Diagnosis of tubular injury in renal transplant patients by a urinary assay for a proximal tublar antigen, the adenosine-deaminase-binding protein Journal Article

  

Authors:	Tolkoff-Rubin, N. E.; Cosimi, A. B.; Delmonico, F. L.; Russell, P. S.; Thompson, R. E.; Piper, D. J.; Hansen, W. P.; Bander, N. H.; Finstad, C. L.; Cordon-Cardo, C.; Klotz, L. H.; Old, L. J.; Rubin, R. H.
Article Title:	Diagnosis of tubular injury in renal transplant patients by a urinary assay for a proximal tublar antigen, the adenosine-deaminase-binding protein
Abstract:	Two murine monoclonal antibodies (URO-4 and URO-4a)—which detect different epitopes of a proximal tabular cell glycoprotein antigen the adenosine-deaminase-binding protein (ABP)–have been formatted into sandwich enzyme immunoassay for detection of ABP in the urine. Serial urine samples from 34 renal transplant patients during the first six months posttransplant were analyzed to determine the correlation of this test with clinical rejection and cyclosporin (CsA) nephrotoxicity. In 29/29 acute rejection episodes the ABP level was elevated, beginning 1–7 days prior to treatment of rejection. Eighteen patients were treated fro rejection with courses of OKT3 or antithymocyte globulin: 0/6 whose ABP level fell to normal during therapy had rerejection; 10/12 whose ABP level remained elevated had rerejection within 7 had no rejection or drug toxicity; all 7 and normal ABP levels. The remaining 8 had CsA nephrotoxicity, all in association with elevated ABP levels that rapidly fell to normal with decreased CsA dose. An additional 7 patients with creatinine elevations more than 6 months posttransplant were studied: 5 had chronic vascular changes on biopsy, no response to increased immunosuppression, and normal ABP levels; 2 had a cellular infiltrate on biopsy, response to increased immunosuppression, and elevated ABP levels. We conclude that the urinary ABP assay provides information useful in the management of renal transplant patients with acute and chronic rejection and CsA toxicity. © 1986 by The Williams and Wilkins Co.
Keywords:	unclassified drug; cytology; nephrotoxicity; kidney failure; monoclonal antibody; antibodies, monoclonal; kidney; carrier proteins; graft rejection; cyclosporin a; glycoproteins; kidney transplantation; intoxication; kidney tubules, proximal; kidney diseases; adenosine deaminase; cyclosporins; kidney tubule damage; humans; human; priority journal; article; antigens, cd26; nucleoside deaminases; kidney tubule antigen
Journal Title:	Transplantation
Volume:	41
Issue:	5
ISSN:	0041-1337
Publisher:	Lippincott Williams & Wilkins
Date Published:	1986-05-01
Start Page:	593
End Page:	597
Language:	English
DOI:	10.1097/00007890-198605000-00008
PUBMED:	2871646
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-0022548387&doi=10.1097%2f00007890-198605000-00008&partnerID=40&md5=1e8144d01c923c6f1c623ff2a47d36b6
Notes:	Article -- Export Date: 18 August 2021 -- Source: Scopus

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