Abstract
BACKGROUND: Periostin (POSTN) is a matricellular protein involved in kidney fibrosis and inflammation but also linked to tumor progression and regulation of the local microenvironment. AIMS: This study aimed to evaluate the association between serum POSTN, transgelin (TAGLN) and highly sensitive interleukin 6 (hsIL-6) and de novo malignancy occurrence post kidney transplant (KTx). METHODS: Serum concentrations of POSTN, TAGLN, and hsIL-6 were measured in 127 KTRs and compared with 32 healthy controls. Patients were followed for a median (IQR) of 29 (25-32) months. RESULTS: Log-transformed serum POSTN concentrations were lower in the KTx group (mean [SD]: 6.80[0.53] vs. 7.06[0.33] pmol/l), whereas transgelin (4.62[0.34] vs. 4.30[0.29] ng/mL) and hsIL-6 (1.51[0.50] vs. 0.99[0.37] pg/mL) were elevated (p < 0.001 for all). Final model showed satisfactory discrimination (AUC 0.83; 95% CI 0.74-0.91). Patients in the moderate POSTN zone were characterized higher odds of malignancy (OR 4.40; 95% CI 1.21-16.91, p = 0.011). Higher POSTN levels were independently associated with time post-KTx (β = 0.20; p < 0.001). Lower TAGLN levels were observed in older patients (β = -0.005; p = 0.011), those with CV disease (β = -0.200; p = 0.008) and among smokers (β = -0.19; p = 0.026). CONCLUSIONS: In patients post-KTx, elevated serum POSTN is an independent predictor of new-onset malignancy. Further prospective evaluation is warranted.