PURPOSE: The outcome of renal transplantation is difficult to predict, even with an allograft biopsy. The aim of this study was to develop a sensitive, specific and noninvasive method for prediction of acute cellular rejection (ACR). METHODS: Luminex analysis was used to determine the levels of 95 cytokines/chemokines and their soluble receptors in sera from recipients with: ACR (in the first month post-transplantation, before and during rejection, and after rejection reversal); stable allograft function; delayed graft function (DGF); pulmonary infection. Evaluation of significant differential protein expression in ACR patients compared with stable allograft controls revealed a three-analyte combination as a marker of renal transplantation outcome. The predictive value of this combination was further validated in DGF and infection groups and in a blind binary code study of 24 additional serum samples. RESULTS: Significant differential expression was detected in 26 proteins expressed in patients during the period preceding an ACR episode compared with stable controls. A blood test for discrimination of such patients was developed based on the simultaneous quantification of three analytes (IL-1 receptor antagonist, IL-20 and sCD40 ligand). This test exhibited 90.9 % sensitivity, 96 % specificity, a positive predictive value (PPV) of 95.2 % and a negative predictive value (NPV) of 92.3 %. Moreover, this combination allowed discrimination between patients with ACR and DGF and pulmonary infection. CONCLUSIONS: With further development and validation, this blood test can be used to predict ACR and direct the treatment of transplant patients in the clinic.
PURPOSE: The outcome of renal transplantation is difficult to predict, even with an allograft biopsy. The aim of this study was to develop a sensitive, specific and noninvasive method for prediction of acute cellular rejection (ACR). METHODS: Luminex analysis was used to determine the levels of 95 cytokines/chemokines and their soluble receptors in sera from recipients with: ACR (in the first month post-transplantation, before and during rejection, and after rejection reversal); stable allograft function; delayed graft function (DGF); pulmonary infection. Evaluation of significant differential protein expression in ACR patients compared with stable allograft controls revealed a three-analyte combination as a marker of renal transplantation outcome. The predictive value of this combination was further validated in DGF and infection groups and in a blind binary code study of 24 additional serum samples. RESULTS: Significant differential expression was detected in 26 proteins expressed in patients during the period preceding an ACR episode compared with stable controls. A blood test for discrimination of such patients was developed based on the simultaneous quantification of three analytes (IL-1 receptor antagonist, IL-20 and sCD40 ligand). This test exhibited 90.9 % sensitivity, 96 % specificity, a positive predictive value (PPV) of 95.2 % and a negative predictive value (NPV) of 92.3 %. Moreover, this combination allowed discrimination between patients with ACR and DGF and pulmonary infection. CONCLUSIONS: With further development and validation, this blood test can be used to predict ACR and direct the treatment of transplant patients in the clinic.
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Authors: Mary E Ziegler; Tingchao Chen; James F LeBlanc; Xuelian Wei; David W Gjertson; Ker-Chau Li; Mazdak A Khalighi; Charles R Lassman; Jeffrey L Veale; H Albin Gritsch; Elaine F Reed Journal: Transplantation Date: 2011-08-27 Impact factor: 4.939
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Authors: Richard Kowalski; Diane Post; Mary C Schneider; Judith Britz; Judy Thomas; Mark Deierhoi; Andrew Lobashevsky; Robert Redfield; Eugene Schweitzer; Alonso Heredia; Elise Reardon; Charles Davis; Carol Bentlejewski; John Fung; Ron Shapiro; Adriana Zeevi Journal: Clin Transplant Date: 2003-04 Impact factor: 2.863
Authors: Steven C Hoffmann; Douglas A Hale; David E Kleiner; Roslyn B Mannon; Robert L Kampen; Lynn M Jacobson; Linda C Cendales; S John Swanson; Bryan N Becker; Allan D Kirk Journal: Am J Transplant Date: 2005-03 Impact factor: 8.086
Authors: Pauline Erpicum; Oriane Hanssen; Laurent Weekers; Pierre Lovinfosse; Paul Meunier; Luaba Tshibanda; Jean-Marie Krzesinski; Roland Hustinx; François Jouret Journal: Clin Kidney J Date: 2016-09-06