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Circulating adhesion molecules during kidney allograft rejection

G Alcalde1, J Merino, S Sanz

  • 1Nephrology Services, University Hospital Marqués de Valdecilla, Santander, Spain.

Transplantation
|June 27, 1995
PubMed
Summary
This summary is machine-generated.

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Soluble adhesion molecules like ICAM-1, VCAM-1, and E-selectin are not reliable indicators of kidney transplant rejection. Chronic renal failure patients show elevated levels, possibly due to impaired elimination.

Area of Science:

  • Immunology
  • Nephrology
  • Biochemistry

Background:

  • Adhesion molecules on leukocytes and endothelial cells mediate immune cell trafficking to inflammation sites.
  • Upregulated adhesion molecules are observed in rejecting kidney grafts.
  • Soluble forms of adhesion molecules in serum may regulate inflammatory processes.

Purpose of the Study:

  • To measure serum levels of soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), and soluble E-selectin (sE-selectin).
  • To investigate the potential of these soluble adhesion molecules as biomarkers for kidney transplant rejection.
  • To assess adhesion molecule levels in patients with chronic renal failure (CRF) and end-stage renal disease on hemodialysis (HD).

Main Methods:

  • Enzyme-linked immunosorbent assay (ELISA) was used to quantify serum levels of sICAM-1, sVCAM-1, and sE-selectin.

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  • Measurements were taken in healthy controls, CRF patients, HD patients, stable kidney transplant recipients (STx), and patients experiencing steroid-responsive or steroid-resistant rejection.
  • Correlation analysis was performed between serum creatinine and soluble adhesion molecule levels.

    • Main Results:

    • Serum sICAM-1 and sE-selectin levels did not increase during kidney transplant rejection episodes.
    • Serum sVCAM-1 levels were elevated in patients treated with OKT3 for steroid-resistant rejection.
    • CRF and HD patients exhibited higher sICAM-1 levels compared to other groups. sVCAM-1 levels were elevated in HD and OKT3-treated groups compared to controls and STx patients. CRF patients showed higher sE-selectin levels than rejection groups. Serum creatinine correlated with sICAM-1 and sVCAM-1.

    Conclusions:

    • Soluble adhesion molecules (sICAM-1, sVCAM-1, sE-selectin) are not sensitive or specific biomarkers for detecting kidney transplant rejection.
    • Elevated serum levels of these molecules in CRF and HD patients may indicate impaired clearance rather than active inflammation.
    • Further research is needed to understand the role of soluble adhesion molecules in renal disease and transplantation.