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Nephrology Dialysis Transplantation, Vol 12, Issue 12 2687-2693, Copyright © 1997 by Oxford University Press

PRELIMINARY REPORTS

Renal expression and urinary concentration of EGF and IL-6 in acutely dysfunctioning kidney transplanted patients

S Di Paolo, L Gesualdo, G Stallone, E Ranieri and F Schena
Institute of Nephrology, University of Bari, Polyclinic, Piazza Giulio Cesare, 11, I-70124 Bari, Italy

Background: Despite marked improvements in the success of solid organ transplantation, a significant percentage of transplanted organs is lost due to recurrent episodes of acute cellular rejection. The mechanisms that govern allograft rejection likely include a complex regulatory network of multiple cytokines and growth factors. Design and Method: This study investigated the kidney gene (in situ hybridization) and protein (immunohistochemistry) expression and the urinary excretion rate of IL-6 and EGF in 29 renal transplant recipients: 16 with acute cellular rejection (AR) and 13 with acute tubular damage/cyclosporine toxicity (ATD). Results: AR patients displayed a 4-fold increase of renal IL-6 expression, which localized chiefly to proximal tubular cells and monocytes/macrophages, whereas EGF signal was extremely weak or even absent. In ATD patients, EGF expression was markedly reduced, while IL-6 specific signal was unchanged. In all the patients examined the renal expression of IL-6 and EGF strictly correlated with their urinary excretion rate (r:0.459, P:0.001). Thus, urinary IL-6/EGF ratio was markedly increased in the former group (>20-fold at day 1), where it parallelled the modifications of plasma creatinine over time (r:0.603, P <0.0001), and was only slightly increased in the latter group (<3-fold). Conclusion: Kidney transplanted patients with acute cellular rejection or acute tubular damage/CyA nephrotoxicity exhibit a distinctly different pattern of intragraft expression of IL-6 and EGF, which is closely reflected by their rate of urinary excretion. Key words: acute graft dysfunction; EGF; IL-6; kidney transplantation; renal expression; urine excretion rate
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