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Serum sCD 30: A promising biomarker for predicting the risk of bacterial infection after kidney transplantation
Author(s) -
FernándezRuiz Mario,
Parra Patricia,
LópezMedrano Francisco,
RuizMerlo Tamara,
González Esther,
Polanco Natalia,
Origüen Julia,
San Juan Rafael,
Andrés Amado,
Aguado José María
Publication year - 2017
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12668
Subject(s) - medicine , hazard ratio , confidence interval , gastroenterology , transplantation , biomarker , kidney transplantation , proportional hazards model , incidence (geometry) , risk factor , confounding , immunology , biochemistry , chemistry , physics , optics
Background The transmembrane glycoprotein CD 30 contributes to regulate the balance between Th 1 and Th 2 responses. Previous studies have reported conflicting results on the utility of its soluble form ( sCD 30) to predict post‐transplant infection. Methods Serum sCD 30 was measured by a commercial ELISA assay at baseline and post‐transplant months 1, 3, and 6 in 100 kidney transplant ( KT ) recipients (279 monitoring points). The impact of sCD 30 levels on the incidence of overall, bacterial and opportunistic infection during the first 12 months after transplantation was assessed by Cox regression. Results There were no differences in serum sCD 30 according to the occurrence of overall or opportunistic infection. However, sCD 30 levels were higher in patients with bacterial infection compared to those without at baseline ( P =.038) and months 1 ( P <.0001), 3 ( P =.043), and 6 after transplantation ( P =.006). Patients with baseline sCD 30 levels ≥13.5 ng/mL had lower 12‐month bacterial infection‐free survival (35.0% vs 80.0%; P <.0001). After adjusting for potential confounders, baseline sCD 30 levels ≥13.5 ng/mL remained as an independent risk factor for bacterial infection (adjusted hazard ratio [ aHR ]: 4.65; 95% confidence interval [ CI ]: 2.05‐10.53; <.001). Analogously, sCD 30 levels ≥6.0 ng/mL at month 1 acted as a risk factor for subsequent bacterial infection ( aHR : 5.29; 95% CI : 1.11‐25.14; P =.036). Conclusion Higher serum sCD 30 levels were associated with an increased risk of bacterial infection after KT . We hypothesize that this biomarker reflects a Th 2 ‐polarized T‐cell response, which exerts a detrimental effect on the immunity against bacterial pathogens.