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Through the Looking Glass: Unraveling the Stage-Shift of Acute Rejection in Renal Allografts

Sub-optimal sensitivity and specificity in current allograft monitoring methodologies underscore the need for more accurate and reflexive immunosurveillance to uncover the flux in alloimmunity between allograft health and the onset and progression of rejection. QSant—a urine based multi-analyte diag...

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Autores principales: Sarwal, Reuben D., Yazar, Wanzin, Titzler, Nicholas, Wong, Jeremy, Lai, Chih-hung, Chin, Christopher, Krieger, Danielle, Stoll, Jeff, Dias Lourenco, Francisco, Sarwal, Minnie M., Ghosh, Srinka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8879913/
https://www.ncbi.nlm.nih.gov/pubmed/35207183
http://dx.doi.org/10.3390/jcm11040910
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author Sarwal, Reuben D.
Yazar, Wanzin
Titzler, Nicholas
Wong, Jeremy
Lai, Chih-hung
Chin, Christopher
Krieger, Danielle
Stoll, Jeff
Dias Lourenco, Francisco
Sarwal, Minnie M.
Ghosh, Srinka
author_facet Sarwal, Reuben D.
Yazar, Wanzin
Titzler, Nicholas
Wong, Jeremy
Lai, Chih-hung
Chin, Christopher
Krieger, Danielle
Stoll, Jeff
Dias Lourenco, Francisco
Sarwal, Minnie M.
Ghosh, Srinka
author_sort Sarwal, Reuben D.
collection PubMed
description Sub-optimal sensitivity and specificity in current allograft monitoring methodologies underscore the need for more accurate and reflexive immunosurveillance to uncover the flux in alloimmunity between allograft health and the onset and progression of rejection. QSant—a urine based multi-analyte diagnostic test—was developed to profile renal transplant health and prognosticate injury, risk of evolution, and resolution of acute rejection. Q-Score—the composite score, across measurements of DNA, protein and metabolic biomarkers in the QSant assay—enables this risk prognostication. The domain of immune quiescence—below a Q-Score threshold of 32—is well established, based on published AUC of 98% for QSant. However, the trajectory of rejection is variable, given that causality is multi-factorial. Injury and subtypes of rejection are captured by the progression of Q-Score. This publication explores the clinical utility of QSant across the alloimmunity gradient of 32–100 for the early diagnosis of allograft injury and rejection.
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spelling pubmed-88799132022-02-26 Through the Looking Glass: Unraveling the Stage-Shift of Acute Rejection in Renal Allografts Sarwal, Reuben D. Yazar, Wanzin Titzler, Nicholas Wong, Jeremy Lai, Chih-hung Chin, Christopher Krieger, Danielle Stoll, Jeff Dias Lourenco, Francisco Sarwal, Minnie M. Ghosh, Srinka J Clin Med Article Sub-optimal sensitivity and specificity in current allograft monitoring methodologies underscore the need for more accurate and reflexive immunosurveillance to uncover the flux in alloimmunity between allograft health and the onset and progression of rejection. QSant—a urine based multi-analyte diagnostic test—was developed to profile renal transplant health and prognosticate injury, risk of evolution, and resolution of acute rejection. Q-Score—the composite score, across measurements of DNA, protein and metabolic biomarkers in the QSant assay—enables this risk prognostication. The domain of immune quiescence—below a Q-Score threshold of 32—is well established, based on published AUC of 98% for QSant. However, the trajectory of rejection is variable, given that causality is multi-factorial. Injury and subtypes of rejection are captured by the progression of Q-Score. This publication explores the clinical utility of QSant across the alloimmunity gradient of 32–100 for the early diagnosis of allograft injury and rejection. MDPI 2022-02-09 /pmc/articles/PMC8879913/ /pubmed/35207183 http://dx.doi.org/10.3390/jcm11040910 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sarwal, Reuben D.
Yazar, Wanzin
Titzler, Nicholas
Wong, Jeremy
Lai, Chih-hung
Chin, Christopher
Krieger, Danielle
Stoll, Jeff
Dias Lourenco, Francisco
Sarwal, Minnie M.
Ghosh, Srinka
Through the Looking Glass: Unraveling the Stage-Shift of Acute Rejection in Renal Allografts
title Through the Looking Glass: Unraveling the Stage-Shift of Acute Rejection in Renal Allografts
title_full Through the Looking Glass: Unraveling the Stage-Shift of Acute Rejection in Renal Allografts
title_fullStr Through the Looking Glass: Unraveling the Stage-Shift of Acute Rejection in Renal Allografts
title_full_unstemmed Through the Looking Glass: Unraveling the Stage-Shift of Acute Rejection in Renal Allografts
title_short Through the Looking Glass: Unraveling the Stage-Shift of Acute Rejection in Renal Allografts
title_sort through the looking glass: unraveling the stage-shift of acute rejection in renal allografts
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8879913/
https://www.ncbi.nlm.nih.gov/pubmed/35207183
http://dx.doi.org/10.3390/jcm11040910
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