Diagnose Kidney transplant rejection via blood test Is the new study where Rothstein and his colleagues at the Thomas E. Starzl Transplantation Institute at Pitt analyzed blood samples taken from 244 patients .
They received kidney transplants at UPMC between 2013-2015,
also as another 95 kidney transplant casualties who are treated at Royal Free Hospital, London, and located a highly predictive biomarker.
Drs. Rothstein and Cherukuri discuss the importance of a predictive biomarker in kidney transplantation and review their findings. Credit: David Rothstein and Aravind Cherukuri
Of the patients who are identified as high-risk for rejection supported this new biomarker,
91% rejected the organ within the primary year, compared to 10% within the low-risk group.
Therefore the high-risk group was significantly more likely to lose their transplanted kidneys five years after the surgery.
The biomarker Rothstein and colleagues discovered may be a proxy for the functioning of regulatory B cells—a sort of immune cell that tunes up or down the immune response—
which have recently been implicated in organ rejection and proved challenging to live .
B cells can secrete both IL-10 and tumour necrosis factor (TNF) and,
consistent with this new study, it is the ratio of those two molecules that best measures regulatory B cell activity and predicts whether a patient is at high risk of rejection.
“Being a functional biomarker, ours gives us a thought of what goes wrong in these high-risk patients,” Rothstein said.
“The balance between IL-10 and TNF seems to point your immune setpoint—
is your system getting to be quiescent or is it getting to be revived up and check out to reject the transplant?
We hope we will restore that balance with anti-TNF drugs.”
Anti-TNF drugs haven’t been used much for transplant patients,
but they seem to be a mainstay for treating atrophic arthritis ,inflammatory bowel disease and other conditions marked by inflammation, .
Therefore the side effect profile is well-known.
To mitigate that risk, the thought is to treat patients with anti-TNF drugs for just a couple of months,
which could be enough to “reset” the system to stop rejection before it starts.
A human clinical test is required .
This is to point out proof of principle, Rothstein and colleagues applied anti-TNF to B cell s taken from high-risk patients
and saw not only changes within the biomarker but also a number of other changes indicative of restored regulatory B cell activity.
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