The value of serum neopterin, interferon-gamma levels and interleukin-12B polymorphisms in predicting acute renal allograft rejection

Abstract

SummaryAcute rejection remains a poor predictor of graft outcome. In this study, we measured serum levels of interferon (IFN)-g and neopterin by enzyme-linked immunosorbent assay and a single nucleotide polymorphism (SNP) within the 3Ј untranslated region of the interleukin (IL)-12 B gene (1188 A/C) to determine whether either of these factors could predict acute rejection in renal transplantation. Significantly higher early post-transplant neopterin levels (days 5-7; 35·7 versus 19·9 nmol/l) were observed in recipients who subsequently rejected their grafts. Post-transplant neopterin levels showed a strong positive correlation with 1-month creatinine levels (Spearman's correlation 0·62, P < 0·001), suggesting macrophage activation early after transplantation. Pretransplant neopterin and IFN-g levels and the IL-12B gene SNP did not predict acute rejection in this small retrospective study. The ability to predict acute rejection non-invasively early after transplantation could lead to individual tailoring of immunosuppressive regimens and perhaps lead eventually to longer graft survival.

Neopterin is associated with cardiovascular events and all‐cause mortality in renal transplant patients

“…They later extended their data to include urinary neopterin measurements in 294 kidney allograft recipients 33. Subsequent studies by others have confirmed that elevation of serum or urinary neopterin precedes the rise in creatinine by up to several days in patients with acute early complications 34,35, and routine daily post-operative neopterin measurements have been suggested for the early detection of immunologic complications in kidney allograft recipients 36.…”

Evaluation of neopterin levels in patients undergoing hemodialysis

“…Neopterin has been reported to be a useful marker in detecting graft rejection and cytomegalovirus infection in kidney transplant recipients 3,19–29 . In contrast, the information about interrelation between neopterin and glomerulonephritis has been very limited 30–32 .…”

Genetic polymorphisms in the immune response: A focus on kidney transplantation

“…On the other hand, it activates macrophages, the cytotoxic activities of other cells, and induces apoptosis [25]. It may contribute to the severity of the rejection episode by stimulating neopterin by monocytes derived macrophages, which are also effectors of tissue damage in the acute rejection process [26]. Association studies with this gene are reported in Table 2 and discussed below.…”