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2016 ; 16
(7
): 1982-98
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Gene Expression in Biopsies of Acute Rejection and Interstitial Fibrosis/Tubular
Atrophy Reveals Highly Shared Mechanisms That Correlate With Worse Long-Term
Outcomes
#MMPMID26990570
Modena BD
; Kurian SM
; Gaber LW
; Waalen J
; Su AI
; Gelbart T
; Mondala TS
; Head SR
; Papp S
; Heilman R
; Friedewald JJ
; Flechner SM
; Marsh CL
; Sung RS
; Shidban H
; Chan L
; Abecassis MM
; Salomon DR
Am J Transplant
2016[Jul]; 16
(7
): 1982-98
PMID26990570
show ga
Interstitial fibrosis and tubular atrophy (IFTA) is found in approximately 25% of
1-year biopsies posttransplant. It is known that IFTA correlates with decreased
graft survival when histological evidence of inflammation is present. Identifying
the mechanistic etiology of IFTA is important to understanding why long-term
graft survival has not changed as expected despite improved immunosuppression and
dramatically reduced rates of clinical acute rejection (AR) (Services UDoHaH.
http://www.ustransplant.org/annual_reports/current/509a_ki.htm). Gene expression
profiles of 234 graft biopsy samples were obtained with matching clinical and
outcome data. Eighty-one IFTA biopsies were divided into subphenotypes by degree
of histological inflammation: IFTA with AR, IFTA with inflammation, and IFTA
without inflammation. Samples with AR (n = 54) and normally functioning
transplants (TX; n = 99) were used in comparisons. A novel analysis using gene
coexpression networks revealed that all IFTA phenotypes were strongly enriched
for dysregulated gene pathways and these were shared with the biopsy profiles of
AR, including IFTA samples without histological evidence of inflammation. Thus,
by molecular profiling we demonstrate that most IFTA samples have ongoing
immune-mediated injury or chronic rejection that is more sensitively detected by
gene expression profiling. These molecular biopsy profiles correlated with future
graft loss in IFTA samples without inflammation.