PRO – AND ANTI-INFLAMMATORY CYTOKINES ARE EARLY MARKERS OF ACUTE REJECTION OF THE TRANSPLANTED KIDNEY

Abstract

Aim. Determination of diagnostic significance of pro − and anti-inflammatory cytokines in early prognosis of posttransplant renal failure in patients with chronic renal disease.Materials and methods. In the peripheral blood of patients with chronic kidney disease 6 hours before kidney transplantation, multiplex analysis using Simplex ProcartaPlex panel (Bioscience, USA) and xMAP technology (principle of flow cytometry) was used to estimate the content of 10 cytokines: 7 proinflammatory (IL-1b, IL-6, IL-12p70, IL-27, IL-17A, IL-18) and 3 antiinflammatory (IL-1RA, IL-4, IL-13). Identification of HLA-antibodies was carried out with the help of multiplex immunological analysis, using test systems (Gen-Prob, USA), flow analyzer Luminex 200 xMAP technology (bimolecular reactions on the surface of microspheres).Results. The limited diagnostic significance of HLA-antibodies is due to the fact that their detection in the posttransplantation period can be either in the development of acute graft rejection, or in the favorable course of the period after the operation. Meanwhile, the determination of a number of blood cytokines before kidney transplantation allows predicting post-transplantation rejection. In particular, certain criteria favorable course of the period after kidney transplantation by absence of HLA antibodies in patients with chronic renal failure can be considered as the initial (within 6 hours of transplantation) low levels of IL1β, IL6, IL17а. Prognostically the increase in the blood levels of proinflammatory cytokines − IL6, IL17a and anti-inflammatory IL1-RA is a significant marker of acute rejection of a transplanted kidney. Along with this, it is important to note that the appearance of HLA antibodies in patients with a favorable course of the post-transplantation period is associated with an initially elevated level of proinflammatory cytokines such as Il1ß and IL6.Conclusion. Diagnostic value of the evaluated cytokines at the pre-transplant kidney patients determines the feasibility of the inclusion of evaluation of the serum concentration of IL1β, IL6, IL17a, IL1-RA in the programme of pre-transplant laboratory tests .