Nephrology Department, Hospital 12 de Octubre, 28041 Madrid, Spain.
Nephrology Department, Hospital del Mar, Institut Mar for Medical Research, 08003 Barcelona, Spain.
Int J Mol Sci. 2023 Mar 8;24(6):5201. doi: 10.3390/ijms24065201.
Immunosuppressive drugs are widely used to prevent rejection after kidney transplantation. However, the pharmacological response to a given immunosuppressant can vary markedly between individuals, with some showing poor treatment responses and/or experiencing serious side effects. There is an unmet need for diagnostic tools that allow clinicians to individually tailor immunosuppressive therapy to a patient's immunological profile. The Immunobiogram (IMBG) is a novel blood-based in vitro diagnostic test that provides a pharmacodynamic readout of the immune response of individual patients to a range of immunosuppressants commonly used in kidney transplant recipients. Here, we discuss the current approaches used to measure the pharmacodynamic responses of individual patients to specific immunosuppressive drugs in vitro, which can then be correlated with patient's clinical outcomes. We also describe the procedure of the IMBG assay, and summarize the results obtained using the IMBG in different kidney transplant populations. Finally, we outline future directions and other novel applications of the IMBG, both in kidney transplant patients and other autoimmune diseases.
免疫抑制剂广泛用于预防肾移植后的排斥反应。然而,个体对特定免疫抑制剂的药物反应差异很大,一些人治疗反应不佳,/或出现严重的副作用。因此,人们迫切需要诊断工具,以便临床医生根据患者的免疫状况为其量身定制免疫抑制治疗方案。免疫生物图(IMBG)是一种新型的基于血液的体外诊断测试,可提供个体患者对肾移植受者常用的一系列免疫抑制剂的免疫反应的药效学读数。在这里,我们讨论了目前用于体外测量个体患者对特定免疫抑制剂的药效反应的方法,然后可以将这些方法与患者的临床结果相关联。我们还描述了 IMBG 检测的程序,并总结了在不同的肾移植人群中使用 IMBG 获得的结果。最后,我们概述了 IMBG 在肾移植患者和其他自身免疫性疾病中的未来发展方向和其他新的应用。