CIRCULATING ADHESION MOLECULES DURING KIDNEY ALLOGRAFT-REJECTION

Adhesion molecules appear on leukocytes and endothelial cells mediatin g the localization and migration of leukocytes to sites of inflammatio n. Rejecting kidney grafts have shown an increased expression of these molecules. Recent reports have detected in serum soluble forms of adh esion molecules that could play a role in regulating inflammation. We have measured by ELISA the circulating serum levels of ICAM-1, VCAM-1 and E-selectin in: 23 controls, 33 chronic renal failure patients (CRF ), 20 hemodialysis patients (HD), 17 samples from 6 patients with stab le kidney graft function (STx), 25 samples from 8 patients with steroi d-responsive rejection proven by biopsy, and 28 samples from 9 patient s with steroid-resistant rejection and good response to OKT3. There wa s not a rise in cICAM-1 or cE-selectin levels during rejection compare d with the steady phase before and after rejection. In the case of cVC AM-1, only the OKT3 group showed increased rejection levels (P<0.05) t hat were maintained after rejection. For ICAM-1, CRF and HD groups had higher levels than the remaining groups. cVCAM-1 levels were elevated in all groups when compared with control, furthermore, OKT3 and HD gr oups had higher levels than the STx, CRF, or steroid-responsive groups . For cE-selectin, we only found differences between the CRF and both rejection groups. Serum creatinine correlated significantly with c-ICA M-1 and cVCAM-1 R=0.30 and R=0.22), but not with cE-selectin. We concl ude that soluble adhesion molecules levels are not valuable markers fo r rejection. Patients with chronic renal failure have increased levels of adhesion molecules, which could reflect an impaired elimination.