BÖBREK NAKLİ BEKLEME LİSTESİNDEKİ HASTALARDA ANJİYOPOETİN’İN İFADESİ: TEK MERKEZLİ BİR ÇALIŞMA

Abstract

Amaç: Anjiyopoietin-2 (Ang-2), anjiyopoietin (Ang)/Tie sinyal yolağına ait bir büyüme faktörüdür. Akut böbrek hasarı (AKH) olan hastalarda inflamasyondan bağımsız olarak özellikle Ang-2’nin plazma düzeylerinin önemli ölçüde arttığı düşünülmektedir. Ang-2, endotel homeostazının bozulmasında önemli bir rol oynadığı için diyaliz ve transplantasyonda da önemlidir. Çalışmamızda organ nakli bekleme listesinde olan son dönem böbrekhastalığı (SDBY) hastalarında anti-HLA antikor yükleri ile Ang düzeyleri arasındaki ilişkinin araştırılması amaçlandı. Gereç ve Yöntem: Çalışmamıza 2018-2020 yılları arasında panel reaktif antikor (PRA) tarama ve tanımlama testi çalışılmış bekleme listesinde bulunan 80 SDBY (son dönem böbrek yetmezliği) hastası katıldı. Hastalara önce PRA tarama testi, PRA pozitif çıkan hastalara sınıf I-II tanımlama testleri çalışıldı. Ang-2 düzeyi ELISA yöntemi ile değerlendirildi. PRA pozitif ve negatif hastalarda Ang-2 düzeyleri ile PRA yüzdeleri arasındaki ilişki değerlendirildi. Bulgular: SDBY olan hastalarda anti-HLA antikoru ile Ang-2 düzeyleri arasında pozitif korelasyon (sınıf I, p=0,024; sınıf II, p=0,032) ve PRA ≥%50 pozitif olan hastalarda Ang-2 düzeyinde istatistiksel olarak anlamlı bir artış bulundu (sınıf I, p=0,038). Bu bulgu, Ang-2’nin kronik böbrek yetmezliğinin ilerlemesinde önemli bir rolü olabileceğini ve nakil sonrası greft sağkalımını tahmin etmede etkili olabileceğini düşündürmektedir. Sonuç: Ang-2’nin renal progresyon üzerindeki etkisini tam olarak aydınlatmak için daha ileri çalışmalara ihtiyaç duyulmaktadır.

Keywords

• Anjiyopoetin-2
• anti-HLA antikoru
• böbrek nakli

EXPRESSION OF ANGIOPOETIN ON THE KIDNEY TRANSPLANT WAITING LIST: A SINGLE-CENTER STUDY

Abstract

Objective: Angiopoietin-2 (Ang-2) is a growth factor belonging to the angiopoietin (Ang)/Tie signaling pathway. Plasma levels of especially Ang- 2, are thought to be significantly increased in patients with acute kidney injury (AKI), independent of inflammation. Ang-2 is also important in dialysis and transplantation, as it plays an important role in the disruption of endothelial homeostasis. Our study aimed to investigate the relationship between anti-HLA antibody loads and Ang levels in patients with endstage renal disease (ESRD) who are on the organ transplant waiting list. Material and Method: 80 ESRD patients who were on the waiting list between 2018 and 2020 and whose panel reactive antibody (PRA) screening and identification test were studied participated in our study. First, the PRA screening test was performed on the patients, and the class I-II identification tests were studied on the patients who were positive for PRA. The Ang-2 level was evaluated by the ELISA method. The relationship between Ang-2 levels and PRA percentages in PRA positive and negative patients was evaluated. Results: A positive correlation was found between anti-HLA antibody and Ang-2 levels in patients with ESRD (class I, p=0.024; class II, p=0.032), and a statistically significant increase in Ang-2 level was found in patients with PRA ≥50% positive (class I, p=0.038) This finding suggests that Ang-2 may have an important role in the progression of chronic renal failure and may be effective in predicting graft survival after transplantation. Conclusions: Further studies will be required to fully elucidate the effect of Ang-2 on renal progression.

Keywords

• Angiopoetin-2
• anti-HLA antibody
• kidney transplantation

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