Targeted Urine Metabolomics for Monitoring Renal Allograft Injury and Immunosuppression in Pediatric Patients
| Autor: | Juliane Liberto, Minnie M. Sarwal, Reuben D. Sarwal, Tara K. Sigdel, Andrew Schroeder, Joshua Y. C. Yang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
allograft Kidney Disease medicine.medical_treatment Metabolite Clinical Sciences Renal and urogenital 030232 urology & nephrology Urology lcsh:Medicine kidney transplantation Urine acute rejection Article 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Immune system Metabolomics Clinical Research Biopsy Medicine Kidney transplantation 030304 developmental biology Pediatric Transplantation 0303 health sciences immunosuppression medicine.diagnostic_test business.industry lcsh:R Immunosuppression Organ Transplantation General Medicine medicine.disease metabolomics urine 4.1 Discovery and preclinical testing of markers and technologies chemistry business Nephritis |
| Zdroj: | Journal of Clinical Medicine Volume 9 Issue 8 Journal of Clinical Medicine, Vol 9, Iss 2341, p 2341 (2020) Journal of clinical medicine, vol 9, iss 8 |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm9082341 |
| Popis: | Despite new advancements in surgical tools and therapies, exposure to immunosuppressive drugs related to non-immune and immune injuries can cause slow deterioration and premature failure of organ transplants. Diagnosis of these injuries by non-invasive urine monitoring would be a significant clinical advancement for patient management, especially in pediatric cohorts. We investigated the metabolomic profiles of biopsy matched urine samples from 310 unique kidney transplant recipients using gas chromatography&ndash mass spectrometry (GC-MS). Focused metabolite panels were identified that could detect biopsy confirmed acute rejection with 92.9% sensitivity and 96.3% specificity (11 metabolites) and could differentiate BK viral nephritis (BKVN) from acute rejection with 88.9% sensitivity and 94.8% specificity (4 metabolites). Overall, targeted metabolomic analyses of biopsy-matched urine samples enabled the generation of refined metabolite panels that non-invasively detect graft injury phenotypes with high confidence. These urine biomarkers can be rapidly assessed for non-invasive diagnosis of specific transplant injuries, opening the window for precision transplant medicine. |
| Databáze: | OpenAIRE |
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