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Recent Advances on Biomarkers of Early and Late Kidney Graft Dysfunction

New biomarkers of early and late graft dysfunction are needed in renal transplant to improve management of complications and prolong graft survival. A wide range of potential diagnostic and prognostic biomarkers, measured in different biological fluids (serum, plasma, urine) and in renal tissues, ha...

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Autores principales: Quaglia, Marco, Merlotti, Guido, Guglielmetti, Gabriele, Castellano, Giuseppe, Cantaluppi, Vincenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432796/
https://www.ncbi.nlm.nih.gov/pubmed/32751357
http://dx.doi.org/10.3390/ijms21155404
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author Quaglia, Marco
Merlotti, Guido
Guglielmetti, Gabriele
Castellano, Giuseppe
Cantaluppi, Vincenzo
author_facet Quaglia, Marco
Merlotti, Guido
Guglielmetti, Gabriele
Castellano, Giuseppe
Cantaluppi, Vincenzo
author_sort Quaglia, Marco
collection PubMed
description New biomarkers of early and late graft dysfunction are needed in renal transplant to improve management of complications and prolong graft survival. A wide range of potential diagnostic and prognostic biomarkers, measured in different biological fluids (serum, plasma, urine) and in renal tissues, have been proposed for post-transplant delayed graft function (DGF), acute rejection (AR), and chronic allograft dysfunction (CAD). This review investigates old and new potential biomarkers for each of these clinical domains, seeking to underline their limits and strengths. OMICs technology has allowed identifying many candidate biomarkers, providing diagnostic and prognostic information at very early stages of pathological processes, such as AR. Donor-derived cell-free DNA (ddcfDNA) and extracellular vesicles (EVs) are further promising tools. Although most of these biomarkers still need to be validated in multiple independent cohorts and standardized, they are paving the way for substantial advances, such as the possibility of accurately predicting risk of DGF before graft is implanted, of making a “molecular” diagnosis of subclinical rejection even before histological lesions develop, or of dissecting etiology of CAD. Identification of “immunoquiescent” or even tolerant patients to guide minimization of immunosuppressive therapy is another area of active research. The parallel progress in imaging techniques, bioinformatics, and artificial intelligence (AI) is helping to fully exploit the wealth of information provided by biomarkers, leading to improved disease nosology of old entities such as transplant glomerulopathy. Prospective studies are needed to assess whether introduction of these new sets of biomarkers into clinical practice could actually reduce the need for renal biopsy, integrate traditional tools, and ultimately improve graft survival compared to current management.
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spelling pubmed-74327962020-08-27 Recent Advances on Biomarkers of Early and Late Kidney Graft Dysfunction Quaglia, Marco Merlotti, Guido Guglielmetti, Gabriele Castellano, Giuseppe Cantaluppi, Vincenzo Int J Mol Sci Review New biomarkers of early and late graft dysfunction are needed in renal transplant to improve management of complications and prolong graft survival. A wide range of potential diagnostic and prognostic biomarkers, measured in different biological fluids (serum, plasma, urine) and in renal tissues, have been proposed for post-transplant delayed graft function (DGF), acute rejection (AR), and chronic allograft dysfunction (CAD). This review investigates old and new potential biomarkers for each of these clinical domains, seeking to underline their limits and strengths. OMICs technology has allowed identifying many candidate biomarkers, providing diagnostic and prognostic information at very early stages of pathological processes, such as AR. Donor-derived cell-free DNA (ddcfDNA) and extracellular vesicles (EVs) are further promising tools. Although most of these biomarkers still need to be validated in multiple independent cohorts and standardized, they are paving the way for substantial advances, such as the possibility of accurately predicting risk of DGF before graft is implanted, of making a “molecular” diagnosis of subclinical rejection even before histological lesions develop, or of dissecting etiology of CAD. Identification of “immunoquiescent” or even tolerant patients to guide minimization of immunosuppressive therapy is another area of active research. The parallel progress in imaging techniques, bioinformatics, and artificial intelligence (AI) is helping to fully exploit the wealth of information provided by biomarkers, leading to improved disease nosology of old entities such as transplant glomerulopathy. Prospective studies are needed to assess whether introduction of these new sets of biomarkers into clinical practice could actually reduce the need for renal biopsy, integrate traditional tools, and ultimately improve graft survival compared to current management. MDPI 2020-07-29 /pmc/articles/PMC7432796/ /pubmed/32751357 http://dx.doi.org/10.3390/ijms21155404 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Quaglia, Marco
Merlotti, Guido
Guglielmetti, Gabriele
Castellano, Giuseppe
Cantaluppi, Vincenzo
Recent Advances on Biomarkers of Early and Late Kidney Graft Dysfunction
title Recent Advances on Biomarkers of Early and Late Kidney Graft Dysfunction
title_full Recent Advances on Biomarkers of Early and Late Kidney Graft Dysfunction
title_fullStr Recent Advances on Biomarkers of Early and Late Kidney Graft Dysfunction
title_full_unstemmed Recent Advances on Biomarkers of Early and Late Kidney Graft Dysfunction
title_short Recent Advances on Biomarkers of Early and Late Kidney Graft Dysfunction
title_sort recent advances on biomarkers of early and late kidney graft dysfunction
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432796/
https://www.ncbi.nlm.nih.gov/pubmed/32751357
http://dx.doi.org/10.3390/ijms21155404
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