The Summarized Assessment of Endothelin A Receptor Expression in Renal Transplant Compartments Associated with Antibody-Mediated Rejection
Mirosław Banasik,
Magdalena Kuriata-Kordek,
Piotr Donizy,
Katarzyna Nowańska,
Krzysztof Wiśnicki,
Krzysztof Letachowicz,
Sławomir Zmonarski,
Dorota Kamińska,
Oktawia Mazanowska,
Tomasz Dawiskiba,
Dariusz Janczak,
Agnieszka Hałoń,
Marta Kepinska,
Bartosz Uchmanowicz,
Justyna Zachciał,
Andrzej Tukiendorf,
Magdalena Krajewska
Affiliations
Mirosław Banasik
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Magdalena Kuriata-Kordek
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Piotr Donizy
Department of Clinical and Experimental Pathology, Wroclaw Medical University, 50-556 Wroclaw, Poland
Katarzyna Nowańska
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Krzysztof Wiśnicki
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Krzysztof Letachowicz
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Sławomir Zmonarski
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Dorota Kamińska
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Oktawia Mazanowska
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Tomasz Dawiskiba
Department of General, Vascular and Transplant Surgery, Wroclaw Medical University, 50-556 Wroclaw, Poland
Dariusz Janczak
Department of General, Vascular and Transplant Surgery, Wroclaw Medical University, 50-556 Wroclaw, Poland
Agnieszka Hałoń
Department of Clinical and Experimental Pathology, Wroclaw Medical University, 50-556 Wroclaw, Poland
Marta Kepinska
Department of Biomedical and Environmental Analyses, Faculty of Pharmacy, Wroclaw Medical University, Borowska 211, 50-556 Wroclaw, Poland
Bartosz Uchmanowicz
Department of Nervous System Diseases, Faculty of Health Sciences, Wroclaw Medical University, 51-618 Wroclaw, Poland
Justyna Zachciał
Department of Clinical Nursing, Division of Nursing in Internal Medicine Procedures, Faculty of Health Sciences, Wroclaw Medical University, 50-556 Wroclaw, Poland
Andrzej Tukiendorf
Department of Social Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
Magdalena Krajewska
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland
The occurrence of anti-endothelin A receptor antibodies may be useful in diagnosis of transplant damage. We noticed that the presence of the endothelin A receptor (ETA receptor) in biopsy compartments is yet to be defined. We decided therefore to analysed the presence and relevance of the ETA receptor in biopsy to define the cause. Our study aims to evaluate the expression of ETA receptors in renal recipients after a biopsy due to the worsening of transplant function. Methods: The expression of ETA receptors was analyzed in renal transplant biopsies using the immunohistochemical method. The evaluation of ETA receptors was performed on paraffin sections. ETA receptor expression was analyzed in four compartments of renal transplant biopsies: glomeruli; vessels; tubular epithelium; and interstitium. The assessment was presented using a three-step scale (0: lack of expression; 1: mild to moderate immunoreactivity; 2: high expression). The results of each compartment from a single biopsy were summarized and assessed in the context of antibody-mediated rejection (AMR). Results: We analyzed 156 patients who had a renal allograft biopsy after renal transplantation. For each patient, we created a summarized ETA receptor expression score. The summarized ETA receptor expression score analysis showed statistically significant differences in patients with and without AMR. In addition, we noticed that patients with AMR had a significantly higher mean summarized expression of ETA receptor score of 3.28 ± 1.56 compared to patients who had a biopsy for other reasons with a mean summarized ETA receptor expression score of 1.47 ± 1.35 (p < 0.000001). ROC analysis of the ETA receptor expression score for detecting AMR status showed that the most appropriate cut-off for the test of the chosen binary classifier is between 2 and 3 of the summarized ETA receptor expression score. Conclusions: The expression of endothelin A receptors in renal transplant compartments may be associated with antibody-mediated rejection. The positive ETA receptor staining might be a vital feature in the diagnosis of damage in AMR. The summarized ETA receptor expression score seems to be an exciting diagnostic tool in transplant injury assessment.
