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Development and validation of the first consensus gene-expression signature of operational tolerance in kidney transplantation, incorporating adjustment for immunosuppressive drug therapy
S. Christakoudi, M. Runglall, P. Mobillo, I. Rebollo-Mesa, TL. Tsui, E. Nova-Lamperti, C. Taube, S. Norris, Y. Kamra, R. Hilton, T. Augustine, S. Bhandari, R. Baker, D. Berglund, S. Carr, D. Game, S. Griffin, PA. Kalra, R. Lewis, PB. Mark, SD....
Jazyk angličtina Země Nizozemsko
Typ dokumentu srovnávací studie, časopisecké články
NLK
Directory of Open Access Journals
od 2014
PubMed Central
od 2014
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- MeSH
- dospělí MeSH
- genové regulační sítě * účinky léků MeSH
- imunosupresiva farmakologie terapeutické užití MeSH
- konsensus MeSH
- kvantitativní polymerázová řetězová reakce MeSH
- lidé středního věku MeSH
- lidé MeSH
- logistické modely MeSH
- rejekce štěpu genetika prevence a kontrola MeSH
- senioři MeSH
- stanovení celkové genové exprese metody MeSH
- studie případů a kontrol MeSH
- transplantace ledvin škodlivé účinky MeSH
- transplantační tolerance * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
BACKGROUND: Kidney transplant recipients (KTRs) with "operational tolerance" (OT) maintain a functioning graft without immunosuppressive (IS) drugs, thus avoiding treatment complications. Nevertheless, IS drugs can influence gene-expression signatures aiming to identify OT among treated KTRs. METHODS: We compared five published signatures of OT in peripheral blood samples from 18 tolerant, 183 stable, and 34 chronic rejector KTRs, using gene-expression levels with and without adjustment for IS drugs and regularised logistic regression. FINDINGS: IS drugs explained up to 50% of the variability in gene-expression and 20-30% of the variability in the probability of OT predicted by signatures without drug adjustment. We present a parsimonious consensus gene-set to identify OT, derived from joint analysis of IS-drug-adjusted expression of five published signature gene-sets. This signature, including CD40, CTLA4, HSD11B1, IGKV4-1, MZB1, NR3C2, and RAB40C genes, showed an area under the curve 0⋅92 (95% confidence interval 0⋅88-0⋅94) in cross-validation and 0⋅97 (0⋅93-1⋅00) in six months follow-up samples. INTERPRETATION: We advocate including adjustment for IS drug therapy in the development stage of gene-expression signatures of OT to reduce the risk of capturing features of treatment, which could be lost following IS drug minimisation or withdrawal. Our signature, however, would require further validation in an independent dataset and a biomarker-led trial. FUNDING: FP7-HEALTH-2012-INNOVATION-1 [305147:BIO-DrIM] (SC,IR-M,PM,DSt); MRC [G0801537/ID:88245] (MPH-F); MRC [MR/J006742/1] (IR-M); Guy's&StThomas' Charity [R080530]&[R090782]; CONICYT-Bicentennial-Becas-Chile (EN-L); EU:FP7/2007-2013 [HEALTH-F5-2010-260687: The ONE Study] (MPH-F); Czech Ministry of Health [NV19-06-00031] (OV); NIHR-BRC Guy's&StThomas' NHS Foundation Trust and KCL (SC); UK Clinical Research Networks [portfolio:7521].
Cardiff and Vale University Health Board Cardiff CF14 4XW UK
Evelina London Children's Hospital Westminster Bridge Rd Lambeth London SE1 7EH UK
Guy's and St Thomas' NHS Foundation Trust Great Maze Pond London SE1 9RT UK
Hospital Universitario Vall d'Hebrón Passeig de la Vall d'Hebron 119 129 08035 Barcelona Spain
Hull University Teaching Hospitals NHS Trust Anlaby Rd Hull HU3 2JZ UK
Internal Medicine Lindenhofgruppe Berne Switzerland
King's College Hospital NHS Foundation Trust Denmark Hill London SE5 9RS UK
King's Health Partners Guy's Hospital London SE1 9RT UK
Leicester General Hospital Gwendolen Rd Leicester LE5 4PW UK
Manchester Royal Infirmary Oxford Rd Manchester M13 9WL UK
MRC Centre for Transplantation King's College London Great Maze Pond London SE1 9RT UK
Northern General Hospital Herries Rd Sheffield S5 7AU UK
Queen Alexandra Hospital Southwick Hill Rd Cosham Portsmouth PO6 3LY UK
Salford Royal NHS Foundation Trust Stott Ln Salford M6 8HD UK
School of Medicine University of Nottingham Nottingham NG5 1PB UK
St James's University Hospital Beckett St Leeds LS9 7TF UK
Citace poskytuje Crossref.org
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