不同的分子过程调解来自捐赠者的无细胞DNA释放,来自不同疾病状态的移植
Patrick T Gauthier1,2, Katelynn S Madill-Thomsen1,2, Zachary Demko3
1Alberta Transplant Applied Genomics Centre, Edmonton, AB, Canada.
Transplantation
|December 27, 2023
概括
移植患者体内细胞自由DNA (dd-cfDNA) 的升高表明了抗体中介排斥 (AMR),T细胞中介排斥 (TCMR) 或急性损伤 (AKI). 微妙的分子变化也可以在看似正常的活检中提升dd-cfDNA.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 分子诊断学 分子诊断学
背景情况:
- 来自捐赠者的无细胞DNA (dd-cfDNA) 是移植中的一个有前途的生物标志物.
- 在抗体介导排斥 (AMR),T细胞介导排斥 (TCMR),急性损伤 (AKI) 甚至在一些正常活检中观察到 dd-cfDNA 的升高.
- 这些状态中dd-cfDNA升高的分子基础需要进一步定义.
研究的目的:
- 在特定的移植状态下定义血dd-cfDNA的分子相关物.
- 调查移植接受者的活检中dd-cfDNA水平和基因表达特征之间的关联.
主要方法:
- 使用Prospera测试测量了等离子 dd-cfDNA.
- 用分子显微镜系统确定了分子排斥和损伤状态.
- 对dd-cfDNA与基因表达,转录集和分类器分数之间的相关性进行了分析,活检分类为AMR,TCMR,AKI和正常/无损伤 (NRNI).
主要成果:
- 血dd-cfDNA在所有评估状态中都升高:AMR,TCMR和AKI.
- 在AMR中,dd-cfDNA与排斥活性和阶段相关.
- 在AKI中,dd-cfDNA相关性反映了急性辅酶体损伤和细胞循环.
- 即使在被归类为正常的活检中,dd-cfDNA也与排斥和受伤相关的基因相关.
- TCMR活性与dd-cfDNA相关,但基因相关性很复杂,并不总是选择TCMR.
结论:
- 移植患者血dd-cfDNA的升高与分子抗体中介排斥 (AMR),最近的辅酶体损伤 (包括细胞循环) 和T细胞中介排斥 (TCMR) 有关.
- 微妙的分子变化表明在捐赠组织中排斥或损伤,可以导致dd-cfDNA升高,即使在被认为没有排斥或损伤的移植中也是如此.
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