Evaluation of non-invasive biomarkers of kidney allograft rejection in a prospective multicenter unselected cohort study (EU-TRAIN).

Details

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_1CCC1ACCEB87
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Evaluation of non-invasive biomarkers of kidney allograft rejection in a prospective multicenter unselected cohort study (EU-TRAIN).
Journal
Kidney international
Author(s)
Goutaudier V., Danger R., Catar R.A., Racapé M., Philippe A., Elias M., Raynaud M., Aubert O., Bouton D., Girardin F., Vicaut É., Yaiche S., Demotes J., Heidecke H., Taupin J.L., Randoux-Lebrun C., Zaidan M., Papuchon E., Le Mai H., Nguyen T.V., Moreso F., Berney T., Villard J., Legendre C., Dragun D., Papalois V., Potena L., Giral M., Gourraud P.A., Brouard S., Crespo E., Halleck F., Budde K., Bestard O., Loupy A., Lefaucheur C.
Working group(s)
EU-TRAIN Consortium
ISSN
1523-1755 (Electronic)
ISSN-L
0085-2538
Publication state
Published
Issued date
11/2024
Peer-reviewed
Oui
Volume
106
Number
5
Pages
943-960
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
Non-invasive biomarkers are promising tools for improving kidney allograft rejection monitoring, but their clinical adoption requires more evidence in specifically designed studies. To address this unmet need, we designed the EU-TRAIN study, a large prospective multicentric unselected cohort funded by the European Commission. Here, we included consecutive adult patients who received a kidney allograft in nine European transplant centers between November 2018 and June 2020. We prospectively assessed gene expression levels of 19 blood messenger RNAs, four antibodies targeting non-human leukocyte antigen (HLA) endothelial antigens, together with circulating anti-HLA donor-specific antibodies (DSA). The primary outcome was allograft rejection (antibody-mediated, T cell-mediated, or mixed) in the first year post-transplantation. Overall, 412 patients were included, with 812 biopsies paired with a blood sample. CD4 gene expression was significantly associated with rejection, while circulating anti-HLA DSA had a significant association with allograft rejection and a strong association with antibody-mediated rejection. All other tested biomarkers, including AKR1C3, CD3E, CD40, CD8A, CD9, CTLA4, ENTPD1, FOXP3, GZMB, ID3, IL7R, MS4A1, MZB1, POU2AF1, POU2F1, TCL1A, TLR4, and TRIB1, as well as antibodies against angiotensin II type 1 receptor, endothelin 1 type A receptor, C3a and C5a receptors, did not show significant associations with allograft rejection. The blood messenger RNAs and non-HLA antibodies did not show an additional value beyond standard of care monitoring parameters and circulating anti-HLA DSA to predict allograft rejection in the first year post-transplantation. Thus, our results open avenues for specifically designed studies to demonstrate the clinical relevance and implementation of other candidate non-invasive biomarkers in kidney transplantation practice.
Keywords
Humans, Graft Rejection/immunology, Graft Rejection/blood, Graft Rejection/diagnosis, Kidney Transplantation/adverse effects, Prospective Studies, Male, Biomarkers/blood, Female, Middle Aged, Adult, HLA Antigens/immunology, HLA Antigens/blood, HLA Antigens/genetics, Europe, Isoantibodies/blood, Isoantibodies/immunology, Aged, Allografts/immunology, Biopsy, biomarkers, kidney transplantation, monitoring, rejection
Pubmed
Web of science
Open Access
Yes
Create date
29/08/2024 12:58
Last modification date
20/12/2024 7:07
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