MicroRNA signatures of cancer risk in kidney transplant patients: insights from the COMETA study

Mariadelina Simeoni ^1,2, Rossella Tufano ^3,2, Valeria Grandinetti ⁴

¹Nephrology Dialysis and Kidney Transplant Follow-up-"L. Vanvitelli" University Hospital-Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Via Leonardo Bianchi 25, 80131, Naples, Italy.
²Biogem Scarl, Institute of Genetic Research, Via Camporeale, 83031, Ariano Irpino, Italy.
³Department of Electrical Engineering and Information Technology (DIETI), University of Naples "Federico II", Via Claudio 21, Naples, 80125, Italy.
⁴Nephrology, Dialysis and Kidney Transplant Unit, IRCCS University Hospital of Bologna, Via Albertoni 15, 40138, Bologna, Italy.
⁵Biogem Scarl, Institute of Genetic Research, Via Camporeale, 83031, Ariano Irpino, Italy. alessiamaria.cossu@unicampania.it.
⁶Department of Precision Medicine, University of Campania "L. Vanvitelli", Via L. De Crecchio 7, 80138, Naples, Italy. alessiamaria.cossu@unicampania.it.
⁷Nephrology Dialysis and Renal Transplantation - IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy. carlo.alfieri@unimi.it.
⁸Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122, Milan, Italy. carlo.alfieri@unimi.it.
⁹Department of Life Health Sciences and Health Professions, Link Campus University, 00165, Rome, Italy.
¹⁰Department of Precision Medicine, University of Campania "L. Vanvitelli", Via L. De Crecchio 7, 80138, Naples, Italy.
¹¹Humanitas Research Hospital, 20089, Rozzano, Italy.
¹²Nephrology Dialysis and Renal Transplantation, IRCCS "A. Gemelli" University Hospital, Largo Agostino Gemelli 8, 00136, Rome, Italy.
¹³Dell Medical School, Livestrong Cancer Institutes, University of Texas, 3401 Webberville Rd, Austin, TX, 78702, USA.
¹⁴Nephrology Dialysis and Renal Transplantation - IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy.
¹⁵Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122, Milan, Italy.
¹⁶Division of Nephrology Dialysis and Renal Transplantation - Città della Salute e della Scienza" University Hospital, Corso Bramante 88, 10126, Turin, Italy.
¹⁷Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA.
¹⁸Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum - University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy.

⁰Nephrology Dialysis and Kidney Transplant Follow-up-"L. Vanvitelli" University Hospital-Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Via Leonardo Bianchi 25, 80131, Naples, Italy.

Journal of Translational Medicine +

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October 4, 2025

View abstract on PubMed

Summary

Kidney transplant recipients (KTRs) face cancer risks. This study identified serum microRNA (miRNA) profiles that predict cancer development, offering potential for early diagnosis and targeted therapies in KTRs.

Area Of Science

Oncology
Transplantation Immunology
Molecular Diagnostics

Background

Post-transplant malignancies are a major cause of morbidity, mortality, and graft failure in kidney transplant recipients (KTRs).
The precise mechanisms driving cancer development post-transplant are not fully understood.
There is a critical need for predictive cancer biomarkers in KTRs.

Purpose Of The Study

To investigate the relationship between the immune system and cancer in KTRs.
To identify serum microRNA (miRNA) profiles associated with cancer in KTRs.
To develop predictive miRNA classifiers for post-transplant malignancies.

Main Methods

The COMETA study analyzed clinical data and serum small-RNA sequencing from 138 KTRs.
High-throughput sequencing identified distinct serum miRNA profiles.
miRNA classifiers were developed and their predictive performance evaluated.

Main Results

Three distinct serum miRNA profiles were identified, linked to kidney transplantation, pro-oncogenic, and onco-protective factors.
Developed miRNA classifiers showed promising predictive capabilities, particularly for tumor-promoting signatures.
Up-regulation of miR-210-3p was associated with non-melanoma skin cancer in KTRs.

Conclusions

Serum miRNA profiles can serve as potential biomarkers for cancer in KTRs.
These findings support the development of novel tools for early cancer diagnosis and prognosis in transplant patients.
This research paves the way for targeted therapies for KTRs experiencing neoplastic complications.

Keywords:

Cancer Kidney transplant MiRNA Non-coding RNA

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