ISSN:
1432-2277
Keywords:
Key words TNF-α
;
Soluble TNF receptors
;
Living-related
;
Kidney transplantation
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract The TNF-α system is thought to play a central role in the reduced immunity of haemodialysis patients. The imbalance between the high levels of soluble TNF receptors R 1 and R 2 and the low levels of immunoactive TNF-α results in an increased TNF-α buffering capacity leading to reduced immune responses. Apart from impaired renal clearance of the receptors, inefficient TNF-α production as a result of the uraemia may also contribute to the imbalance between this cytokine and its receptors. In patients receiving a living-related kidney transplant, renal function is nearly normalized in a very short period. This restoration of renal function may result in a state of better immunocompetence, either as a result of improved clearance of the receptors or as a result of reversal of the uraemic state. To differentiate between these two possibilities, we measured TNF-α protein, mRNA and the soluble TNF receptors R 1 and R 2 before and after successful renal transplantation. TNF-α mRNA was not affected by transplantation, indicating constant TNF-α production. The imbalance in the TNF-α system was markedly improved after transplantation, although normal values of the soluble receptors were not reached. One year after transplantation in stable kidney transplant recipients there was still an imbalance in the TNF-α system caused by persistently elevated levels of the soluble TNF-receptors. These results suggest that even after successful kidney transplantation the TNF-α system remains activated. However, despite immunosuppressive therapy, recipients of a living-related kidney do have a better balanced TNF-α system compared to haemodialysis patients.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001470050424
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