생체 신이식 후 이식신 기능과 산화성 스트레스, 혈청 IL-6, 수용성 IL-6R, TGF-β1, HSP 70 및 CRP 농도와의 상관관계 연구

Abstract

Purpose: Increased oxidative stress and chronic inflammatory process have been substantially linked with the development and progression of chronic renal failure. However, the roles of oxidative stress and inflammation in chronic renal allograft dysfunction are not yet clear. The present study examined the plasma levels of lipid peroxides (LPO), C-reactive protein (CRP), interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), transforming growth factor-β1 (TGF-β1), and heat shock protein 70 (Hsp 70) as the representative markers of oxidative stress, the inflammatory process and fibrosis among healthy control subjects (kidney donors, n=24), end-stage renal disease (ESRD) patients (n=28), transplant recipients with a serum creatinine (Scr) less than 1.5 mg% (n=30), and transplant recipients with Scr between 1.5 and 5.0 mg% (n=32) during the time at least one year after renal transplantation. Methods: The plasma LPO concentration was measured by a thiobarbituric acid (TBA) reaction, CRP was measured by latex-enhanced immunonephelometric assay, and TGF-β1, IL-6, sIL-6R, and HSP 70 were measured by enzyme-linked immunosorbent assay (ELISA), respectively. Results: The Plasma concentrations of LPO, TGF-β1, Hsp 70, and IL-6 were significantly higher in both the ESRD and renal transplant recipients with Scr levels between 1.5 and 5.0 mg% than in both the healthy controls and transplant patients with Scr levels below 1.5 mg%. Plasma sIL-6R was significantly increased only in the ESRD patients. Among the other 3 groups, the concentrations of sIL-6R were not different between the groups. The plasma CRP concentrations were not different among the 4 study groups. Upon regression analysis, the plasma concentrations of LPO, TGF-β1, Hsp 70, IL-6 and sIL-6R were positively correlated with the Scr level, respectively. Conclusion: Our results demonstrate that the markers of oxidative stress, inflammation and fibrosis were correlated with the Scr level which represents the graft (and native) renal function.