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Biomarkers of calcineurin inhibitor nephrotoxicity in transplantation

Mangalee Fernando1, Philip W Peake, Zoltan H Endre

  • 1Department of Nephrology, Prince of Wales Hospital, Barker St., Randwick, Sydney, NSW, Australia.

Biomarkers in Medicine
|December 20, 2014
PubMed

Insights

Calcineurin inhibitors (CNI) prevent transplant rejection but cause kidney toxicity.

Area of Science:

  • Nephrology
  • Immunosuppression
  • Translational Medicine

Background:

  • Calcineurin inhibitors (CNI) are vital immunosuppressants post-transplant.
  • CNI use is associated with significant renal and non-renal toxicities.
  • Understanding CNI nephrotoxicity mechanisms is crucial for patient outcomes.

Purpose of the Study:

  • To review advancements in identifying calcineurin inhibitor nephrotoxicity pathways.
  • To discuss the progress in validating biomarkers for CNI toxicity.
  • To highlight the role of 'Omics' studies in this research.

Main Methods:

  • Literature review focusing on CNI nephrotoxicity.
  • Analysis of 'Omics' data to identify molecular pathways.
  • Evaluation of current diagnostic standards (histology) and biomarker potential.

Main Results:

  • Ischemia, driven by vasoconstrictor-vasodilator imbalance, is a key factor in CNI nephrotoxicity.
  • 'Omics' studies reveal protein changes linked to inflammation, oxidative stress, and ER stress.
  • Current histological assessments for CNI toxicity lack specificity, hindering biomarker validation.

Conclusions:

  • Progress has been made in defining CNI nephrotoxicity pathways using molecular approaches.
  • Biomarker validation remains challenging due to limitations in current diagnostic methods.
  • Further research is needed to develop specific and reliable biomarkers for CNI nephrotoxicity.
Keywords:
biomarkerscalcineurin inhibitorscyclophylinscyclosporinenephrotoxicitytacrolimus

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