of this study was to assess whether measurement of urinary vascular endothelial growth factor (VEGF) could be adopted as a new non-invasive diagnostic tool for acute rejection following renal transplantation. METHODS: Urinary concentration of VEGF was determined by an enzyme-linked immunosorbent assay technique in 215 renal allograft recipients and 80 healthy controls. RESULTS: Subjects with acute rejection (n=67) excreted urinary VEGF at a significantly higher level (28.57+/-6.21, 95% CI: 16.18-40.97 pg/mumol creatinine) than those without acute rejection. This included subjects with stable renal function and no abnormal histological findings (n=119), acute tubular necrosis (n=15), chronic allograft nephropathy (n=14) and healthy controls (n=80). Using a urinary VEGF/creatinine ratio of 3.64 pg/micromol as the cut-off point, the sensitivity and specificity for diagnosing acute rejection were 85.1 and 74.8%, respectively (P<0.001). Patients with steroid-resistant acute rejection had significantly greater urinary VEGF concentration than patients with steroid-sensitive acute rejection (42.09+/-10.00 vs 9.74+/-2.63 pg/micromol creatinine, P<0.001). Patients with graft loss after acute rejection had significantly greater urinary VEGF concentration than patients with reversible acute rejection (106.66+/-38.60 vs 19.46+/-4.13 pg/micromol creatinine, P=0.001). Using a urinary VEGF/creatinine ratio of 22.48 pg/micromol as the cut-off point, the sensitivity and specificity of the prediction to graft loss after acute rejection were 85.7% and 78.3%, respectively (P=0.001). CONCLUSION: This study demonstrates that the monitoring of urinary VEGF may be a useful non-invasive approach for the detection of acute rejection. Additionally, urinary VEGF levels were shown to predict the response to anti-rejection therapy and to predict a poor outcome after acute rejection.
AIM: The purpose of this study was to assess whether measurement of urinary vascular endothelial growth factor (VEGF) could be adopted as a new non-invasive diagnostic tool for acute rejection following renal transplantation. METHODS: Urinary concentration of VEGF was determined by an enzyme-linked immunosorbent assay technique in 215 renal allograft recipients and 80 healthy controls. RESULTS: Subjects with acute rejection (n=67) excreted urinary VEGF at a significantly higher level (28.57+/-6.21, 95% CI: 16.18-40.97 pg/mumol creatinine) than those without acute rejection. This included subjects with stable renal function and no abnormal histological findings (n=119), acute tubular necrosis (n=15), chronic allograft nephropathy (n=14) and healthy controls (n=80). Using a urinary VEGF/creatinine ratio of 3.64 pg/micromol as the cut-off point, the sensitivity and specificity for diagnosing acute rejection were 85.1 and 74.8%, respectively (P<0.001). Patients with steroid-resistant acute rejection had significantly greater urinary VEGF concentration than patients with steroid-sensitive acute rejection (42.09+/-10.00 vs 9.74+/-2.63 pg/micromol creatinine, P<0.001). Patients with graft loss after acute rejection had significantly greater urinary VEGF concentration than patients with reversible acute rejection (106.66+/-38.60 vs 19.46+/-4.13 pg/micromol creatinine, P=0.001). Using a urinary VEGF/creatinine ratio of 22.48 pg/micromol as the cut-off point, the sensitivity and specificity of the prediction to graft loss after acute rejection were 85.7% and 78.3%, respectively (P=0.001). CONCLUSION: This study demonstrates that the monitoring of urinary VEGF may be a useful non-invasive approach for the detection of acute rejection. Additionally, urinary VEGF levels were shown to predict the response to anti-rejection therapy and to predict a poor outcome after acute rejection.
Authors: Rong Chen; Tara K Sigdel; Li Li; Neeraja Kambham; Joel T Dudley; Szu-Chuan Hsieh; R Bryan Klassen; Amery Chen; Tuyen Caohuu; Alexander A Morgan; Hannah A Valantine; Kiran K Khush; Minnie M Sarwal; Atul J Butte Journal: PLoS Comput Biol Date: 2010-09-23 Impact factor: 4.475
Authors: Sarah Bruneau; Craig Bryan Woda; Kevin Patrick Daly; Leonard Boneschansker; Namrata Gargee Jain; Nora Kochupurakkal; Alan Gabriel Contreras; Tatsuichiro Seto; David Michael Briscoe Journal: Front Immunol Date: 2012-04-02 Impact factor: 7.561