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Circulating and Urinary CCL20 in Human Kidney Disease.

Noelia Molina-Cazallas1, Diego García-Ayuso1, Beatriz Fernández-Fernández2,3

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CC motif chemokine ligand 20 (CCL20) is elevated in biological fluids and locally produced in chronic kidney disease (CKD). Higher CCL20 levels in diabetic kidney disease and autosomal dominant polycystic kidney disease may aid risk stratification.

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Area of Science:

  • Nephrology
  • Immunology
  • Biochemistry

Background:

  • CC motif chemokine ligand 20 (CCL20) and its receptor CCR6 are implicated in kidney inflammation.
  • Clinical data on CCL20 in diabetic kidney disease (DKD) and autosomal dominant polycystic kidney disease (ADPKD) are limited.

Purpose of the Study:

  • To analyze CCL20 levels in plasma and urine of DKD and ADPKD patients.
  • To investigate the association of CCL20 with baseline characteristics and long-term clinical outcomes.
  • To identify the source of CCL20 within the kidney.

Main Methods:

  • Analysis of plasma and urinary CCL20 levels in 98 DKD and 85 ADPKD patients.
  • Utilized single-cell kidney transcriptomics to identify CCL20-expressing cells.
  • Long-term follow-up (median 4.9 years for DKD, 7.1 years for ADPKD) to assess clinical outcomes.

Main Results:

  • Plasma CCL20 was significantly higher in DKD and ADPKD patients compared to a reference group.
  • Urinary CCL20 was detectable in DKD patients but not in the reference group.
  • In DKD, higher CCL20 correlated with earlier stages of CKD and higher albuminuria.
  • In ADPKD, elevated CCL20 was associated with lower eGFR, increased albuminuria, and larger kidney size, but not with disease progression or mortality.

Conclusions:

  • CCL20 is upregulated in biological fluids and produced locally within the kidney in CKD.
  • CCL20 may serve as a potential biomarker for risk stratification in kidney diseases.
  • Further research is warranted to fully elucidate the role and clinical utility of CCL20 in CKD.