Dynamic changes of chemokines Mig, IP10, and ITAC in early diagnosis of acute rejection after liver transplantation / 第二军医大学学报

ABSTRACT

Objective: To investigate the dynamic expression of chemokines Mig, IP10, and ITAC after liver transplantation and to study its role in early diagnosis of acute rejection in humans. Methods: Thirty patients receiving liver transplantation (April 2005 to September 2005) were divided into acute rejection (AR) group (n=9) and non-acute rejection (NAR) group (n=18) based on the clinical symptoms and pathological examination. Three patients were excluded due to post-operation infection. The chemokines expression was determined in all patients 1 day before and day 1, 3, 5, 7 after transplantation. Sixteen patients with liver cirrhosis (cancer) and 16 normal adults were also examined as control in this study. Patients in AR group received pulse glucocorticoid treatment from the onset of AR and the expression of chemokines was determined on the day of AR diagnosis and day 3, 7 after glucocorticoid treatment. The relationship between Banff rejection activity index (RAI) and 3 chemokines expression on the day of AR onset was analyzed. Results: Chemokines expression was not significantly different between transplantation group and liver cirrhosis (cancer) group one day before transplantation; however, it was significantly higher than that of the normal control group (P<0.01). The expression of Mig, IP10 and ITAC was increased markedly in AR and NAR group day 3 after transplantation (P<0.05). AR was confirmed in 9 patients on day 11, 12 and 14 after transplantation. The serum contents of Mig, IP10 and ITAC in AR group were higher than those in NAR group at all defined time points after transplantation. There was a positive relationship between RAI and the expression of Mig, IP10 and ITAC on the day of AR onset (r=0.88, 0.94, 0.80, respectively). In AR patients, the expression of Mig, IP10 and ITAC decreased after pulse treatment with glucocorticoid (P<0.01). Conclusion: Serum level of Mig, IP10 and ITAC can serve as a sensitive, specific marker for early predication of AR in liver transplant patients.