Article ; Online: Use of the Tissue Common Rejection Module Score in Kidney Transplant as an Objective Measure of Allograft Inflammation.
2021 Volume 11, Page(s) 614343
Abstract: Long-term kidney transplant (KT) allograft outcomes have not improved as expected despite a better understanding of rejection and improved immunosuppression. Previous work had validated a computed rejection score, the tissue common rejection module (tCRM) ...
| Abstract | Long-term kidney transplant (KT) allograft outcomes have not improved as expected despite a better understanding of rejection and improved immunosuppression. Previous work had validated a computed rejection score, the tissue common rejection module (tCRM), measured by amplification-based assessment of 11 genes from formalin-fixed paraffin-embedded (FFPE) biopsy specimens, which allows for quantitative, unbiased assessment of immune injury. We applied tCRM in a prospective trial of 124 KT recipients, and contrasted assessment by tCRM and histology reads from 2 independent pathologists on protocol and cause biopsies post-transplant. Four 10-μm shaves from FFPE biopsy specimens were used for RNA extraction and amplification by qPCR of the 11 tCRM genes, from which the tCRM score was calculated. Biopsy diagnoses of either acute rejection (AR) or borderline rejection (BL) were considered to have inflammation present, while stable biopsies had no inflammation. Of the 77 biopsies that were read by both pathologists, a total of 40 mismatches in the diagnosis were present. The median tCRM scores for AR, BL, and stable diagnoses were 4.87, 1.85, and 1.27, respectively, with an overall significant difference among all histologic groups (Kruskal-Wallis, p < 0.0001 |
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| MeSH term(s) | Allografts/immunology ; Biomarkers/metabolism ; Biopsy ; Female ; Graft Rejection/diagnosis ; Graft Rejection/genetics ; Graft Rejection/immunology ; Graft Rejection/metabolism ; Graft Survival/immunology ; Humans ; Immunosuppression/methods ; Inflammation/genetics ; Inflammation/metabolism ; Kidney Transplantation ; Logistic Models ; Male ; Middle Aged ; Prospective Studies ; Real-Time Polymerase Chain Reaction ; Transcriptome/genetics ; Transplantation, Homologous |
| Chemical Substances | Biomarkers |
| Language | English |
| Publishing date | 2021-02-03 |
| Publishing country | Switzerland |
| Document type | Controlled Clinical Trial ; Journal Article ; Research Support, N.I.H., Extramural |
| ZDB-ID | 2606827-8 |
| ISSN | 1664-3224 ; 1664-3224 |
| ISSN (online) | 1664-3224 |
| ISSN | 1664-3224 |
| DOI | 10.3389/fimmu.2020.614343 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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