Blood biomarkers of kidney transplant rejection, an endless search?

Expert Rev Mol Diagn. 2017 Jul;17(7):687-697. doi: 10.1080/14737159.2017.1337512. Epub 2017 Jun 7.

Abstract

The tailoring of immunosuppressive treatment is recognized as a promising strategy to improve long-term kidney graft outcome. To guide the standard care of transplant recipients, physicians need objective biomarkers that can identify an ongoing pathology with the graft or low intensity signals that will be later evolved to accelerated transplant rejection. The early identification of 'high-risk /low-risk' patients enables the adjustment of standard of caring, including managing the frequency of clinical visits and the immunosuppression dosing. Given their ease of availability and the compatibility with a large technical array, blood-based biomarkers have been widely scrutinized for use as potential predictive and diagnostic biomarkers. Areas covered: Here, the authors report on non-invasive biomarkers, such as modification of immune cell subsets and mRNA and miRNA profiles, identified in the blood of kidney transplant recipients collected before or after transplantation. Expert commentary: Combined with functional tests, the identification of biomarkers will improve our understanding of pathological processes and will contribute to a global improvement in clinical management.

Keywords: Biomarker; kidney transplantation; lymphocyte; personalized medicine; rejection.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • B-Lymphocytes / immunology
  • Biomarkers / blood*
  • Gene Expression Profiling
  • Graft Rejection / blood*
  • Graft Rejection / genetics
  • Graft Rejection / immunology
  • Humans
  • Kidney Transplantation*
  • Killer Cells, Natural / immunology
  • Monitoring, Physiologic
  • Precision Medicine
  • T-Lymphocytes / immunology

Substances

  • Biomarkers