1
|
van Straalen KR, Dudink K, Aarts P, van der Zee HH, van den Bosch TPP, Giang J, Prens EP, Damman J. Complement activation in Hidradenitis suppurativa: Covert low-grade inflammation or innocent bystander? Front Immunol 2022; 13:953674. [PMID: 36211440 PMCID: PMC9535337 DOI: 10.3389/fimmu.2022.953674] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic auto-inflammatory skin disease with a complex and multifactorial pathogenesis involving both the innate and adaptive immune system. Despite limited evidence for local complement activation, conflicting results have been published on the role of systemic complement activation in HS. It was hypothesized that complement was consumed in highly inflamed HS skin, trapping complement from the circulation. Therefore, the aim of this study was to evaluate this local complement deposition in HS skin lesions using routine and commonly used complement antibodies.Direct immunofluorescence for C1q, C3c, C4d, C5b-9, and properdin was performed on frozen tissue sections of 19 HS patients and 6 controls. C5a receptor 1 (C5aR1) was visualized using immunohistochemistry.Overall, we found no significant local complement deposition in HS patients versus controls regarding C1q, C3c, C4d, C5b-9, or properdin on either vessels or immune cells. C5aR1 expression was exclusively found on immune cells, predominantly neutrophilic granulocytes, but not significantly different relatively to the total infiltrate in HS lesions compared with controls. In conclusion, despite not being able to confirm local complement depositions of C1q, C3c, C4d, or properdin using highly sensitive and widely accepted techniques, the increased presence of C5aR1 positive immune cells in HS suggests the importance of complement in the pathogenesis of HS and supports emerging therapies targeting this pathway.
Collapse
Affiliation(s)
- K. R. van Straalen
- Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, United States
| | - K. Dudink
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - P. Aarts
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - H. H. van der Zee
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - T. P. P. van den Bosch
- Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - J. Giang
- Department of Pathology, Maasstad Hospital, Rotterdam, Netherlands
| | - E. P. Prens
- Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
- Laboratory for Experimental Immunodermatology, Department of Dermatology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - J. Damman
- Department of Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
- *Correspondence: J. Damman,
| |
Collapse
|
2
|
Wang D, Damman J, van Doorn MBA. [A woman with bumps in the eyebrows]. Ned Tijdschr Geneeskd 2020; 164:D4914. [PMID: 32395957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 28-year-old woman was seen at our clinic with asymptomatic bumps in the eyebrows which arose 3 months after microblading, a cosmetic procedure to make the eyebrows appear fuller. Physical examination showed red-brown confluent papules. A skin biopsy revealed a non-necrotizing granulomatous reaction with sarcoid granulomas. Blood test and a chest X-ray showed no abnormalities and histopathological stains were negative. We diagnosed her with a granulomatous reaction in response to pigment. The skin lesions eventually disappeared spontaneously within 6 months.
