Early Monitoring of Soluble Immune Checkpoints in Kidney Transplantation and Their Potential Associations with Kidney Function
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Abstract
Objective:
Kidney transplantation is the most effective treatment for end-stage renal disease. Soluble immune checkpoints may regulate immune responses and serve as biomarkers for monitoring and graft function prediction.
Materials and Methods:
In this study, serum samples collected and stored from healthy controls (n = 15) and kidney transplant recipients (n = 30) before transplantation (day 0) and after transplantation (days 3 and 7) were analyzed for levels of sCD25, s4-1BB, sCD86, active TGF-β1, sCTLA-4, sPD-L1, sPD-1, sTIM-3, sLAG-3, sGalectin-9, sCD27, and sPD-L2 using a flow cytometry–based multiplex bead assay. Kidney function parameters (creatinine and GFR calculated by CKD-EPI) were retrospectively determined at different time points (day 0, day 3, day 7, week 2, month 1, and month 3). Data were analyzed using SPSS to evaluate the post-transplant dynamics of soluble immune checkpoints and their associations with kidney function parameters.
Results:
In pre-transplant patients, levels of sCD25, sPD-L1, sTIM-3, sGalectin-9, sCD27, and sPD-L2 were significantly higher compared with healthy individuals. In the post-transplant period, statistically significant temporal changes were observed in the levels of sCD25, sPD-L1, sTIM-3, sGalectin-9, sCD27, sPD-L2, and sCD86. In contrast, no temporal changes were detected in the levels of s4-1BB, sLAG-3, sCTLA-4, active TGF-β1, or sPD-1, and these levels were comparable to those of healthy controls. Correlation analyses and subgroup analyses based on post-transplant GFR indicated that higher sLAG-3 and sCTLA-4 levels were associated with better kidney function, whereas higher sCD25 and sGalectin-9 levels were associated with poorer kidney function.
Conclusion:
Soluble immune checkpoints are linked to early kidney function and may serve as biomarkers and therapeutic targets. Larger studies are needed to confirm their clinical value in improving transplant outcomes.

