Circulating endothelial cells in pediatric renal transplant recipients

Pediatr Nephrol. 2013 Dec;28(12):2377-82. doi: 10.1007/s00467-013-2588-3. Epub 2013 Sep 10.

Abstract

Background: An increase in the number of circulating endothelial cells (CEC) indicates endothelial damage and the risk of cardiovascular disease. The aim of our study was to investigate the association of CEC with various clinical parameters in pediatric renal transplant recipients.

Methods: CEC, defined as CD45(-)CD146(+), were enumerated by flow cytometry from the peripheral blood of 50 pediatric renal transplant recipients and 20 healthy controls. Clinical parameters, including renal function tests, fasting blood glucose, serum cholesterol and triglyceride, cyclosporine A (CsA) (trough and 2nd-hour) and tacrolimus (tac) trough blood levels and their association with CEC numbers were analyzed.

Results: CEC numbers of patients were higher than those of controls (respectively, 128 ± 89 cells/ml (42-468 cells/ml), 82 ± 33 cells/ml (32-137 cells/ml), p = 0.024). There was a statistically significant negative correlation between CEC numbers and glomerular filtration rate (GFR) (r = -0.300, p = 0.012). There was also a statistically positive association between CEC numbers and transplant duration as well as cyclosporine trough level (respectively, r = 0.397, p = 0.004, r = 0.714, p = 0.004). CEC numbers in patients on tac and CsA were similar (p = 0.716).

Conclusions: Our results demonstrate that renal transplant recipients with high CsA trough blood level, longer transplant duration, and lower GFR, are at greater risk of developing endothelial damage.

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • CD146 Antigen / blood
  • Case-Control Studies
  • Cell Count
  • Child
  • Cyclosporine / blood
  • Cyclosporine / therapeutic use
  • Endothelial Cells* / drug effects
  • Endothelial Cells* / immunology
  • Endothelial Cells* / pathology
  • Female
  • Flow Cytometry
  • Glomerular Filtration Rate
  • Humans
  • Immunosuppressive Agents / blood
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / adverse effects*
  • Leukocyte Common Antigens / blood
  • Male
  • Postoperative Complications / blood
  • Postoperative Complications / etiology*
  • Postoperative Complications / immunology
  • Postoperative Complications / pathology
  • Risk Factors
  • Tacrolimus / blood
  • Tacrolimus / therapeutic use
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • CD146 Antigen
  • Immunosuppressive Agents
  • MCAM protein, human
  • Cyclosporine
  • Leukocyte Common Antigens
  • PTPRC protein, human
  • Tacrolimus