Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Background: Noninvasive methods for the early diagnosis of chronic antibody-mediated rejection (cAMR) are desired for patients with de novo (dn) donor-specific HLA antibody (DSA) because of the lack of effective methods other than graft biopsy. The aim of this study to elucidate the clinical relevance of immune-related gene expression in peripheral blood of kidney transplant recipients. Materials and Methods: Fourteen key molecules (Foxp3, CTLA-4, CCR7, TGF-β, IGLL-1, IL-10, ITCH, CBLB, Bcl-6, CXCR5, granzyme B, CIITA, Baff, TOAG-1/TCAIM) related to regulatory/cytotoxic function of immune cells were examined in the peripheral blood of 93 kidney transplant recipients by RT-PCR. The expression levels were compared among patients who had clinical cAMR with dn DSA (group A, N=16), subclinical cAMR with dn DSA (group B, N=17), negative cAMR with dn DSA (group C, N=21), and clinically stable function without dn DSA (group D, N=39). Results: On multivariate analysis, CIITA mRNA expression levels in groups B and C (potential risk groups for clinical cAMR) were significantly lower than those in group D (p < 0.01). Moreover, the CTLA-4 mRNA expression in group A (clinical cAMR group due to dn DSA) was significantly higher than that in groups B and C (p < 0.01). However, no biomarker could effectively differentiate between groups B and C. ROC curve analysis suggested that CIITA [area under the curve (AUC) = 0.902] and CTLA-4 (AUC = 0.785) may serve as valuable biomarkers of the stage of dn DSA production and clinical cAMR, respectively. Conclusions: In addition to dn DSA screening, monitoring of CIITA and CTLA-4 in peripheral blood could offer useful information on the time course of the development of cAMR.
CITATION INFORMATION: Yamamoto T., Iwasaki K., Murotani K., Takeda A., Tsujita M., Hiramitsu T., Goto N., Narumi S., Watarai Y., Uchida K., Kobayashi T. Peripheral Blood Immune Response-Related Gene Analysis for Evaluating the Development of Subclinical Antibody-Mediated Rejection Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Yamamoto T, Iwasaki K, Murotani K, Takeda A, Tsujita M, Hiramitsu T, Goto N, Narumi S, Watarai Y, Uchida K, Kobayashi T. Peripheral Blood Immune Response-Related Gene Analysis for Evaluating the Development of Subclinical Antibody-Mediated Rejection [abstract]. https://atcmeetingabstracts.com/abstract/peripheral-blood-immune-response-related-gene-analysis-for-evaluating-the-development-of-subclinical-antibody-mediated-rejection/. Accessed December 5, 2019.
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