Pregnancy-associated plasma protein-A: evaluation of a new biomarker in renal transplant patients

Transplant Proc. 2007 Dec;39(10):3072-6. doi: 10.1016/j.transproceed.2007.08.111.

Abstract

Objective: Trophoblasts produce high concentrations of pregnancy-associated plasma protein-A (PAPP-A) during pregnancy. PAPP-A has been described as a new inflammatory marker and an independent risk factor for posttransplant cardiovascular risk. This study evaluated the clinical significance of PAPP-A in renal transplant patients.

Methods: The study included 78 adult renal transplant patients (56 men and 22 women) and 37 control subjects (27 men and 10 women). We determined serum PAPP-A, urea, creatinine, uric acid, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, 24-hour proteinuria, and C-reactive protein (CRP) levels.

Results: The PAPP-A level was significantly higher among renal transplant patients [median (interquartile range), 10.5 (6.4 to 15.4) mU/L] than the control group [3.9 (3.1 to 5.2) mU/L; P<.001]. There were significant positive correlations between serum PAPP-A levels and urea (r=.547, P=.001), creatinine (r=.497, P=.001), uric acid (r=.452, P=.001), and CRP values (r=.387, P=.001). The drugs used for immunosuppression in transplant patients (cyclosporine, tacrolimus, and others) did not significantly affect serum PAPP-A levels (P>.05).

Conclusion: We concluded that PAPP-A level was elevated in renal transplant patients and that high levels of PAPP-A might be a prognostic marker owing to their close association with high serum levels of urea, creatinine, uric acid, and CRP.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Creatinine / blood
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / immunology
  • Kidney Transplantation / physiology*
  • Kinetics
  • Male
  • Middle Aged
  • Pregnancy-Associated Plasma Protein-A / metabolism*
  • Reference Values
  • Urea / blood
  • Uric Acid / blood

Substances

  • Biomarkers
  • Immunosuppressive Agents
  • Uric Acid
  • Urea
  • C-Reactive Protein
  • Creatinine
  • Pregnancy-Associated Plasma Protein-A