Measurement of serum levels of mannose-binding lectin in hemodialysis patients. A comparison with healthy individuals

Mannose-binding lectin [MBL] is a part of the innate immune system. Many studies showed an association of low serum MBL levels with decreased host defense against various infectious agents. Considering paradoxical reports about the serum level of MBL in hemodialysis patients, this study aimed to measure and compare serum MBL levels in hemodialysis patients and healthy individuals. In a cross-sectional study, 70 hemodialysis patients and 70 volunteers with normal routine laboratory tests and physical examination were assessed for serum MBL level [measured by an enzyme-linked immunosorbent assay]. In addition, serum C-reactive protein levels in hemodialysis patients were measured to rule out correlation of increased serum MBL level with inflammation. In hemodialysis patients, 32 [45.7%] were men and 38 [54.3%] were women. In the control group, 34 [48.6%] were men and 36 [51.4%] were women [P = .87]. The mean age showed no significant difference in hemodialysis [44.5 +/- 13.5 year] and control [46.4 +/- 12.4 years] groups. Serum level of MBL was significantly higher in hemodialysis patients [2.12 +/- 1.49 microg/mL] than that in the controls [1.49 +/- 2.12] microg/mL; P < .001]. No significant correlation was found between serum MBL and C-reactive protein levels [r = 0.002, P = .98] among the hemodialysis patients. Serum MBL level in hemodialysis patients was significantly higher than that in the control group of healthy individuals. This may have some implications in management of patients and prediction of kidney allograft survival

predictive value of HLA-DR matching and cytokine gene polymorphisms in renal allograft acute rejection: a living-unrelated donor [LURD] study

In addition to Human Leukocyte Antigens [HLA] compatibility, gene polymorphisms in cytokines might also be important in the quality of allogeneic immune response. To evaluate the influence of HLA-DR matching and a number of cytokine gene polymorphisms on acute rejection after living-unrelated donor [LURD] kidney transplantation. A total of 42 renal transplants performed at Hashemi Nejad Kidney Hospital [Tehran/Iran] and followed up for 3 months post-transplantation were included. Using PCR-SSP, HLA-DR alleles [DR1-18] of recipients and donors and gene polymorphisms in TNF-a, TGF-b1, IL-10, IL- 6, and IFN-g of recipients were determined. Acute rejection was observed in 11[26.2%] of renal recipients. The frequency of one and two HLA-DR mismatches in rejector group was 2[18.2%] and 9[81.8%] and in non-rejector group was 13[41.9%] and 17[54.8%], respectively. HLA-DR incompatibility was not significantly higher in rejector [1.82 +/- 0.40] compared with non-rejector [1.52 +/- 0.57] recipients [P=0.069] and more than half of non-rejectors had ompletely mismatched HLA-DR antigens with donors. Polymorphisms associated with the mentioned cytokines had no correlation with acute rejection. The predictive value of HLA-DR mismatching for acute rejection is not as prominent in LURD kidney transplantation as in the cadaveric one. In addition, we failed to demonstrate an association between combined cytokine genotypes and HLA-DR matching with acute rejection. Further and more detailed immunogenetic investigations are required in order to have a better prediction of the transplant outcome