Neutrophils Degranulation Marker - Leucocyte Elastase - A;1protease Inhibitor Complex: A Comparative Study With Classic (A;1m, B;2m) and Novel (Ngal, Il-18) Kidney Graft Injury Markers.

Abstract

Introduction: Low molecular proteins are established markers of kidney graft function. The peritransplant events modify serum and urine ;1microglobulin ( ;1M). ;2microglobulin ( ;2M) as well as neutrophil gelatinase-associated lipocalin (NGAL). interleukin18 (IL-18) release. The mechanism of those protein concentration changes is not completely clear in an early period after kidney transplantation (kTx). The aim of the study was to seek correlations between neutrophils (PMN) activation (EL-;1PI complex) and classic ( ;1M, ;2M) as well as novel (NGAL, IL-18) kidney graft tubulo-intestinal injury markers measured in blood and urine of deceased renal allograft recipients. Patients and methods:The study was performed on the 24 kidney graft recipients from the deceased donors. The plasma and urine EL-;1PI were analyzed 3 times in the fi rst week after kTx (on postoperative (PO) days 1, 3, 7) by ELISA test. The other kidney injury markers in serum and urine were measured similarly on days 1, 3, and 7. NGAL, IL-18 and ;2M were measured by ELISA test. Serum and urine ;1M test was done by nephelometric method. Results: There was an important positive correlation between plasma EL-;1PI (pEL) and serum NGAL on 1 and 3rd PO day (p<0,02 and 0,002 respectively). Strong correlation was observe between urine EL-;1PI (uEL) on 1st PO day and serum NGAL on day 3 and 7 (p<0,03 and p<0,001 respectively). Urine EL on 1 PO day correlated with urine NGAL on 3 and 7 PO day (p<0,009 and p<0,001 respectively). There was no important association between EL-;1PI (in plasma and urine) and IL-18 level in serum and urine.