title: Immune monitoring in renal transplantation: The search for biomarkers.
abstract: It is now widely accepted that in order to improve long-term graft function and survival, a more personalized immunosuppressive treatment of transplant patients according to the individual anti-donor immune response status is needed. This applies to the identification of potentially "high-risk" patients likely to develop acute rejection episodes or display an accelerated decline of graft function, patients who might need immunosuppression intensification, and operationally tolerant patients suitable for immunosuppression minimization or weaning off. Such a patient stratification would benefit from biomarkers, which enable categorization into low and high risk or, ideally, identification of operational tolerant patients. Here, we report on recent developments regarding identification and performance analysis of noninvasive biomarkers such as mRNA and miRNA expression profiles, chemokines, or changes in immune cell subsets in either blood or urine of renal transplant patients. We will also discuss which future steps are needed to accelerate their clinical implementation.
authors.affiliation: Inserm, , Center for Research in Transplantation and Immunology (CRTI) U1064, Nantes, France.|Université de Nantes, , UMR1064, Nantes, France.|CHU Nantes, Institut de Transplantation Urologie Néphrologie (ITUN), Nantes, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Danger
authors.affiliation: Institute of Medical Immunology, Charité University Berlin, Germany.|Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité University Berlin, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Sawitzki
authors.affiliation: Inserm, , Center for Research in Transplantation and Immunology (CRTI) U1064, Nantes, France.|Université de Nantes, , UMR1064, Nantes, France.|CHU Nantes, Institut de Transplantation Urologie Néphrologie (ITUN), Nantes, France.|CIC Biotherapy, CHU Nantes, , 30 bd Jean-Monnet, Nantes, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Brouard
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D006084:Graft Rejection / Q000175:diagnosis* / Q000276:immunology; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation; D015166:Monitoring, Immunologic / Q000379:methods*; D057285:Precision Medicine; D011379:Prognosis
chemical_list: D015415:Biomarkers
keywords: Biomarker; Immunosuppression; Rejection; Renal transplantation; Tolerance