Indoleamine 2,3-dioxygenase (IDO), an enzyme expressed in many cell types, catalyses degradation of tryptophan (Trp) to kynurenine (Kyn) and may exert immunosuppressive functions, mediated mainly by kynurenines. Therefore, increased Kyn concentrations would be expected to protect allografts from rejection. We conducted this study to examine whether Kyn has predictive value for kidney graft outcome. End-stage renal disease patients (n = 210) demonstrated an increased Kyn/Trp ratio compared with healthy controls (n = 30). Both Kyn and Trp levels were significantly higher in patients who subsequently developed acute rejection than in patients who did not (p < 0.001 and p < 0.001, respectively). Furthermore, pretransplantation Kyn and Trp plasma concentrations were significantly different in patients who went on to develop acute rejection (high values) or acute tubular necrosis (low values) (p = 0.007 and p = 0.021, respectively). After transplantation Kyn levels decreased. Approximately 3 days before biopsy-confirmed rejection. Kyn was significantly increased in patients with rejection compared with those without rejection (p < 0.001). Contrary to expectation, high Kyn plasma levels before transplantation were not predictive of low rejection risk. Although informative in overall terms, at the present stage, Kyn levels do not allow the concise risk differentiation of individual patients. (C) 2010 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.
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Univ Tehran Med Sci, Sch Med, Dept Immunol, Tehran, IranUniv Tehran Med Sci, Sch Med, Dept Immunol, Tehran, Iran
Jafari, Davood
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Nafar, Mohsen
Yekaninejad, Mir Saeed
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Univ Tehran Med Sci, Sch Publ Hlth, Dept Biostat, Tehran, IranUniv Tehran Med Sci, Sch Med, Dept Immunol, Tehran, Iran
Yekaninejad, Mir Saeed
Abdolvahabi, Razieh
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Univ Tehran Med Sci, Sch Publ Hlth, Dept Immunol, Tehran, IranUniv Tehran Med Sci, Sch Med, Dept Immunol, Tehran, Iran
Abdolvahabi, Razieh
Pezeshki, Mahboob Lesan
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Univ Tehran Med Sci, Imam Khomeini Hosp, Nephrol Res Ctr, Tehran, IranUniv Tehran Med Sci, Sch Med, Dept Immunol, Tehran, Iran
Pezeshki, Mahboob Lesan
Razaghi, Efat
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Univ Tehran Med Sci, Sina Hosp, Urol Res Ctr, Tehran, IranUniv Tehran Med Sci, Sch Med, Dept Immunol, Tehran, Iran
Razaghi, Efat
Amirzargar, Ali Akbar
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Univ Tehran Med Sci, Sch Med, Dept Immunol, Tehran, Iran
Univ Tehran Med Sci, Mol Immunol Res Ctr, Tehran, IranUniv Tehran Med Sci, Sch Med, Dept Immunol, Tehran, Iran