Analysis of transcriptional factors and regulation networks in patients with acute renal allograft rejection.

Acute rejection (AR) remains a major clinical challenge, leading to the development of chronic renal allograft failure. The aim of the present study was to explore potential transcriptional factors and regulation networks in the disease to predict the occurrence and process of AR and understand potential strategies to prevent from the disease. Three-hundred fifty-two patients with renal failure had kidney transplantation during March 2006 and March 2010, of which 85 suffered from AR. Plasma from 13 patients with kidney transplantation was collected, of which 5 were from patients with AR and 8 from those without AR. Among the 179 proteins identified by using iTRAQ labeling and quantitative proteomic technology, 66 proteins were at least 2-fold different between patients with or without AR. The results demonstrated that the dominant processes and responses were associated with inflammation and complement activation in AR. A number of transcription factors were identified in AR patients, including nuclear factor-κB, signal transducer and activator of transcription 1, signal transducer and activator of transcription 3. The analysis of transcription regulation networks suggested that the cross-talks among these key transcription factors might contribute to the acute response and coagulation pathway. Thus, our study provides a new description and insight into the molecular events in AR and potential strategies for identifying diagnostic biomarkers.