Adipocytokines in renal transplant recipients

Abstract

In the last two decades, perceptions about the role of body fat have changed. Adipocytes modulate endocrine and immune homeostasis by synthesizing hundreds of hormones, known as adipocytokines. Many studies have been investigating the influences and effects of these adipocytokines and suggest that they are modulated by the nutritional and immunologic milieu. Kidney transplant recipients (KTRs) are a unique and relevant population in which the function of adipocytokines can be examined, given their altered nutritional and immune status and subsequent dysregulation of adipocytokine metabolism. In this review, we summarize the recent findings about four specific adipocytokines and their respective roles in KTRs. We decided to evaluate the most widely described adipocytokines, including leptin, adiponectin, visfatin and resistin. Increasing evidence suggests that these adipocytokines may lead to cardiovascular events and metabolic changes in the general population and may also increase mortality and graft loss rate in KTRs. In addition, we present findings on the interrelationship between serum adipocytokine levels and nutritional and immunologic status, and mechanisms by which adipocytokines modulate morbidity and outcomes in KTRs.

Progranulin serum levels in human kidney transplant recipients: A longitudinal study

“…The beneficial effects of higher ADPN, however, are not effective in CKD, mainly due to ADPN resistance at the post-receptor level [ 43 ]. In the present work, ADPN concentration decreased at three months and the decrement reached statistical significance at one year, findings that are corroborated by previous studies [ 17 , 18 , 41 ]. This reduction could be associated with improved eGFR and other factors as increased in BMI, waist circumference and trunk fat [ 18 , 39 ].…”

“…This reduction could be associated with improved eGFR and other factors as increased in BMI, waist circumference and trunk fat [ 18 , 39 ]. We further observed that serum ADPN was increased in renal recipients compared to controls, which is also in accordance with other studies [ 17 , 44 , 45 ]. No correlation between PGRN and ADPN was observed, except in the univariable analysis.…”

“…Other adipokines, mainly leptin, were previously evaluated in kidney transplant recipients [ 17 ]. Serum leptin levels evaluated up to five years after renal transplantation [ 14 ] presented a similar behavior to PGRN: elevated levels pre-transplantation, decline in the early period after transplantation and later increment [ 14 , 47 ].…”

“…These complications are possibly related to immunosuppressive therapy and changes in the metabolism [ 14 – 16 ]. Many adipokines have been studied in this context [ 17 ]. After kidney transplantation, their levels decrease, perhaps due to an improvement in eGFR [ 14 , 18 ]; however, in the later period after transplantation, adipokine serum levels tend to increase [ 14 ].…”

Combined donor-recipient genotypes of leptin receptor and adiponectin gene polymorphisms affect the incidence of complications after renal transplantation

“…In any case, adiponectin enhances anti-inflammatory cytokine synthesis, inhibits angiotensin II-induced inflammation and decreases albuminuria. Interestingly, these anti-inflammatory actions also take place locally in the kidney, as adiponectin receptors are present in renal cells [ 29 ]. Moreover, Tian et al recently showed in rodents that adiponectin is a renoprotective agent that attenuates kidney injury and fibrosis [ 30 ].…”