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Non-Invasive Diagnosis for Acute Rejection Using Urinary mRNA Signature Reflecting Allograft Status in Kidney
Jung-Woo Seo1,2, Yu Ho Lee2, Dong Hyun Tae3
1Department of Core Research Laboratory, Medical Science Institute, Kyung Hee University Hospital at Gangdong, Seoul, South Korea.
Frontiers in Immunology
|June 28, 2021
Summary
Urinary mRNA analysis offers a non-invasive method to detect acute kidney transplant rejection. A predictive model using specific urinary mRNA biomarkers demonstrated high accuracy in identifying rejection, potentially guiding clinical decisions for biopsies.
Area of Science:
- Nephrology
- Immunology
- Molecular Biology
Background:
- Urine is a potential source for monitoring kidney allograft status.
- Urinary mRNA may reflect kidney transcriptional activity and allograft injury.
Purpose of the Study:
- To identify urinary mRNA biomarkers for acute rejection in kidney transplant recipients.
- To develop and validate a non-invasive prediction model for acute rejection.
Main Methods:
- Meta-analysis to select candidate genes.
- Quantitative PCR to measure gene expression in urinary samples.
- Development and validation of a binary logistic regression model for acute rejection prediction.
Main Results:
- Expression of 9 out of 14 candidate genes (including CXCL9) differed significantly between acute rejection and stable graft.
- A urinary mRNA-based prediction model achieved an AUC of 0.89 in the training set and 0.84 in the validation set.
- In situ hybridization confirmed CXCL9 expression in rejected allografts.
Conclusions:
- Urinary mRNA signatures can serve as a non-invasive tool for monitoring acute kidney transplant rejection.
- This approach may aid in determining the necessity of performing a biopsy in patients with elevated creatinine.
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