title: Sequential monitoring of TIM-3 gene expression in peripheral blood for diagnostic and prognostic evaluation of acute rejection in renal graft recipients.
abstract: BACKGROUND
  TIM-3 is expressed on primary T effector cells, including th1, ctl, and Th17, which play essential roles in acute allograft rejection (AR). In this study we monitored sequential changes of TIM-3 gene expression among peripheral blood leukocytes (PBL) from renal transplant recipients.
  
  
  METHODS
  The study consisted of an AR group (n=24), a no AR group (n=20), and a stable group (n=18). Prospective serial blood samples were collected after allotransplantation and during AR episodes. The mRNA encoding for TIM-3 was quantified using real-time reverse-transcription polymerase chain reaction (RT-PCR). Statistical analyses were performed to correlate gene transcript measurements with clinical events.
  
  
  RESULTS
  TIM-3 mRNA in PBL showed significantly higher expression in the AR compared with the no AR and stable groups: 286.72±86.28 vs 126.10±28.31 vs 96.91±17.88, respectively (P=.00). The receiver operating characteristic curve showed a specificity of 100% and a sensitivity of 87.5% for the utility of TIM-3 for rejection diagnosis. Antirejection therapy decreased TIM-3 mRNA expression in all AR patients. There was a positive correlation between TIM-3 mRNA expression and serum creatinine (r2=0.716; P=.00).
  
  
  CONCLUSIONS
  TIM-3 mRNA quantification by RT-PCR in PBL may be a promising tool for a noninvasive diagnosis of AR. But the utility for predicting the prognosis of AR after antirejection treatment was limited, owing to the great variations of TIM-3 mRNA expression during AR episodes.
authors.affiliation: Organ Transplant Center, 309th Hospital, PLA Postgraduate Medical School, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Luo
authors.forename: B
authors.initials: B
authors.lastname: Shi
authors.forename: Y
authors.initials: Y
authors.lastname: Qian
authors.forename: H
authors.initials: H
authors.lastname: Bai
authors.forename: J
authors.initials: J
authors.lastname: Chang
mesh_terms: D000208:Acute Disease; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002681:China; D003404:Creatinine / Q000097:blood; D005260:Female; D005819:Genetic Markers; D005820:Genetic Testing / Q000379:methods; D006084:Graft Rejection / Q000097:blood / Q000235:genetics* / Q000276:immunology / Q000517:prevention & control; D000072597:Hepatitis A Virus Cellular Receptor 2; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology*; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008297:Male; D008565:Membrane Proteins / Q000235:genetics*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012333:RNA, Messenger / Q000097:blood; D012372:ROC Curve; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D005819:Genetic Markers; C448908:HAVCR2 protein, human; D000072597:Hepatitis A Virus Cellular Receptor 2; D007166:Immunosuppressive Agents; D008565:Membrane Proteins; D012333:RNA, Messenger; D003404:Creatinine