Biomarkers for Early and Late Stage Chronic Allograft Nephropathy by Genomic Profiling of Peripheral Blood. Homo sapiens

Despite significant improvements in life expectancy of kidney transplant patients due to advances in surgery and immunosuppression, Chronic Allograft Nephropathy (CAN) remains a daunting problem. A complex network of cellular mechanisms in both graft and peripheral immune compartments complicates the non-invasive diagnosis of CAN, which still requires biopsy histology. This is compounded by non-immunological factors contributing to graft injury. There is a pressing need to identify and validate minimally invasive biomarkers for CAN to serve as early predictors of graft loss and as metrics for managing long-term immunosuppression. This study attempts to identify sets of unique transcript biomarkers with high predictive accuracy for both mild and moderate/severe CAN. These biomarkers are the necessary first step to a genomic classification of CAN based on peripheral blood and the targets for a prospective, serial-monitoring clinical study. Overall design: We used DNA microarrays and bioinformatics to identify candidate genomic markers of mild and moderate/severe CAN in peripheral blood of two distinct cohorts (n=42 and n=35, respectively) of kidney transplant patients with biopsy-documented histology.