Qi Yu, Yan Zhang, Zijian Gao, Boqian Wang, Hongwei Yang, Long He
{"title":"dd-cfDNA和CXCL-10对肾移植受者急性排斥反应的诊断价值。","authors":"Qi Yu, Yan Zhang, Zijian Gao, Boqian Wang, Hongwei Yang, Long He","doi":"10.1016/j.trim.2025.102307","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Acute rejection (AR) remains a major challenge in kidney transplantation. Current methods used to diagnose acute rejection are either invasive or not sufficiently sensitive. Thus, in this study, we aimed to develop a novel and sensitive diagnostic tool for predicting acute rejection after kidney transplantation. We investigated if donor-derived cell-free DNA (dd-cfDNA) in the serum and C-X-C motif chemokine 10 (CXCL-10) levels were closely related to the occurrence of AR after renal transplantation.</p><p><strong>Methods: </strong>We collected data and tested the serum levels of dd-cfDNA and CXCL-10 in AR patients and patients who underwent kidney transplantation during the same period. Logistic analysis was used to verify risk factors associated with AR. The analysis of the receiver operating characteristic curve(ROC) was used to reveal correlation between dd-cfDNA，CXCL-10 levels and AR patients.</p><p><strong>Results: </strong>We included 13 AR patients and 18 patients without acute rejection. The AR group had a lower BMI (P = 0.006), and higher levels of eGFR (P = 0.006) and CysC (P = 0.009). Additionally, ln dd-cfDNA percentage and ln CXCL-10 content were higher in the AR group compared to the control group (P = 0.007, P = 0.004).The results of logistic analysis suggested CysC(OR:2.562[95 % CI:1.377-4.766]，P = 0.003),ln dd-cfDNA percent (OR: 10.521 [95 % CI: 2.091-52.938]，P = 0.004), and ln CXCL-10 content(OR:49.052 [95 % CI: 1.730-1391.073]，P = 0.023) can indicate the risk of AR and were independently correlated with the occurrence of acute rejection of the kidney graft. The AUC of serum dd-cfDNA (AUC = 0.723, P = 0.0348) percent and CXCL-10 content (AUC = 0.814, P = 0.0029) showed significant diagnostic performance. The combined dd-cfDNA and CXCL-10 diagnosis showed higher AUC and specificity.</p><p><strong>Conclusions: </strong>Serum dd-cfDNA and CXCL-10 levels were significantly elevated in patients with acute rejection. Thus, dd-cfDNA and CXCL-10 can play suggestive roles in detecting graft injury after kidney transplantation.</p>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":" ","pages":"102307"},"PeriodicalIF":1.4000,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnostic value of dd-cfDNA and CXCL-10 in kidney allograft recipients for identifying acute rejection.\",\"authors\":\"Qi Yu, Yan Zhang, Zijian Gao, Boqian Wang, Hongwei Yang, Long He\",\"doi\":\"10.1016/j.trim.2025.102307\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and hypothesis: </strong>Acute rejection (AR) remains a major challenge in kidney transplantation. Current methods used to diagnose acute rejection are either invasive or not sufficiently sensitive. Thus, in this study, we aimed to develop a novel and sensitive diagnostic tool for predicting acute rejection after kidney transplantation. We investigated if donor-derived cell-free DNA (dd-cfDNA) in the serum and C-X-C motif chemokine 10 (CXCL-10) levels were closely related to the occurrence of AR after renal transplantation.</p><p><strong>Methods: </strong>We collected data and tested the serum levels of dd-cfDNA and CXCL-10 in AR patients and patients who underwent kidney transplantation during the same period. Logistic analysis was used to verify risk factors associated with AR. The analysis of the receiver operating characteristic curve(ROC) was used to reveal correlation between dd-cfDNA，CXCL-10 levels and AR patients.