Histologic and Molecular Patterns in Responders and Non-responders With Chronic-Active Antibody-Mediated Rejection in Kidney Transplants.
Banff classification
chronic-active ABMR
eGFR slope
kidney transplantation
therapy response
transcriptome
Journal
Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047
Informations de publication
Date de publication:
2022
2022
Historique:
received:
22
11
2021
accepted:
05
04
2022
entrez:
16
5
2022
pubmed:
17
5
2022
medline:
17
5
2022
Statut:
epublish
Résumé
There is no proven therapy for chronic-active antibody-mediated rejection (caABMR), the major cause of late kidney allograft failure. Histological and molecular patterns associated with possible therapy responsiveness are not known. Based on rigorous selection criteria this single center, retrospective study identified 16 out of 1027 consecutive kidney transplant biopsies taken between 2008 and 2016 with pure, unquestionable caABMR, without other pathologic features. The change in estimated GFR pre- and post-biopsy/treatment were utilized to differentiate subjects into responders and non-responders. Gene sets reflecting active immune processes of caABMR were defined A reductionist approach applying very tight criteria to identify caABMR and treatment response excluded the vast majority of clinical ABMR cases. Only 16 out of 139 cases with a written diagnosis of chronic rejection fulfilled the caABMR criteria. Histological associations with therapy response included a lower peritubular capillaritis score ( In caABMR active microvascular injury, in particular peritubular capillaritis, differentiates treatment responders from non-responders. Transcriptome changes in NK cell and endothelial cell associated genes may further help to identify treatment response. Future prospective studies will be needed which include more subjects, who receive standardized treatment protocols to identify biomarkers for treatment response. [ClinicalTrials.gov], identifier [NCT03430414].
Identifiants
pubmed: 35573002
doi: 10.3389/fmed.2022.820085
pmc: PMC9099145
doi:
Banques de données
ClinicalTrials.gov
['NCT03430414']
Types de publication
Journal Article
Langues
eng
Pagination
820085Informations de copyright
Copyright © 2022 Sazpinar, Gaspert, Sidler, Rechsteiner and Mueller.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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