Lee, Arah; Jeong, Jong-Cheol; Choi, Young-Wook; Seok, Hwa-Young; Kim, Yang-Gyun; Jeong, Kyung-Hwan; Moon, Ju-Young; Lee, Tae-Won; Ihm, Chun-Gyoo; Jeon, Hee Jung; Koo, Tai-Yeon; Ahn, Curie; Lim, Sung-Jig; Yang, Jaeseok; Lee, Sang-Ho
Transplantation
2014Oct ; 98 ( 7 ) :760-5.
PMID : 25208320
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Lee, Arah -
Jeong, Jong-Cheol -
Choi, Young-Wook -
Seok, Hwa-Young -
Kim, Yang-Gyun -
Jeong, Kyung-Hwan -
Moon, Ju-Young -
Lee, Tae-Won -
Ihm, Chun-Gyoo -
Jeon, Hee Jung -
Koo, Tai-Yeon -
Ahn, Curie -
Lim, Sung-Jig -
Yang, Jaeseok -
Lee, Sang-Ho -
ABSTRACT
BACKGROUND: Diagnosing acute rejection (AR) in kidney transplant recipients typically requires an invasive kidney biopsy. A previous study has suggested that expression of five genes in peripheral blood can indicate the presence of AR in American pediatric kidney transplant recipients. This study aims to validate if these five genes are also useful to diagnose AR in Korean adult kidney transplant patients.
METHODS: Blood samples were collected from 143 patients (39 biopsy-proven AR, 84 stable patients, and 20 other graft injuries) at an average of 9 months posttransplantation and performed real-time PCR for five-gene biomarkers (DUSP1, NKTR, MAPK9, PSEN1, and PBEF1).
RESULTS: Patients with acute cellular rejection (ACR) had a significantly decreased level of MAPK9 and a significantly increased level of PSEN1 when compared with controls and also with patients with other graft injury (OGI). In multivariate logistic regression analysis, for discrimination between ACR and OGI, an excellent diagnostic accuracy was observed in the gene sets but five-gene set generated a higher AUC than two-gene set. With clinical variables combined to these gene sets, the diagnostic accuracy increased in both five-gene set and two-gene set.
CONCLUSIONS: These results support the validity of 5 gene-set for the prediction of AR in Asian adult kidney transplant recipients and suggest the promising role of the peripheral blood gene test in the diagnosis of AR in kidney transplantation.
Kidney transplantation, Acute rejection, Biomarker
MESH
Adult, Area Under Curve, Biomarkers/blood, Biopsy, Diagnostic Tests, Routine, Female, Graft Rejection/blood/*diagnosis, HLA Antigens/metabolism, Hematologic Tests, Humans, Kidney/pathology, Kidney Transplantation/*adverse effects, Male, Middle Aged, Mitogen-Activated Protein Kinase 9/metabolism, Multivariate Analysis, Presenilin-1/metabolism, Real-Time Polymerase Chain Reaction, Renal Insufficiency/*blood/*surgery, Republic of Korea
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