ESM-1 (endothelial specific molecule-1) is exclusively secreted from vascular endothelial cells. In patients with hypertension and chronic kidney disease, plasma ESM-1 correlated with disease severity and outcomes. We measured plasma and urine ESM-1 (endothelial cell specific molecule-1) level from renal allograft recipients to investigate whether there is the difference in ESM-1 level according to allograft status.Design and Method:
We measured plasma and urine ESM-1 in 153 patients who underwent KTP. The concentration of ESM-1 was analyzed by commercial enzyme linked immunosorbent assay kit. Patients were divided into 6 different groups based on their allograft status; stable, acute tubular necrosis (ATN), acute cellular rejection (ACR), acute antibody-mediated rejection (aABMR), long term good survival (LTGS), and chronic active antibody-mediated rejection (cABMR). We compared plasma and urine ESM-1 levels among different groups.Results:
Plasma ESM-1 level was higher in aABMR group than in stable, ATN and ACR group. cABMR group showed higher plasma ESM-1 levels than LTGS. Similar results were observed in urine analysis; urine ESM-1 levels were significantly higher in aABMR group compared to stable, ATN and ACR groups. Urine ESM-1 level was also higher in cABMR group than LTSG group. Patients with high plasma and/or urine ESM-1 levels showed severe glomerulitis, peritubular capillaritis and microvascular inflammation score, which are the hallmarks of ABMR.Conclusions:
Plasma and urine ESM-1 could be a surrogate marker for the differential diagnosis of ABMR.