游离DNA在肾移植中的新作用
Emerging role of cell-free DNA in kidney transplantation.
作者信息
Chopra Bhavna, Sureshkumar Kalathil K
机构信息
Nephrology and Hypertension, Allegheny General Hospital, Pittsburgh, PA 15212, United States.
Division of Nephrology, Department of Medicine, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA 15212, United State.
出版信息
World J Exp Med. 2021 Nov 20;11(5):55-65. doi: 10.5493/wjem.v11.i5.55.
Abstract
Monitoring kidney transplants for rejection conventionally includes serum creatinine, immunosuppressive drug levels, proteinuria, and donor-specific antibody (DSA). Serum creatinine is a late marker of allograft injury, and the predictive ability of DSA regarding risk of rejection is variable. Histological analysis of an allograft biopsy is the standard method for diagnosing rejection but is invasive, inconvenient, and carries risk of complications. There has been a long quest to find a perfect biomarker that noninvasively predicts tissue injury caused by rejection at an early stage, so that diagnosis and treatment could be pursued without delay in order to minimize irreversible damage to the allograft. In this review, we discuss relatively novel research on identifying biomarkers of tissue injury, specifically elaborating on donor-derived cell-free DNA, and its clinical utility.
摘要
传统上，监测肾移植排斥反应包括检测血清肌酐、免疫抑制药物水平、蛋白尿和供者特异性抗体（DSA）。血清肌酐是同种异体移植损伤的晚期标志物，而DSA对排斥反应风险的预测能力存在差异。同种异体移植活检的组织学分析是诊断排斥反应的标准方法，但具有侵入性、不方便且有并发症风险。长期以来，人们一直在寻找一种完美的生物标志物，能够在早期非侵入性地预测由排斥反应引起的组织损伤，以便能够及时进行诊断和治疗，从而将对同种异体移植的不可逆损伤降至最低。在本综述中，我们讨论了关于识别组织损伤生物标志物的相对新颖的研究，特别阐述了供者来源的游离DNA及其临床应用。
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本文引用的文献
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Donor-Derived Cell Free DNA: Is It All the Same?供体细胞游离 DNA：都一样吗？
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Time-Dependent Apparent Increase in dd-cfDNA Percentage in Clinically Stable Patients Between One and Five Years Following Kidney Transplantation.移植肾后 1 至 5 年临床稳定患者的 dd-cfDNA 百分比随时间呈持续增加。
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Donor-derived Cell-free DNA in Infections in Kidney Transplant Recipients: Case Series.肾移植受者感染中供体来源的游离DNA：病例系列
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