Enzymuria and low molecular weight protein excretion as the differentiating marker of complications in the early post kidney transplantation period.

Renal function in the early post-transplantation period depends largely on factors affecting the kidney prior to implantation. Function of the graft may be also disturbed by the most common complications of the early post-operative period such as acute graft rejection (AGR), acute tubular necrosis (ATN) and may be modified by nephrotoxic action of cyclosporine A (CsA). Evaluation of excretion of enzymes and low molecular weight proteins (LMWP) may help in the differentiation of these complications. Aim Comparison of the urinary excretion of markers of tubular injury in patients with AGR, ATN, or patients with stable graft function (SGF) was made and differences between groups and correlations between markers and cold ischemia time (CIT), warm ischemia time (WIT) and blood trough level of cyclosporine A (CsA0) were determined. Material and methods In 60 cadaveric renal allograft recipients in the early post-transplantation period urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG) and B isoenzyme (NAG-B), alanylaminopeptidase (AAP), gamma-glutamyltransferase (GGT), alpha and pi isoenzymes of glutathione S-transferase (alpha-GST, pi-GST), retinol binding protein (RBP) and beta2- microglobulin (beta2M), were analyzed. Results NAG and NAB-B activities were higher in ATN (P<0.05, P<0.01) and in AGR (P<0.005, P<0.02) than in SGF. Excretion of pi-GST was higher in AGR than in SGF (P<0.0002) or ATN (P<0.007). CIT and WIT in patients with ATN were higher (P<0.05) than in SGF group. In ATN patients, correlations of CIT with RBP (P<0.05) and pi-GST (P<0.05), and WIT with RBP (P<0.05), and pi-GST (P<0.001) were found. Conclusions High urinary NAG and NAG B excretion characterizes ATN and AGR patients. Evaluating urinary excretion of pi-GST may be helpful in differentiating AGR from ATN. However, taking into account ischemia time is necessary in interpreting the pi-GST value in early post transplant period.

Predictive value of Banff score of early kidney allograft biopsies for 1-year graft survival.

The aim of this study was to evaluate the Banff score of early kidney allograft biopsies, taken during the first month after transplantation, seeking an association between early rejection and acute tubular necrosis. We analyzed data from 71 patients transplanted between 2000 and 2004 who had renal allograft biopsies performed within the first posttransplant month (23 women, 48 men), ages 18 to 67 years. All biopsies performed in cases of delayed or deteriorated graft function were graded according to the Banff' 97 classification. Twelve months after transplantation, 19 patients exhibited excellent renal function (group 1, serum creatinine concentration [Scr] < or = 1.5 mg/dL); 25 patients demonstrated preserved renal function (group II, Scr 1.51-1.99 mg/dL); and 19 patients showed deteriorated renal function (group III, Scr > or = 2.0 mg/dL). Eight recipients lost their grafts within 1 year after transplantation (group IV). The Banff index was defined as a sum of all components (value of glomerulitis ["g"] + interstitial inflammation ["i"] + tubulitis ["t"] + arteriolar hyaline thickening ["ah"] + intimal arteritis ["v"]). The deterioration of renal function was associated with a higher Banff index; patients who lost their grafts showed the highest values of this index. Scores of "v," "ah," and Banff index were positively correlated with serum creatinine concentrations at 28, 90, 180, and 360 days (P < .05). Glomerulitis ("g") was correlated with creatinine concentrations at 90 and 360 days (P < .05). Tubulitis ("t") and interstitial inflammation ("i") displayed no association with renal function at any time.

[The effect of unfractionated heparin and low molecular weight heparins on chemotaxis of peripheral blood neutrophils]. / Wplyw heparyny niefrakcjonowanej i kilku heparyn drobnoczasteczkowych na chemotaksje granulocytów obojetnochlonnych krwi obwodowej.

