Serum endocan may be used as a new biomarker for chronic kidney disease staging after renal transplantation

• Main Authors: Yu-Hsuan Su, 蘇祐萱
• Other Authors: Seng-Sheen Fan
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/02302227531683011871

碩士 === 東海大學 === 生命科學系 === 101 === The gradual decline in renal graft function is inevitable in renal transplant recipients. The causes are thought to be chronic inflammation and atherosclerosis. Endocan, also called endothelial cell-specific molecule-1 (ESM-1), is mainly expressed in the endothelial cells in human lung and kidney tissues, is increased in acute and severe inflammation. Thus, it can be considered as a marker for the activation of endothelial cells. We established a primary endothelial cell culture system from human umbilical vein endothelial cells (HUVECs) for the study of the effect with different concentrations of TNF-α on endothelial cells. Endocan was induced in TNF-α-induced inflamed HUVECs. To verify this finding in patients, we recruited 97 renal transplantation recipients and followed for 7.0 ± 5.7 years. The mean age of patients was 43.6 ± 13.2 years and 55.7% (54/97) were male patients. We found that the serum endocan level was correlated with the concentration of TNF-α (r = 0.286, p = 0.002). We also found that the staging of the chronic kidney disease in these patients is positively correlated with the serum endocan level (p = 0.077). After analysis by a receiver operating characteristic (ROC) curve, a concentration of endocan > 643.19 pg/ml was used to differentiate disease progression (AUC: 0.732, 95% confidence interval 0.632 - 0.818). The patients with endocan > 643.19 pg/ml had a higher follow-up creatinine level (1.6 ± 1.1 mg/dL) but lower glomerular filtration rate than those with endocan ≤ 643.19 pg/ml (1.2 ± 0.4 mg/dL, p = 0.029). Our findings suggested that the function of the grafted kidney deteriorated along with the increase of TNF-α and endocan in patient serum. Thus, endocan, an indicator of endothelial injury, may be used as a new biomarker for the deterioration of kidney function in renal transplantation or chronic kidney disease patients.