Collapse
Affiliation(s)
- D Wang
- Erasmus MC, Rotterdam, afd. Dermatologie
| | - J Damman
- Erasmus MC, Rotterdam,afd. Pathologie
| | - M B A van Doorn
- Erasmus MC, Rotterdam, afd. Dermatologie
- Contact: M. B.A. van Doorn
| |
Collapse
|
3
|
de Wijs LEM, Nguyen NT, Kunkeler ACM, Nijsten T, Damman J, Hijnen DJ. Clinical and histopathological characterization of paradoxical head and neck erythema in patients with atopic dermatitis treated with dupilumab: a case series. Br J Dermatol 2019; 183:745-749. [PMID: 31749159 PMCID: PMC7586932 DOI: 10.1111/bjd.18730] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2019] [Indexed: 12/29/2022]
Abstract
Dupilumab is the first biologic registered for the treatment of atopic dermatitis (AD). We report on seven patients with AD presenting with a paradoxical head and neck erythema that appeared 10-39 weeks after the start of dupilumab treatment. The patients presented with a relatively sharply demarcated, patchy erythema in the head and neck area that showed no or less scaling compared with their usual eczema. Only one patient experienced symptoms of itch and burning, although this was notably different from his pre-existent facial AD. Except for a notable 'red face', eczema on other body parts had greatly improved in six of the seven patients, with a mean numerical rating scale for treatment satisfaction of 9 out of 10 at the time of biopsy. Treatment of the erythema with topical and systemic drugs was unsuccessful. Despite the presence of this erythema, none of our patients discontinued dupilumab treatment. Lesional skin biopsies showed an increased number of ectatic capillaries, and a perivascular lymphohistiocytic infiltration in all patients. In addition, epidermal hyperplasia with elongation of the rete ridges was observed in four patients, resembling a psoriasiform dermatitis. Additional immunohistochemical stainings revealed increased numbers of plasma cells, histiocytes and T lymphocytes. Interestingly, spongiosis was largely absent in all biopsies. We report on patients with AD treated with dupilumab developing a paradoxical erythema in a head and neck distribution. Both clinically and histopathologically we found a heterogeneous response, which was most suggestive of a drug-induced skin reaction.
Collapse
Affiliation(s)
- L E M de Wijs
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - N T Nguyen
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - A C M Kunkeler
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - T Nijsten
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - J Damman
- Department of Pathology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - D J Hijnen
- Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
4
|
Deenen NJ, Damman J, Nijsten TEC. Galli-Galli disease successfully treated with alitretinoin. J Eur Acad Dermatol Venereol 2019; 33:e232-e233. [PMID: 30742719 DOI: 10.1111/jdv.15485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- N J Deenen
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - J Damman
- Department of Pathology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - T E C Nijsten
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, The Netherlands
| |
Collapse
|
5
|
Bouamar R, Shuker N, Osinga JAJ, Clahsen-van Groningen MC, Damman J, Baan CC, van de Wetering J, Rowshani AT, Kal-van Gestel J, Weimar W, van Gelder T, Hesselink DA. Conversion from tacrolimus to everolimus with complete and early glucocorticoid withdrawal after kidney transplantation: a randomised trial. Neth J Med 2018; 76:14-26. [PMID: 29380728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND While conversion from cyclosporine to everolimus is well documented, conversion from tacrolimus has been poorly studied. In this randomised, controlled trial the safety and tolerability of switching from tacrolimus to everolimus with glucocorticoid withdrawal after living-donor kidney transplantation was studied. METHODS A total of 194 patients were planned to be randomised 1:1 to either continue tacrolimus or to convert to everolimus at month 3 after transplantation. At randomisation, all patients received tacrolimus, mycophenolate mofetil and prednisolone. Everolimus was started in a dose of 1.5 mg twice daily, aiming for predose concentrations of 4-7 ng/ml. Prednisolone was gradually withdrawn in both groups. RESULTS The trial was stopped prematurely after the inclusion of 60 patients. The interim analysis showed an unacceptably high rejection rate in the everolimus group as compared with the control group: 30.0% vs. 6.7% (95% CI: 0.047-0.420; p = 0.045). An additional 8 patients stopped everolimus because of toxicity. At the end of follow-up (month 12) only 12 (40%) patients assigned to everolimus were still on the study drug. CONCLUSIONS Conversion from tacrolimus to everolimusbased immunosuppression with withdrawal of prednisolone three months after kidney transplantation results in an unacceptably high risk of acute rejection and causes considerable toxicity. Based on our findings, such a switch strategy cannot be recommended.
