Gene-Based Bio-Signature Patterns and Cardiac Allograft Rejection
| Autor: | Mandeep R. Mehra, Patricia A. Uber, Benitez Rm |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Graft Rejection
Transplantation Conditioning Biopsy medicine.medical_treatment MicroRNA Gene Gene Expression Interleukin 1 receptor type II Bioinformatics Polymorphism Single Nucleotide Risk Assessment Pharmacotherapy Risk Factors medicine Humans Heart Failure medicine.diagnostic_test business.industry Gene Expression Profiling Myocardium Immunosuppression General Medicine Prognosis Gene expression profiling Transplantation Multigene Family Heart Transplantation Cardiology and Cardiovascular Medicine business Signal Transduction |
| Zdroj: | Heart Failure Clinics. 6:87-92 |
| ISSN: | 1551-7136 |
| DOI: | 10.1016/j.hfc.2009.08.010 |
| Popis: | Clinicians have long awaited an alternative to invasive endomyocardial biopsy for surveillance of cardiac transplant rejection. Transcriptional signals in peripheral blood mononuclear cells allow for the development of multigene-based panels that can inform on the presence or absence of immunologic quiescence. The informative genes represent several biologic pathways, including T-cell activation (PDCD1), T-cell migration (ITGA4), and mobilization of hematopoietic precursors (WDR40A and microRNA gene family cMIR), and steroid-responsive genes such as IL1R2, the decoy receptor for interleukin 2. The greatest value may include the ability to inform on the potential of future proclivity for rejection, allowing patients to be stratified into low, intermediate, or high risk subsets for future rejection. In these individuals, this knowledge may allow clinicians to use tailored approaches to immunosuppression, thereby avoiding adverse pharmacologic effects in low-risk patients while improving rejection outcomes in those at high risk for future allograft compromise. Despite these advances, clinical entrenchment of gene-based pharmacotherapy in cardiac transplantation will require independent replication and validation of investigational findings. |
| Databáze: | OpenAIRE |
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