Pancreas-specific protein (PASP), serum amyloid A [SAA), and neopterin (NEOP) in the diagnosis of rejection after simultaneous pancreas and kidney transplantation

Abstract

A reliable, noninvasive indicator of pancreatic allograft rejection is urgently needed. In this study, serum (S), plasma (P), and urine (U) levels of pancreas-specific protein (P-PASP, U-PASP), neopterin (S-NEOP, U-NEOP), amylase (U-AMYL), and amyloid A (SAA) were measured daily in ten type I diabetic patients following simultaneous pancreas and kidney transplantation (SPK). Rejection episodes occurred in three isolated pancreas, nine isolated kidney, and five simultaneous pancreas and kidney transplants. In the case of the eight pancreas rejections, SAA was the rejection marker with the highest diagnostic accuracy (94%). Using P-PASP and U-PASP, an accuracy of 81% and 79%, respectively, was achieved. During viral infections, U-NEOP levels increased to a maximum level of 1904 mumol/mol creatinine, whereas during bacterial infections, SAA levels increased to a maximum value of 43 mg/dl. SAA, measured for the first time in SPK, appears to be a valuable rejection parameter. In combination with U-NEOP and U-AMYL, a differential diagnosis between rejection, bacterial infection, and viral infection was possible. Neither U-PASP nor P-PASP monitoring led to a significant improvement in the results.

Serum biomarkers which correlate with failure to respond to immunotherapy and tumor progression in a murine colorectal cancer model

“…In the present study, a mass value of 1132 Da was identified as SAA1 with the sequence of EAFQEFFGR, which is identical to the reported biomarker peptide identified in the plasma of mice bearing tumors established from human gastric cancer cell lines 3. Elevated levels of SAA have been reported in the plasma/serum of mice bearing intestinal tumors 4 and neuroblastomas 6, as well as in sera of patients with various types of human cancers including nasopharyngeal 29, prostate 30, pancreatic 31.…”