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慢性的な損傷のリスクのある腎臓移植を特定するための生検トランスクリプトーム発現プロファイリング:多センター,前向きな研究
Philip J O'Connell1, Weijia Zhang2, Madhav C Menon2
1Renal Unit, University of Sydney at Westmead Hospital, Sydney, NSW, Australia.
Lancet (London, England)
|July 26, 2016
まとめ
新しい13の遺伝子組は 腎臓移植の繊維症と 異種移植の損失を 正確に予測します この発見により 早期の介入により 回復不能な損傷を防止し 移植の結果を改善できます
科学分野:
- ゲノミクス
- 移植免疫学
- 腎臓科
背景:
- 慢性腎臓移植の損傷はアロインプラントの喪失の主な原因です.
- 線維症の早期の兆候を特定することは 移植の失敗を防ぐために不可欠です
研究 の 目的:
- 線維症による進行性損傷のリスクを予測できる遺伝子セットを特定する.
- 腎臓移植繊維症の早期発見のための予測ツールを開発する.
主な方法:
- 長期的な多センターゲノミクス研究 (GoCAR)
- 159個の腎臓アロインプラントバイオプシーサンプルをマイクロアレイ分析した.
- 線維症の予測遺伝子を特定するために,罰則的な回帰と変異に基づくアプローチ.
主要な成果:
- 1年後に繊維症を独立して予測する13の遺伝子群が特定された (AUC0. 967).
- この遺伝子組は 線維症とアロ移植の喪失を予測する臨床的および病理学的変数を上回った.
- 独立したコホートでの検証は,13遺伝子セットの予測値 (AUCは0. 831から0. 972まで) を確認した.
結論:
- 13の遺伝子組は 腎臓移植を受けた患者が 回復不能になる前に 腎臓移植が失われる危険性を 特定できます
- この予測ツールは,線維症の進行を防ぐために,適時な治療改変を可能にします.
- リスクの高い患者を早期に特定することで 腎臓移植の長期的な成果が改善されます
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