IMMUNE ACTIVATION AND ENHANCED URINARY ZINC CONCENTRATIONS IN ALLOGRAFT RECIPIENTS

Objectives: Zinc metabolism is frequently abnormal in renal allograft recipients. These abnormalities may be immune mediated because zinc me tabolism is affected by inflammation. Methods: We determined urinary z inc and neopterin concentrations in 24 allograft recipients (18 kidney , 3 combined kidney-pancreas and 3 liver allografts) daily for 1-41 da ys. In addition, serum zinc concentrations were measured in 11 patient s. Results: Serum zinc was decreased and urinary zinc concentrations w ere increased in kidney as well as liver transplant recipients when co mpared with healthy controls. Urinary zinc concentrations were only sl ightly elevated in patients with uncomplicated post-transplant course, but the increase was more pronounced in renal allograft recipients wi th acute tubular necrosis. Urinary zinc concentrations were drasticall y increased during rejection of various organs. In addition, significa nt associations between urinary zinc and neopterin concentrations were observed. Conclusion: Our results suggest that enhanced urinary zinc excretion in allograft recipients is due to immune activation. The dat a indicate that cytokines play a role in zinc metabolism.