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Urinary transglutaminase 2 as a potent biomarker to predict interstitial fibrosis and tubular atrophy of kidney allograft during early posttransplant period in deceased donor kidney transplantation

2019; Volume: 97; Issue: 1 Linguagem: Inglês

10.4174/astr.2019.97.1.27

2288-6796

Jee Yeon Kim, Yu‐Mee Wee, Monica Young Choi, Hey Rim Jung, Ji Yoon Choi, Hyun Wook Kwon, Joo Hee Jung, Yong Mee Cho, Heounjeong Go, Minkyu Han, Young Hoon Kim, Duck Jong Han, Sung Shin,

Chronic Kidney Disease and Diabetes

Transglutaminase type 2 (TG2) is an extracellular matrix crosslinking enzyme with a pivotal role in kidney fibrosis. We tested whether quantification of urinary TG2 may represent a noninvasive method to estimate the severity of kidney allograft fibrosis.We prospectively collected urine specimens from 18 deceased donor kidney transplant recipients at 1-day, 7-day, 1-month, 3-month, and 6-month posttransplant. In addition, kidney allograft tissue specimens at 0-day and 6-month posttransplant were sampled to analyze the correlation of urinary TG2 and kidney allograft fibrosis.Thirteen recipients had increased interstitial fibrosis and tubular atrophy (IFTA) scores at the 6-month protocol biopsy (IFTA group). The mean level of urinary TG2 in the IFTA group was higher compared to that of 5 other recipients without IFTA (no IFTA group). Conversely, the mean level of urinary syndecan-4 in the IFTA group was lower than levels in patients without IFTA. In the IFTA group, double immunofluorescent staining revealed that TG2 intensity was significantly upregulated and colocalizations of TG2/heparin sulfate proteoglycan and nuclear syndecan-4 were prominent, usually around tubular structures.Urinary TG2 in early posttransplant periods is a potent biomarker for kidney allograft inflammation or fibrosis.