Assessment of the Circulating PD-1 and PD-L1 Levels and P53 Expression as a Predictor of Relapse in Pediatric Patients with Wilms Tumor and Hypernephroma.

Background/Objectives: Wilms tumor (WT) is the most common form of pediatric renal tumor, accounting for over 90% of cases followed by hypernephroma. Some pediatric patients with WT (10%) experience relapse or metastasis and have poor survival rates. PD-L1 assists cancer cells in escaping damage from the immune system. P53 mutations are found in relapsed WT tumor samples. We hypothesized that testing circulating PD-1 and PD-L1 and P53 expression levels could offer a simple method to predict patient relapse and explore novel treatments for pediatric WTs and hypernephroma. Methods: Flow cytometric detection of cPD-1, cPD-L1, and P53 expression in relapsed and in-remission WT and hypernephroma before and after one year of chemotherapy was performed. Results: Our data shows increased levels of cPD-L1 in relapsed pediatric patients with WT or hypernephroma before and after chemotherapy. There were also slight and significant increases in cPD-1 levels in relapsed groups before chemotherapy. Additionally, we observed significant decreases in P53 expression after one year of chemotherapy in relapsed pediatric patients. Conclusions: Our study found that circulating PD-L1 can be used as a predictor marker for WT and hypernephroma relapse. In conclusion, these circulating markers can assist in monitoring relapse in WT and hypernephroma patients without the need for several biopsies.

Inflammatory markers in chronic kidney disease and end stage renal disease patients.

BACKGROUND: Chronic kidney disease (CKD) is condition characterized by a gradual loss of kidney function, patient with CKD suffering from a variety of immune system defects. METHODS: This study looked at Fas, T cell, BCl2, and P53 activity in people with CKD, end stage renal disease (ESRD), and stable controls. RESULTS: The CD4+ and CD8+ levels in ESRD patients' peripheral blood were slightly lower than those in CKD patients. The CKD and ESRD groups had slightly higher Fas and FasL mRNA expression and slightly lower BCl2 mRNA gene expression than the normal control group (P < 0.05). P53 mRNA gene expression was shown to be higher in the patients than in the controls (P < 0.01). CONCLUSIONS: ESRD patients have a significantly lower number of T-cell subsets than CKD patients this is related to a higher degree of apoptosis in these cells.