</p><p><strong>Results: </strong>We included 13 AR patients and 18 patients without acute rejection. The AR group had a lower BMI (P = 0.006), and higher levels of eGFR (P = 0.006) and CysC (P = 0.009). Additionally, ln dd-cfDNA percentage and ln CXCL-10 content were higher in the AR group compared to the control group (P = 0.007, P = 0.004).The results of logistic analysis suggested CysC(OR:2.562[95 % CI:1.377-4.766]，P = 0.003),ln dd-cfDNA percent (OR: 10.521 [95 % CI: 2.091-52.938]，P = 0.004), and ln CXCL-10 content(OR:49.052 [95 % CI: 1.730-1391.073]，P = 0.023) can indicate the risk of AR and were independently correlated with the occurrence of acute rejection of the kidney graft. The AUC of serum dd-cfDNA (AUC = 0.723, P = 0.0348) percent and CXCL-10 content (AUC = 0.814, P = 0.0029) showed significant diagnostic performance. The combined dd-cfDNA and CXCL-10 diagnosis showed higher AUC and specificity.</p><p><strong>Conclusions: </strong>Serum dd-cfDNA and CXCL-10 levels were significantly elevated in patients with acute rejection. Thus, dd-cfDNA and CXCL-10 can play suggestive roles in detecting graft injury after kidney transplantation.</p>\",\"PeriodicalId\":23304,\"journal\":{\"name\":\"Transplant immunology\",\"volume\":\" \",\"pages\":\"102307\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-10-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplant immunology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.trim.2025.102307\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplant immunology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.trim.2025.102307","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Diagnostic value of dd-cfDNA and CXCL-10 in kidney allograft recipients for identifying acute rejection.
Background and hypothesis: Acute rejection (AR) remains a major challenge in kidney transplantation. Current methods used to diagnose acute rejection are either invasive or not sufficiently sensitive. Thus, in this study, we aimed to develop a novel and sensitive diagnostic tool for predicting acute rejection after kidney transplantation. We investigated if donor-derived cell-free DNA (dd-cfDNA) in the serum and C-X-C motif chemokine 10 (CXCL-10) levels were closely related to the occurrence of AR after renal transplantation.
Methods: We collected data and tested the serum levels of dd-cfDNA and CXCL-10 in AR patients and patients who underwent kidney transplantation during the same period. Logistic analysis was used to verify risk factors associated with AR. The analysis of the receiver operating characteristic curve(ROC) was used to reveal correlation between dd-cfDNA，CXCL-10 levels and AR patients.
Results: We included 13 AR patients and 18 patients without acute rejection. The AR group had a lower BMI (P = 0.006), and higher levels of eGFR (P = 0.006) and CysC (P = 0.009). Additionally, ln dd-cfDNA percentage and ln CXCL-10 content were higher in the AR group compared to the control group (P = 0.007, P = 0.004).The results of logistic analysis suggested CysC(OR:2.562[95 % CI:1.377-4.766]，P = 0.003),ln dd-cfDNA percent (OR: 10.521 [95 % CI: 2.091-52.938]，P = 0.004), and ln CXCL-10 content(OR:49.052 [95 % CI: 1.730-1391.073]，P = 0.023) can indicate the risk of AR and were independently correlated with the occurrence of acute rejection of the kidney graft. The AUC of serum dd-cfDNA (AUC = 0.723, P = 0.0348) percent and CXCL-10 content (AUC = 0.814, P = 0.0029) showed significant diagnostic performance. The combined dd-cfDNA and CXCL-10 diagnosis showed higher AUC and specificity.
Conclusions: Serum dd-cfDNA and CXCL-10 levels were significantly elevated in patients with acute rejection. Thus, dd-cfDNA and CXCL-10 can play suggestive roles in detecting graft injury after kidney transplantation.
期刊介绍：
Transplant Immunology will publish up-to-date information on all aspects of the broad field it encompasses. The journal will be directed at (basic) scientists, tissue typers, transplant physicians and surgeons, and research and data on all immunological aspects of organ-, tissue- and (haematopoietic) stem cell transplantation are of potential interest to the readers of Transplant Immunology. Original papers, Review articles and Hypotheses will be considered for publication and submitted manuscripts will be rapidly peer-reviewed and published. They will be judged on the basis of scientific merit, originality, timeliness and quality.
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