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

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.