Collapse
Affiliation(s)
- R Bouamar
- Department of Hospital Pharmacy, Erasmus MC, Rotterdam, the Netherlands
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Poppelaars F, Jager N, van Werkhoven M, Damman J, Hillebrand J, Daha M, Leuvenink H, Seelen M. Deficiency of C4 from brain death mice protects against renal injury. Mol Immunol 2017. [DOI: 10.1016/j.molimm.2017.06.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
7
|
Shuker N, Bouamar R, van Schaik RHN, Clahsen-van Groningen MC, Damman J, Baan CC, van de Wetering J, Rowshani AT, Weimar W, van Gelder T, Hesselink DA. A Randomized Controlled Trial Comparing the Efficacy of Cyp3a5 Genotype-Based With Body-Weight-Based Tacrolimus Dosing After Living Donor Kidney Transplantation. Am J Transplant 2016; 16:2085-96. [PMID: 26714287 DOI: 10.1111/ajt.13691] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 12/06/2015] [Accepted: 12/20/2015] [Indexed: 01/25/2023]
Abstract
Patients expressing the cytochrome P450 (CYP) 3A5 gene require a higher tacrolimus dose to achieve therapeutic exposure compared with nonexpressers. This randomized-controlled study investigated whether adaptation of the tacrolimus starting dose according to CYP3A5 genotype increases the proportion of kidney transplant recipients being within the target tacrolimus predose concentration range (10-15 ng/mL) at first steady-state. Two hundred forty living-donor, renal transplant recipients were assigned to either receive a standard, body-weight-based or a CYP3A5 genotype-based tacrolimus starting dose. At day 3, no difference in the proportion of patients having a tacrolimus exposure within the target range was observed between the standard-dose and genotype-based groups: 37.4% versus 35.6%, respectively; p = 0.79. The proportion of patients with a subtherapeutic (i.e. <10 ng/mL) or a supratherapeutic (i.e. >15 ng/mL) Tac predose concentration in the two groups was also not significantly different. The incidence of acute rejection was comparable between both groups (p = 0.82). Pharmacogenetic adaptation of the tacrolimus starting dose does not increase the number of patients having therapeutic tacrolimus exposure early after transplantation and does not lead to improved clinical outcome in a low immunological risk population.
Collapse
Affiliation(s)
- N Shuker
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Hospital Pharmacy, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - R Bouamar
- Department of Hospital Pharmacy, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - R H N van Schaik
- Department of Clinical Chemistry, Erasmus Medical Centre, Rotterdam, The Netherlands
| | | | - J Damman
- Department of Pathology, Academic Medical Centre, Amsterdam, The Netherlands
| | - C C Baan
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - J van de Wetering
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - A T Rowshani
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - W Weimar
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - T van Gelder
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Hospital Pharmacy, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - D A Hesselink
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| |
Collapse
|
8
|
Poppelaars F, Damman J, de Vrij EL, Burgerhof JGM, Saye J, Daha MR, Leuvenink HG, Uknis ME, Seelen MAJ. New insight into the effects of heparinoids on complement inhibition by C1-inhibitor. Clin Exp Immunol 2016; 184:378-88. [PMID: 26874675 DOI: 10.1111/cei.12777] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 01/22/2023] Open
Abstract
Complement activation is of major importance in numerous pathological conditions. Therefore, targeted complement inhibition is a promising therapeutic strategy. C1-esterase inhibitor (C1-INH) controls activation of the classical pathway (CP) and the lectin pathway (LP). However, conflicting data exist on inhibition of the alternative pathway (AP) by C1-INH. The inhibitory capacity of C1-INH for the CP is potentiated by heparin and other glycosaminoglycans, but no data exist for the LP and AP. The current study investigates the effects of C1-INH in the presence or absence of different clinically used heparinoids on the CP, LP and AP. Furthermore, the combined effects of heparinoids and C1-INH on coagulation were investigated. C1-INH, heparinoids or combinations were analysed in a dose-dependent fashion in the presence of pooled serum. Functional complement activities were measured simultaneously using the Wielisa(®) -kit. The activated partial thrombin time was determined using an automated coagulation analyser. The results showed that all three complement pathways were inhibited significantly by C1-INH or heparinoids. Next to their individual effects on complement activation, heparinoids also enhanced the inhibitory capacity of C1-INH significantly on the CP and LP. For the AP, significant potentiation of C1-INH by heparinoids was found; however, this was restricted to certain concentration ranges. At low concentrations the effect on blood coagulation by combining heparinoids with C1-INH was minimal. In conclusion, our study shows significant potentiating effects of heparinoids on the inhibition of all complement pathways by C1-INH. Therefore, their combined use is a promising and a potentially cost-effective treatment option for complement-mediated diseases.
