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2014 ; 28
(3
): 145-54
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Allograft rejection and tubulointerstitial fibrosis in human kidney allografts:
interrogation by urinary cell mRNA profiling
#MMPMID24929703
Muthukumar T
; Lee JR
; Dadhania DM
; Ding R
; Sharma VK
; Schwartz JE
; Suthanthiran M
Transplant Rev (Orlando)
2014[Jul]; 28
(3
): 145-54
PMID24929703
show ga
Because the kidney allograft has the potential to function as an in-vivo flow
cytometer and facilitate the access of immune cells and kidney parenchymal cells
in to the urinary space, we hypothesized that mRNA profiling of urinary cells
offers a noninvasive means of assessing the kidney allograft status. We overcame
the inherent challenges of urinary cell mRNA profiling by developing
pre-amplification protocols to compensate for low RNA yield from urinary cells
and by developing robust protocols for absolute quantification mRNAs using RT-PCR
assays. Armed with these tools, we undertook first single-center studies urinary
cell mRNA profiling and then embarked on the multicenter Clinical Trials in Organ
Transplantation-04 study of kidney transplant recipients. We report here our
discovery and validation of diagnostic and prognostic biomarkers of acute
cellular rejection and of interstitial fibrosis and tubular atrophy (IF/TA). Our
urinary cell mRNA profiling studies, in addition to demonstrating the feasibility
of accurate diagnosis of acute cellular rejection and IF/TA in the kidney
allograft, advance mechanistic and potentially targetable biomarkers.
Interventional trials, guided by urinary cell mRNA profiles, may lead to
personalized immunosuppression in recipients of kidney allografts.