title: Immune monitoring of kidney allografts.
abstract: Current strategies for posttransplant monitoring of kidney transplants consist of measuring serial serum creatinine levels, clinical follow-up, and in some programs, protocol biopsies. These strategies may be insufficient to predict acute rejection in kidney transplants, which remains the major factor affecting long-term transplant outcomes. Immune monitoring may conceptually be divided into strategies for detecting humoral rejection (eg, donor-specific antibody) or cellular rejection. Cellular rejection markers may be separated further into those related to cytotoxic T lymphocytes (granzyme A/B, perforin, Fas ligand, and serpin B9), regulatory T cells (FOXP3), and CD4 T cells (the chemokines CXCL9, CXCL10, CXCL11, CCL2, and fractalkine, as well as TIM-3). Finally, transcriptomic changes and renal tubular injury markers also may be useful for detecting early inflammatory changes post-kidney transplant. Ultimately, novel strategies for monitoring the immune status of the kidney transplant may lead to early therapeutic intervention and improved kidney transplant outcomes.
authors.affiliation: Section of Nephrology, University of Manitoba, Winnipeg, MB, Canada. jho@hsc.mb.ca
authors.forename: Julie
authors.initials: J
authors.lastname: Ho
authors.forename: Chris
authors.initials: C
authors.lastname: Wiebe
authors.forename: Ian W
authors.initials: IW
authors.lastname: Gibson
authors.forename: David N
authors.initials: DN
authors.lastname: Rush
authors.forename: Peter W
authors.initials: PW
authors.lastname: Nickerson
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D006680:HLA Antigens / Q000032:analysis; D006801:Humans; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000276:immunology*; D046228:Microarray Analysis; D008991:Monitoring, Physiologic; D011379:Prognosis; D019707:Receptors, Chemokine / Q000276:immunology; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D014184:Transplantation, Homologous
chemical_list: D015415:Biomarkers; D006680:HLA Antigens; D019707:Receptors, Chemokine