Collapse
Affiliation(s)
- F Poppelaars
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groninge, Groningen
| | - J Damman
- Department of Pathology, University of Amsterdam, Academic Medical Centre, Amsterdam
| | - E L de Vrij
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - J G M Burgerhof
- Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - J Saye
- ViroPharma, Inc., Exton, PA, USA
| | - M R Daha
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groninge, Groningen.,Department of Nephrology, University of Leiden, Leiden University Medical Center, Leiden
| | - H G Leuvenink
- Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - M A J Seelen
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groninge, Groningen
| |
Collapse
|
9
|
van Werkhoven MB, Damman J, van Dijk MCRF, Daha MR, de Jong IJ, Leliveld A, Krikke C, Leuvenink HG, van Goor H, van Son WJ, Olinga P, Hillebrands JL, Seelen MAJ. Complement mediated renal inflammation induced by donor brain death: role of renal C5a-C5aR interaction. Am J Transplant 2013; 13:875-882. [PMID: 23398742 DOI: 10.1111/ajt.12130] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 11/26/2012] [Accepted: 12/10/2012] [Indexed: 01/25/2023]
Abstract
Kidneys retrieved from brain-dead donors have impaired allograft function after transplantation compared to kidneys from living donors. Donor brain death (BD) triggers inflammatory responses, including both systemic and local complement activation. The mechanism by which systemic activated complement contributes to allograft injury remains to be elucidated. The aim of this study was to investigate systemic C5a release after BD in human donors and direct effects of C5a on human renal tissue. C5a levels were measured in plasma from living and brain-dead donors. Renal C5aR gene and protein expression in living and brain-dead donors was investigated in renal pretransplantation biopsies. The direct effect of C5a on human renal tissue was investigated by stimulating human kidney slices with C5a using a newly developed precision-cut method. Elevated C5a levels were found in plasma from brain-dead donors in concert with induced C5aR expression in donor kidney biopsies. Exposure of precision-cut human kidney slices to C5a induced gene expression of pro-inflammatory cytokines IL-1 beta, IL-6 and IL-8. In conclusion, these findings suggest that systemic generation of C5a mediates renal inflammation in brain-dead donor grafts via tubular C5a-C5aR interaction. This study also introduces a novel in vitro technique to analyze renal cells in their biological environment.
Collapse
Affiliation(s)
- M B van Werkhoven
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - J Damman
- Department of Pathology and Medical Biology, Division of Pathology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M C R F van Dijk
- Department of Pathology and Medical Biology, Division of Pathology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M R Daha
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Nephrology, Leiden University Medical Center, Leiden, the Netherlands
| | - I J de Jong
- Department of Urology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - A Leliveld
- Department of Urology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - C Krikke
- Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - H G Leuvenink
- Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - H van Goor
- Department of Pathology and Medical Biology, Division of Pathology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - W J van Son
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - P Olinga
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen Research Institute of Pharmacy, Groningen, the Netherlands
| | - J-L Hillebrands
- Department of Pathology and Medical Biology, Division of Pathology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M A J Seelen
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
10
|
Damman J, Daha MR, Leuvenink HG, van Goor H, Hillebrands JL, Dijk MCV, Hepkema BG, Snieder H, Born JVD, de Borst MH, Bakker SJ, Navis GJ, Ploeg RJ, Seelen MA. Association of complement C3 gene variants with renal transplant outcome of deceased cardiac dead donor kidneys. Am J Transplant 2012; 12:660-8. [PMID: 22176838 DOI: 10.1111/j.1600-6143.2011.03880.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Local renal complement activation by the donor kidney plays an important role in the pathogenesis of renal injury inherent to kidney transplantation. Contradictory results were reported about the protective effects of the donor C3F allotype on renal allograft outcome. We investigated the influence of the donor C3F allotype on renal transplant outcome, taking all different donor types into account. C3 allotypes of 1265 donor-recipient pairs were determined and divided into four genotypic groups according to the C3F allotype of the donor and the recipient. The four genotypic groups were analyzed for association with primary nonfunction (PNF), delayed graft function, acute rejection, death-censored graft survival and patient survival. Considering all donor types, multivariable analysis found no association of the donor C3F allotype with renal allograft outcome. Also, for living and deceased brain-dead donors, no association with allograft outcome was found. Post hoc subgroup analysis within deceased cardiac dead (DCD) donors revealed an independent protective association of donor C3F allotype with PNF. This study shows that the donor C3F allotype is not associated with renal allograft outcome after kidney transplantation. Subgroup analysis within DCD donors revealed an independent protective association of the donor C3F allotype with PNF, which is preliminary and warrants further validation.
