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透析转录组表达特征以确定患有慢性损伤风险的移植患者:多中心前性研究
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
概括
一组新的13个基因准确地预测了移植纤维化和移植损失. 这一发现使得早期干预能够防止不可逆转的损伤,
科学领域:
- 基因组学
- 移植免疫学
- 肝脏病学
背景情况:
- 慢性移植损伤是导致移植损失的主要原因.
- 识别纤维化的早期指标对于预防移植失败至关重要.
研究的目的:
- 确定能够预测因纤维化而导致逐渐损伤的移植的基因组.
- 开发一种用于预测移植纤维化的预测工具.
主要方法:
- 长期异种移植拒绝 (GoCAR) 的前性多中心基因组学研究
- 对159个移植样本进行微阵列分析.
- 基于惩罚性回归和变异的方法来识别纤维化预测基因.
主要成果:
- 鉴定出13个基因组,可在1年内独立预测纤维化,准确度高 (AUC为0.967).
- 这一基因组在预测纤维化和全移植损失方面表现优于临床和病理变量.
- 在独立队列中的验证证实了13基因组的预测值 (AUC从0. 831到0. 972).
结论:
- 这13个基因组可以识别移植患者在不可逆转损伤之前面临移植损失的风险.
- 这种预测工具可以及时进行治疗修改,以防止纤维化进展.
- 早期识别有风险的患者可以改善长期移植结果.
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