Using transcriptional profiling to develop a diagnostic test of operational tolerance in liver transplant recipients.
A fraction of liver transplant recipients are able to discontinue all immunosuppressive therapies without rejecting their grafts and are said to be operationally tolerant to the transplant. However, accurate identification of these recipients remains a challenge. To design a clinically applicable molecular test of operational tolerance in liver transplantation, we studied transcriptional patterns in the peripheral blood of 80 liver transplant recipients and 16 nontransplanted healthy individuals by employing oligonucleotide microarrays and quantitative real-time PCR. This resulted in the discovery and validation of several gene signatures comprising a modest number of genes capable of identifying tolerant and nontolerant recipients with high accuracy. Multiple peripheral blood lymphocyte subsets contributed to the tolerance-associated transcriptional patterns, although NK and gammadeltaTCR+ T cells exerted the predominant influence. These data suggest that transcriptional profiling of peripheral blood can be employed to identify liver transplant recipients who can discontinue immunosuppressive therapy and that innate immune cells are likely to play a major role in the maintenance of operational tolerance in liver transplantation.
Martínez-Llordella
Marc
M
Liver Transplant Unit, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.
Lozano
Juan José
JJ
Puig-Pey
Isabel
I
Orlando
Giuseppe
G
Tisone
Giuseppe
G
Lerut
Jan
J
Benítez
Carlos
C
Pons
Jose Antonio
JA
Parrilla
Pascual
P
Ramírez
Pablo
P
Bruguera
Miquel
M
Rimola
Antoni
A
Sánchez-Fueyo
Alberto
A
D000328:Adult; D000368:Aged; D015704:CD4 Antigens / Q000235:genetics; D016022:Case-Control Studies; D015331:Cohort Studies; D004247:DNA / Q000235:genetics; D004279:DNA, Viral / Q000235:genetics; D020869:Gene Expression Profiling; D006084:Graft Rejection / Q000175:diagnosis / Q000235:genetics / Q000276:immunology; D016174:Hepacivirus / Q000235:genetics / Q000472:pathogenicity; D006801:Humans; D007108:Immune Tolerance; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007694:Killer Cells, Natural / Q000276:immunology; D016031:Liver Transplantation / Q000276:immunology* / Q000473:pathology; D008875:Middle Aged; D008957:Models, Genetic; D018448:Models, Immunological; D020411:Oligonucleotide Array Sequence Analysis; D011237:Predictive Value of Tests; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000235:genetics; D014158:Transcription, Genetic; D014181:Transplantation Immunology / Q000235:genetics*; D023001:Transplantation Tolerance / Q000235:genetics*
D015704:CD4 Antigens; D004279:DNA, Viral; D007166:Immunosuppressive Agents; D016692:Receptors, Antigen, T-Cell, gamma-delta; D004247:DNA