Clinical significance of serum hepcidin-25 levels in predicting invasive fungal disease in patients after transplantation

J. Chen, L. Zhong

Department of Hematology and Department of Clinical Laboratory, Sichuan Academy of Medical Science and Sichuan Provincial Peoples’ Hospital, Chengdu, China. flydc0687@hotmail.com

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• Infectious Diseases

BACKGROUND: Currently, it is important to identify a good biomarker to predict treatment-related complications in patients with transplantation. This study aimed to evaluate the significance of serum hepcidin-25 in predicting invasive fungal disease (IFD) after transplantation.

PATIENTS AND METHODS: A total of 57 patients who underwent transplantation were included in this study, and their serum samples were obtained and stored at –80°C for analysis. The serum hepcidin-25 were assayed using enzyme-liked immunosorbent assay (ELISA), and hypersensitive C reactive protein (hsCRP) and 1,3-beta-D glucan were measured using standard laboratory techniques. These indices were monitored weekly, from one week before transplantation to four weeks after transplantation.

RESULTS: The median pretransplant serum hepcidin-25 level was 37.00 ng/mL which was higher than that of healthy volunteers (p < 0.001). Because the higher hepcidin-25 level of the third tertile among the patients was 39.855 ng/mL, we set a cutoff level of 40 ng/mL to divide them into low- and high-hepcidin-25 groups (n = 38 and 19, respectively). The prevalences of the documented infection in the two groups were 2.6% and 26%, respectively (p = 0.019). The high-hepcidin-25 group was monitored after transplantation. The hepcidin-25 level peaked one week after transplantation, followed by gradual decrease. The plasma (1-3)-beta-D-glucan reached the summit two week. The proven of IFD was delayed 10 days on average after hepcidin-25 had arrived summit and 5 days after (1-3)-beta-D-glucan peaked.

CONCLUSIONS: The pretransplant serum hepcidin-25 level would be a useful indicator for predicting the risk of infection after transplantation; and the dynamic changes of hepcidin-25 in patients with high-hepcidin-25 group would help to predict IFD after transplantation.

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