Collapse
Affiliation(s)
- J Damman
- Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
van Werkhoven M, Damman J, Daha M, Leuvenink H, Ploeg R, van Goor H, Hillebrands J, van Son W, Seelen M. Increased renal C5a receptor expression and systemic complement activation in brain dead donors. Mol Immunol 2011. [DOI: 10.1016/j.molimm.2011.06.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
12
|
Nijboer WN, Schuurs TA, Damman J, Goor HV, Vaidya VS, Heide JJHVD, Leuvenink HGD, Bonventre JV, Ploeg RJ. Kidney injury molecule-1 is an early noninvasive indicator for donor brain death-induced injury prior to kidney transplantation. Am J Transplant 2009; 9:1752-9. [PMID: 19522876 PMCID: PMC2747608 DOI: 10.1111/j.1600-6143.2009.02713.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
With more marginal deceased donors affecting graft viability, there is a need for specific parameters to assess kidney graft quality at the time of organ procurement in the deceased donor. Recently, kidney injury molecule-1 (Kim-1) was described as an early biomarker of renal proximal tubular damage. We assessed Kim-1 in a small animal brain death model as an early and noninvasive marker for donor-derived injury related to brain death and its sequelae, with subsequent confirmation in human donors. In rat kidney, real-time PCR revealed a 46-fold Kim-1 gene upregulation after 4 h of brain death. In situ hybridization showed proximal tubular Kim-1 localization, which was confirmed by immunohistochemistry. Also, Luminex assay showed a 6.6-fold Kim-1 rise in urine after 4 h of brain death. In human donors, 2.5-fold kidney injury molecule-1 (KIM-1) gene upregulation and 2-fold higher urine levels were found in donation after brain death (DBD) donors compared to living kidney donors. Multiple regression analysis showed that urinary KIM-1 at brain death diagnosis was a positive predictor of recipient serum creatinine, 14 days (p < 0.001) and 1 year (p < 0.05) after kidney transplantation. In conclusion, we think that Kim-1 is a promising novel marker for the early, organ specific and noninvasive detection of brain death-induced donor kidney damage.
Collapse
Affiliation(s)
- W. N. Nijboer
- Surgery Research Laboratory and Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
| | - T. A. Schuurs
- Surgery Research Laboratory and Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
| | - J. Damman
- Surgery Research Laboratory and Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
| | - H. van Goor
- Department of Pathology and Laboratory Medicine, University Medical Center Groningen, University of Groningen, The Netherlands
| | - V. S. Vaidya
- Renal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - J. J. Homan van der Heide
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - H. G. D. Leuvenink
- Surgery Research Laboratory and Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
| | - J. V. Bonventre
- Renal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - R. J. Ploeg
- Surgery Research Laboratory and Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands
| |
Collapse
|
13
|
Damman J. Software for Körner. Health Serv J 1987; 97:1289. [PMID: 10284945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|