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Transcriptome Analysis in Renal Transplant Biopsies Not Fulfilling Rejection Criteria

Nephrology Department, Hospital Universitari Vall d’Hebron, Department of Medicine, Autonomous University of Barcelona, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
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Int. J. Mol. Sci. 2020, 21(6), 2245; https://doi.org/10.3390/ijms21062245
Received: 31 January 2020 / Revised: 11 March 2020 / Accepted: 20 March 2020 / Published: 24 March 2020
(This article belongs to the Special Issue Renal Disease and Immunity)
The clinical significance of renal transplant biopsies displaying borderline changes suspicious for T-cell mediated rejection (TCMR) or interstitial fibrosis and tubular atrophy (IFTA) with interstitial inflammation has not been well defined. Molecular profiling to evaluate renal transplant biopsies using microarrays has been shown to be an objective measurement that adds precision to conventional histology. We review the contribution of transcriptomic analysis in surveillance and indication biopsies with borderline changes and IFTA associated with variable degrees of inflammation. Transcriptome analysis applied to biopsies with borderline changes allows to distinguish patients with rejection from those in whom mild inflammation mainly represents a response to injury. Biopsies with IFTA and inflammation occurring in unscarred tissue display a molecular pattern similar to TCMR while biopsies with IFTA and inflammation in scarred tissue, apart from T-cell activation, also express B cell, immunoglobulin and mast cell-related genes. Additionally, patients at risk for IFTA progression can be identified by genes mainly reflecting fibroblast dysregulation and immune activation. At present, it is not well established whether the expression of rejection gene transcripts in patients with fibrosis and inflammation is the consequence of an alloimmune response, tissue damage or a combination of both. View Full-Text
Keywords: renal transplantation; biopsies; transcriptome; microarrays; borderline changes; interstitial fibrosis and tubular atrophy renal transplantation; biopsies; transcriptome; microarrays; borderline changes; interstitial fibrosis and tubular atrophy
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Moreso, F.; Sellarès, J.; Soler, M.J.; Serón, D. Transcriptome Analysis in Renal Transplant Biopsies Not Fulfilling Rejection Criteria. Int. J. Mol. Sci. 2020, 21, 2245.

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