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Kidney - Acute Rejection

Monday September 23, 2024 - 08:00 to 09:15

Room: Üsküdar 3

205.4 Urinary cytokine and microparticles in antibody-mediated renal allograft rejection

Shubhi Kamthan, India



Urinary cytokine and microparticles in antibody-mediated renal allograft rejection

Shubhi Kamthan1, Snigdha Pratap Singh1, Narayan Prasad2, Vikas Agarwal3, Vinita Agrawal1.

1Pathology, SGPGIMS, Lucknow, India; 2Nephrology, SGPGIMS, Lucknow, India; 3Clinical Immunology, SGPGIMS, Lucknow, India

Background and Aim: Endothelial injury and activation in renal allografts due to antibody-mediated rejection (ABMR) can result in the release of various cytokines like von Willebrand Factor (vWF) and circulating microparticles (MPs). We aimed to evaluate the role of circulating urinary microparticles(UMPs), and  urinary vWF as non-invasive biomarkers in ABMR.
Methodology: The study included forty renal allograft recipients, diagnosed as ABMR on for-cause renal graft biopsies and twenty-five with stable graft function (SGF) from Jan 2021 to Jan 2024. All graft biopsies were classified according to Banff’s classification. Twenty-five and sex-matched healthy controls (HC) were also included. Urinary microparticles (MPs) were quantified as total MPs (Annexin V+). Urinary vWF levels were estimated by ELISA.
Result: All the participants were males with a mean age of 37±9 years. Mean serum creatinine in ABMR was 3.2±2.9 mg/dl, SGF 1.2±0.2 mg/dl and HC 0.7±0.1 mg/dl. Urinary MPs were elevated in ABMR (1.5x104 ±6x103) than SGF (1.2x104 ±3.2x103) and HC (1.2x104 ±2.9x103). ABMR has significantly elevated urinary vWF(0.64±0.25ng/ml)  than SGF (0.06±.02 ng/ml) and not detected in HC. In ABMR, UMPs correlated with peritubular capillaritis (PTC) on histology (r=0.391,p=0.008). Urinary vWF also correlated with PTC(r=0.702, p=0.009).
Conclusion: Urinary MPs and urinary vWF were found elevated in ABMR. As urine is readily available non-invasive body fluid for biomarker research on kidney dysfunction, including rejection so urinary MPs might provide highly specific information for the kidney than traditional markers (such as SCr, eGFR) and may be used as non-invasive biomarker of microvascular inflammation.

Keywords – Antibody Mediated Rejection ; von Willebrand Factor; Urinary Microparticles

This study was funded by ICMR, New Delhi (5/4/7-5/2019-NSD II). All the experiments were ethically approved by IEC, SGPGIMS.


[1] Antibody Mediated Rejection
[2] von Willebrand Factor
[3] Urinary Microparticles

Presentations by Shubhi Kamthan

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