Renal transplantasyon uygulanmış normal fonksiyone graftli hastalar ile kronik rejeksiyon gelişmiş hastaların serum intersellüer adezyon molekülü- 1(ICAM- 1) düzeylerinin karşılaştırılması

TEZ2761Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 1998.Kaynakça (s. 23-27) var.iii, 27 s. ; 30 cm.

Serum ICAM-1 levels in kidney transplantation

Purpose: Intercellular adhesion molecule-1 (ICAM-1) is a member of immunoglobulin superfamily and acts as a ligand for the LFA-1 which is a leukocyte integrin. ICAM-1 has a role in the pathogenesis of various inflammatory processes and allograft rejection in kidney and heart transplantation. The aim of this study is to compare the serum ICAM-1 levels of kidney recipients with chronic rejection, recipients with functioning renal allografts and healthy controls. Methods: In this prospective study, serum ICAM-1 values of the 31 kidney transplantation patients (15 with normally functioning grafts and 16 with chronically rejected grafts) and 21 healthy controls were determined with ELISA method. Triple drug immunosuppressive regimen (cyclosporine + azathioprine + methylprednisolone) was given to the patients with kidney grafts. Results: The mean serum ICAM-1 level of the patients with chronic rejection (379.5±244.3 ng/ml) was higher than that of patients with functioning grafts (268.8±88 ng/ml). Although this difference was found to be statistically insignificant (p=0.057), it was close to the significancy limit. There was no statistically significant difference between the serum ICAM-1 levels of the patients either with chronic rejection or functioning grafts and those of healthy controls (307.3±63.6 ng/ml) (p=0.96 and p=0.07 respectively). Conclusion: Our findings suggest that, normal serum levels of ICAM-1 in patients with functioning grafts may be a result of proper immunosuppression. Elevated serum ICAM-1 levels in patients with chronic graft rejection indicate an activation in the immune system. We can conclude that serum ICAM-1 level measurement is not a specific parameter for detection of chronic renal graft rejection.Purpose: Intercellular adhesion molecule-1 (ICAM-1) is a member of immunoglobulin superfamily and acts as a ligand for the LFA-1 which is a leukocyte integrin. ICAM-1 has a role in the pathogenesis of various inflammatory processes and allograft rejection in kidney and heart transplantation. The aim of this study is to compare the serum ICAM-1 levels of kidney recipients with chronic rejection, recipients with functioning renal allografts and healthy controls. Methods: In this prospective study, serum ICAM-1 values of the 31 kidney transplantation patients (15 with normally functioning grafts and 16 with chronically rejected grafts) and 21 healthy controls were determined with ELISA method. Triple drug immunosuppressive regimen (cyclosporine + azathioprine + methylprednisolone) was given to the patients with kidney grafts. Results: The mean serum ICAM-1 level of the patients with chronic rejection (379.5±244.3 ng/ml) was higher than that of patients with functioning grafts (268.8±88 ng/ml). Although this difference was found to be statistically insignificant (p=0.057), it was close to the significancy limit. There was no statistically significant difference between the serum ICAM-1 levels of the patients either with chronic rejection or functioning grafts and those of healthy controls (307.3±63.6 ng/ml) (p=0.96 and p=0.07 respectively). Conclusion: Our findings suggest that, normal serum levels of ICAM-1 in patients with functioning grafts may be a result of proper immunosuppression. Elevated serum ICAM-1 levels in patients with chronic graft rejection indicate an activation in the immune system. We can conclude that serum ICAM-1 level measurement is not a specific parameter for detection of chronic renal graft rejection