Friedmann, Julius and Schuster, Antonia and Reichelt-Wurm, Simone and Banas, Bernhard and Bergler, Tobias and Steines, Louisa (2024) Serum IL-6 predicts risk of kidney transplant failure independently of immunological risk. TRANSPLANT IMMUNOLOGY, 84: 102043. ISSN 0966-3274, 1878-5492
Full text not available from this repository. (Request a copy)Abstract
Interleukin-6 (IL -6) is an important immune mediator and a target for novel antibody therapies. In this study, we aimed to determine whether serum IL -6 levels are associated with immunological risk, allograft rejection and outcomes in kidney transplant (Ktx) patients. We retrospectively analyzed the data of 104 patients who underwent Ktx at our center between 2011 and 2015. The patients were divided into high- and low -risk groups ( n = 52 per group) based on panel reactive antibody (PRA) percentage >= 35%, the existence of pre-Ktx donorspecific antibodies (DSA), or a previous transplant. IL -6 concentrations were measured before and at 3 months, 12 months, and 3 years after Ktx. Serum IL -6 levels tended to be higher in high -risk patients than in low -risk patients prior to Ktx and at 12 months after Ktx; however, the difference did not reach statistical significance (pre-Ktx, high -risk: 1.995 +/- 2.79 pg/ml vs. low -risk: 1.43 +/- 1.76 pg/ml, p = 0.051; 12 mo. high -risk: 1.16 +/- 1.87 pg/ml vs. low -risk: 0.78 +/- 1.13 pg/ml, p = 0.067). IL -6 levels were correlated with the types (no rejection, T cell mediated rejection (TCMR), antibody -mediated rejection (ABMR), or both) and time ( <1 year vs. >1 year after Ktx) of rejection, as well as patient and graft survival. Patients with both TCMR and ABMR had significantly higher IL -6 levels at 3 months (14.1 +/- 25.2 pg/ml) than patients with ABMR (3.4 +/- 4.8 pg/ml, p = 0.017), with TCMR (1.7 +/- 1.3 pg/ml, p < 0.001), and without rejection (1.7 +/- 1.4 pg/ml, p < 0.001). Three years after Ktx, patients with AMBR had significantly higher IL -6 levels (5.30 +/- 7.66 pg/ml) than patients with TCMR (1.81 +/- 1.61 pg/ml, p = 0.009) and patients without rejection (1.19 +/- 0.95 pg/ml; p = 0.001). Moreover, three years after Ktx IL -6 levels were significantly higher in patients with late rejections (3.5 +/- 5.4 pg/ml) than those without rejections (1.2 +/- 1.0 pg/ml) ( p = 0.006). The risk of death -censored graft failure was significantly increased in patients with elevated IL -6 levels at 12 months (IL -6 level > 1.396 pg/ml, HR 4.61, p = 0.007) and 3 years (IL -6 level > 1.976 pg/ml, HR 6.75, p = 0.003), but elevated IL -6 levels were not associated with a higher risk of death. Overall, our study highlights IL -6 as a risk factor for allograft failure and confirms that IL -6 levels are higher in patients developing ABMR compared to TCMR alone or no rejection.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ANTIBODY-MEDIATED REJECTION; RENAL-ALLOGRAFT SURVIVAL; C-REACTIVE PROTEIN; UNITED-STATES; INTERLEUKIN-6; DIFFERENTIATION; INFLAMMATION; MORTALITY; RECEPTOR; T(H)17; Kidney transplantation; Allograft failure; Interleukin-6; Rejection; Cytokines |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Nephrologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 25 Jul 2025 08:51 |
| Last Modified: | 25 Jul 2025 08:51 |
| URI: | https://pred.uni-regensburg.de/id/eprint/63774 |
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