Inserm, , Center for Research in Transplantation and Immunology (CRTI) U1064, Nantes, France.
Université de Nantes, , UMR1064, Nantes, France.
Eur J Immunol. 2016 Dec;46(12):2695-2704. doi: 10.1002/eji.201545963.
It is now widely accepted that in order to improve long-term graft function and survival, a more personalized immunosuppressive treatment of transplant patients according to the individual anti-donor immune response status is needed. This applies to the identification of potentially "high-risk" patients likely to develop acute rejection episodes or display an accelerated decline of graft function, patients who might need immunosuppression intensification, and operationally tolerant patients suitable for immunosuppression minimization or weaning off. Such a patient stratification would benefit from biomarkers, which enable categorization into low and high risk or, ideally, identification of operational tolerant patients. Here, we report on recent developments regarding identification and performance analysis of noninvasive biomarkers such as mRNA and miRNA expression profiles, chemokines, or changes in immune cell subsets in either blood or urine of renal transplant patients. We will also discuss which future steps are needed to accelerate their clinical implementation.
现在人们普遍认为，为了提高长期移植物功能和存活率，需要根据个体的抗供体免疫反应状态，对移植患者进行更具个性化的免疫抑制治疗。这适用于识别可能发生急性排斥反应或移植物功能加速下降的“高危”患者，需要强化免疫抑制的患者，以及适合免疫抑制最小化或逐渐停药的操作性耐受患者。这种患者分层将受益于生物标志物，这些标志物可以将患者分为低风险和高风险，或者理想情况下，识别出操作性耐受的患者。在这里，我们报告了最近在鉴定和分析非侵入性生物标志物方面的进展，如肾移植患者血液或尿液中的 mRNA 和 miRNA 表达谱、趋化因子或免疫细胞亚群变化。我们还将讨论需要采取哪些未来步骤来加速其临床应用。