Heparin and its derivatives exhibit a wide spectrum of biological functions affecting adhesion, activation and trafficking of leukocytes. The aim of that study was to investigate whether heparins are chemoattractants for neutrophils from peripheral blood of healthy volunteers and if chemotactic effects are identical in the same concentrations of unfractionated heparin and 3 low molecular weight heparin-nadroparin, enoxaparin and reviparin. We found that heparins are chemoatractants for neutrophils with potency comparable to fMLP known chemoatractant. Chemotaxis elucidated by identical doses by unfractionated heparin differed significantly from that after reviparin and enoxaparin.

Effect of recombinant IFN-gamma on igE-dependent leukotriene generation by peripheral blood leukocytes in patients with pollinosis and asthma.

Interferon gamma (IFN-gamma) is considered one of the causative and intensifying factors in inflammation. The reaction to allergens releases IFN-gamma, an immunomodulatory cytokine known to inhibit IgE synthesis and Th cell proliferation. The aim of the study was to evaluate the influence of IFN-gamma on leukotriene (LT) release in vitro, from human leukocytes of atopic patients with pollinosis and asthma. Thirty-eight patients were enrolled in the study: 15 with pollinosis and 23 asthmatics. In the presence of IL-3, leukocytes were stimulated with specific allergens. Other samples of leukocytes were preincubated with different concentrations of IFN-gamma for 15 min before allergen stimulation. The concentration of LT in supernatants was measured according to the CAST-ELISA procedure. We stated that IFN-gamma had significantly diminished LT release in a dose-dependent mode from the leukocytes of pollinotics. IFN-gamma did not change LT release in the asthmatic group, although, in leukocytes the small and medium basic production of LT, IFN-gamma caused a statistically significant fall in LT generation.

[Low molecular weight heparin (LMWH) modulates migration of peripheral blood mononuclear cells and neutrophils of asthmatics]. / Drobnoczasteczkowa heparyna moduluje migracje komórek jednojadrzastych i neutrofilów krwi obwodowej chorych na astme.

Evidence has now accumulated that heparin can significantly affect immune response including allergic inflammation. Cell migration is supposed to be very crucial in this process. Thus the aim of that study was to investigate whether low molecular weight heparin-nadroparine is chemoattractant for some inflammatory cells in asthmatics. Peripheral blood mononuclear cells (PBMC) and neutrophils from 15 asthmatics were obtained by gradient centrifugation. Chemotaxis was compared with that induced with known chemoattractants-fMLP and IL-8. We found that nadroparine caused significant and dose dependent chemotaxis of PBMC and comparable with influence of fMLP and IL-8. Nadroparine amplified chemotaxis of neutrophils but not significantly. Chemotaxis induced by fMLP and IL-8 was diminished when blood cells were incubated earlier with 50 mg of nadroparine.

[The effect of low molecular weight heparin on peripheral leukocyte chemotaxis in patients with asthma]. / Wplyw drobnoczasteczkowej heparyny na chemotaksje leukocytów krwi obwodowej chorych na astme oskrzelowa.

Evidence has now accumulated that heparin can significantly affect immune response including allergic inflammation. Cell motility is supposed to be very crucial in this process. Thus the aim of that study was to investigate whether heparin is chemoattractant for some inflammatory cells in asthmatics. Peripheral blood mononuclear cells and neutrophils from 6 healthy subjects and 16 asthmatics were obtained by gradient centrifugation. Chemotaxis assays towards low molecular weight heparin-Clexane were performed in Boyden chambers. We found that heparin is chemoattractant for both PBMCs and neutrophils in the wide concentration range (1-2000 micrograms/ml)--maximal chemotaxis was observed at concentrations 50-500 micrograms/ml. Chemotactic motility of cells from asthmatics was weaker than from healthy subjects; the difference wasn't significant.

[Impairment of endothelial function in hypertension and possible laboratory evaluation of its state]. / Uposledzenie funkcji sródblonka w chorobie nadcisnieniowej i laboratoryjne mozliwosci oceny jego stanu.

An overview of literature data concerning the interactions between hypertension and vascular endothelium is presented. Arterial hypertension is accompanied by morphological and functional changes of endothelium. The laboratory methods measuring endothelial damage are very useful tools in evaluation of endothelium state.