Identification of T Cell–Mediated Vascular Rejection After Kidney Transplantation by the Combined Measurement of 5 Specific MicroRNAs in Blood

Matz, Mareen; Fabritius, Katharina; Lorkowski, Christine; Dürr, Michael; Gaedeke, Jens; Grün, Joachim R.; Goestemeyer, Anne; Bachmann, Friederike; Wu, Kaiyin; Rudolph, Birgit; Schmidt, Danilo; Haftmann, Claudia; Unterwalder, Nadine; Lachmann, Nils; Radbruch, Andreas; Neumayer, Hans‐H.; Mashreghi, Mir‐Farzin; Budde, Klemens

doi:10.1097/tp.0000000000000873

Cited by 35 publications

(36 citation statements)

References 41 publications

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“…An additional 6 articles were included into the process after reference review. A total of 29 articles deemed eligible for inclusion were then assessed by the GRADE quality of evidence tool (see Table ), leaving 23 articles in the current systematic review (see Table ), after scoring above the desired threshold. The complete study inclusion process compliant with PRISMA guidelines can be found in Figure .…”

Section: Resultsmentioning

confidence: 99%

“…Some studies also evaluated performances in specific subsets of rejection, including subclinical rejection (SCR), acute cellular rejection (ACR), and antibody mediated rejection (ABMR) . 19 studies examined adult participants (mean age range 44.6‐50.3 from 11 reported studies), 3 examined paediatric patients (mean age range 11.2‐11.9) and 1 examined both (mean age not reported) . Male to female participant ratio was 3:2 amongst 22 studies .…”

Section: Resultsmentioning

confidence: 99%

“…19 studies examined adult participants (mean age range 44.6‐50.3 from 11 reported studies), 3 examined paediatric patients (mean age range 11.2‐11.9) and 1 examined both (mean age not reported) . Male to female participant ratio was 3:2 amongst 22 studies . Sensitivity, specificity and AUC performance values ranged 36%‐100%, 30%‐100% and 0.55‐0.98, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…However, this study was performed in children and young adults only, and an extension of this work is necessary examining patients of all ages. A five microRNA (miRNA) panel set was identified by Matz et al , capable of accurately identifying severe T‐cell mediated vascular rejection (Banff 4‐II/III), also differentiating patients from those with UTI, Banff 2‐ABMR, Banff 3‐Borderline rejection and Banff 5‐IFTA. Data was supported by an independent cross‐validation set.…”

Section: Discussionmentioning

confidence: 99%

“…Almost all studies in this review have acknowledged common limitations in their study designs, commenting on small patient numbers with highly selective subjects, lacking the clinical complexity of the wider population. Additionally, some of the studies adopted a multi‐cross‐sectional research design, lacking the longitudinal analysis required to comprehensively evaluate a biomarker over time. More multi‐centre validation studies are needed to confirm these preliminary findings in all ages, with sufficient statistical power to provide full confidence in their clinical application.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Novel non-invasive biomarkers diagnostic of acute rejection in renal transplant recipients: A systematic review

et al. 2018

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Although larger, more robust multi-centre validation studies are needed before non-invasive biomarkers can replace the biopsy, numerous candidate tests have demonstrated significant promise for various facets of postoperative management. Suggested uses include: ruling out patients with a low risk of acute rejection to avoid the need for biopsy, non-invasive testing where the biopsy is contraindicated and a prompt diagnosis is needed, and integration into a serial blood monitoring protocol in conjunction with serum creatinine.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Novel non-invasive biomarkers diagnostic of acute rejection in renal transplant recipients: A systematic review

et al. 2018

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Serum TGF‐β as a predictive biomarker for severe disease and fatality of COVID‐19

et al. 2023

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For targeted intervention in coronavirus disease 2019 (COVID‐19), there is a high medical need for biomarkers that predict disease progression and severity in the first days after symptom onset. This study assessed the utility of early transforming growth factor β (TGF‐β) serum levels in COVID‐19 patients to predict disease severity, fatality, and response to dexamethasone therapy. Patients with severe COVID‐19 had significantly higher TGF‐β levels (416 pg/mL) as compared to patients with mild (165 pg/mL, p < 0.0001) or moderate COVID‐19 (241 pg/mL; p < 0.0001). Receiver operating characteristics area under the curve values were 0.92 (95% confidence interval [CI] 0.85–0.99, cut‐off: 255 pg/mL) for mild versus severe COVID‐19, and 0.83 (95% CI 0.65–1.0, cut‐off: 202 pg/mL) for moderate versus severe COVID‐19. Patients who died of severe COVID‐19 had significantly higher TGF‐β levels (453 pg/mL) as compared to convalescent patients (344 pg/mL), and TGF‐β levels predicted fatality (area under the curve: 0.75, 95% CI 0.53–0.96). TGF‐β was significantly reduced in severely ill patients treated with dexamethasone (301 pg/mL) as compared to untreated patients (416 pg/mL; p < 0.05). Early TGF‐β serum levels in COVID‐19 patients predict, with high accuracy, disease severity, and fatality. In addition, TGF‐β serves as a specific biomarker to assess response to dexamethasone treatment.

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Biomarkers to detect rejection after kidney transplantation

Dharnidharka

Malone

2017

Pediatr Nephrol

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Detecting acute rejection in kidney transplantation has been traditionally done using histological analysis of invasive allograft biopsies, but this method carries a risk and is not perfect. Transplant professionals have been working to develop more accurate or less invasive biomarkers that can predict acute rejection or subsequent worse allograft survival. These biomarkers can use tissue, blood or urine as a source. They can comprise individual molecules or panels, singly or in combination, across different components or pathways of the immune system. This review highlights the most recent evidence for biomarker efficacy, especially from multicenter trials.

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Identification of T Cell–Mediated Vascular Rejection After Kidney Transplantation by the Combined Measurement of 5 Specific MicroRNAs in Blood

Abstract: The combined measurement of miRNA-15B, miRNA-16, miRNA-103A, miRNA-106A, and miRNA-107 may help to better identify TCMVR after renal transplantation in a precise and clinically applicable way.

Cited by 35 publications

References 41 publications

Novel non-invasive biomarkers diagnostic of acute rejection in renal transplant recipients: A systematic review

Novel non-invasive biomarkers diagnostic of acute rejection in renal transplant recipients: A systematic review

Serum TGF‐β as a predictive biomarker for severe disease and fatality of COVID‐19

Biomarkers to detect rejection after kidney transplantation

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