A Rejection Gene Expression Score in Indication and Surveillance Biopsies Is Associated with Graft Outcome

Pathology Department, Instituto de Biopatología y Medicina Regenerativa (IBIMER), Instituto de Investigación Biosanitaria (ibs.GRANADA), University of Granada, 18010 Granada, Spain

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Department of Medicine, Autonomous University of Barcelona, 08035 Barcelona, Spain

Author to whom correspondence should be addressed.

Int. J. Mol. Sci. 2020, 21(21), 8237; https://doi.org/10.3390/ijms21218237

Received: 5 October 2020 / Revised: 30 October 2020 / Accepted: 1 November 2020 / Published: 3 November 2020

(This article belongs to the Special Issue Molecular Aspects of Renal Immunology: Current Status and Future Perspectives)

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Abstract

Rejection-associated gene expression has been characterized in renal allograft biopsies for cause. The aim is to evaluate rejection gene expression in subclinical rejection and in biopsies with borderline changes or interstitial fibrosis and tubular atrophy (IFTA). We included 96 biopsies. Most differentially expressed genes between normal surveillance biopsies (n = 17) and clinical rejection (n = 12) were obtained. A rejection-associated gene (RAG) score was defined as its geometric mean. The following groups were considered: (a) subclinical rejection (REJ-S, n = 6); (b) borderline changes in biopsies for cause (BL-C, n = 13); (c) borderline changes in surveillance biopsies (BL-S, n = 12); (d) IFTA in biopsies for cause (IFTA-C, n = 20); and (e) IFTA in surveillance biopsies (IFTA-S, n = 16). The outcome variable was death-censored graft loss or glomerular filtration rate decline ≥ 30 % at 2 years. A RAG score containing 109 genes derived from normal and clinical rejection (area under the curve, AUC = 1) was employed to classify the study groups. A positive RAG score was observed in 83% REJ-S, 38% BL-C, 17% BL-S, 25% IFTA-C, and 5% IFTA-S. A positive RAG score was an independent predictor of graft outcome from histological diagnosis (hazard ratio: 3.5 and 95% confidence interval: 1.1–10.9; p = 0.031). A positive RAG score predicts graft outcome in surveillance and for cause biopsies with a less severe phenotype than clinical rejection. View Full-Text

Keywords: renal transplantation; biopsies; rejection; transcriptomics; microarrays; borderline changes; interstitial fibrosis and tubular atrophy

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Chamoun, B.; Caraben, A.; Torres, I.B.; Sellares, J.; Jiménez, R.; Toapanta, N.; Cidraque, I.; Gabaldon, A.; Perelló, M.; Gonzalo, R.; O’Valle, F.; Moreso, F.; Serón, D. A Rejection Gene Expression Score in Indication and Surveillance Biopsies Is Associated with Graft Outcome. Int. J. Mol. Sci. 2020, 21, 8237. https://doi.org/10.3390/ijms21218237

AMA Style

Chamoun B, Caraben A, Torres IB, Sellares J, Jiménez R, Toapanta N, Cidraque I, Gabaldon A, Perelló M, Gonzalo R, O’Valle F, Moreso F, Serón D. A Rejection Gene Expression Score in Indication and Surveillance Biopsies Is Associated with Graft Outcome. International Journal of Molecular Sciences. 2020; 21(21):8237. https://doi.org/10.3390/ijms21218237

Chicago/Turabian Style

Chamoun, Betty, Anna Caraben, Irina B. Torres, Joana Sellares, Raquel Jiménez, Néstor Toapanta, Ignacio Cidraque, Alejandra Gabaldon, Manel Perelló, Ricardo Gonzalo, Francisco O’Valle, Francesc Moreso, and Daniel Serón. 2020. "A Rejection Gene Expression Score in Indication and Surveillance Biopsies Is Associated with Graft Outcome" International Journal of Molecular Sciences 21, no. 21: 8237. https://doi.org/10.3390/ijms21218237

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A Rejection Gene Expression Score in Indication and Surveillance Biopsies Is Associated with Graft Outcome

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