Urine mRNA Profiles for Differential Diagnosis of Kidney Allograft Dysfunction
- 詳細技術說明
- This inventionprovides urine-based non-invasive methods for the differential diagnosis of thecommon causes of kidney allograft dysfunction: acute cellular rejection (ACR),antibody mediated rejection (AMR), and acute tubular injury (ATI).
- *Abstract
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Acute cellularrejection (ACR), acute antibody mediated rejection (AMR), and acute tubularinjury (ATI) are the common causes of acute allograft dysfunction. Since ACR, AMRand ATI require different treatments, it is important to determine the exact causeof allograft dysfunction. Currently, allograft biopsy is used to confirm acuterejection (AR, either ACR or AMR). However, invasive needle biopsy is not onlyassociated with complications but is costly as well.
Cornell inventorsanalyzed a panel of 26 mRNAs in 84 urine samples from 84 kidney graft recipientswho had undergone kidney allograft biopsy to determine the cause of graftdysfunction. There were 26 transplant recipients with ACR, 26 with AMR, and 32with ATI. A 6-gene urinary cell signature was developed to distinguish AR (bothACR and AMR) from ATI, with an estimate of the area under the curve (AUC) of0.92. Next, among patients diagnosed with AR, a 5-gene urinary cell signaturewas developed to distinguish between ACR and AMR, with an estimate of the AUCof 0.81.
These urine mRNAsignatures provide a non-invasive approach for the differential diagnosis ofkidney allograft dysfunction. Approximately 35-40% of biopsies done to confirm ARare in fact not AR and can potentially be avoided with this approach. Amongpatients identified as AR, incorporating the 5-gene signature will furtherreduce the need for invasive biopsies.
Potential Applications
Non-invasive clinicaltests for the differential diagnosis of kidney allograft dysfunction
Advantages
- Noninvasiveand cost-effective (PCR vs. biopsy)
- Highlyaccurate; heterogeneity in patient and transplant traits or characteristicsdoes not undermine the ability to differentiate
- *Licensing
- Dan-Oscar Antsonda429@cornell.edu212-746-1297
- 其他
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Urinary Cell mRNA Profiles and DifferentialDiagnosis of Acute Kidney Graft Dysfunction. J Am Soc Nephrol, 2014, Mar 7.
- 國家/地區
- 美國
