Proteomics for Biomarker Discovery for Diagnosis and Prognosis of Kidney Transplantation Rejection
Renal transplantation is currently the treatment of choice for end-stage kidney disease, enabling a quality of life superior to dialysis. Despite this, all transplanted patients are at risk of allograft rejection processes. The gold-standard diagnosis of graft rejection, based on histological analys...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Proteomes |
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| Online Access: | https://www.mdpi.com/2227-7382/10/3/24 |
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| author | Luís M. Ramalhete Rúben Araújo Aníbal Ferreira Cecília R. C. Calado |
| author_facet | Luís M. Ramalhete Rúben Araújo Aníbal Ferreira Cecília R. C. Calado |
| author_sort | Luís M. Ramalhete |
| collection | DOAJ |
| description | Renal transplantation is currently the treatment of choice for end-stage kidney disease, enabling a quality of life superior to dialysis. Despite this, all transplanted patients are at risk of allograft rejection processes. The gold-standard diagnosis of graft rejection, based on histological analysis of kidney biopsy, is prone to sampling errors and carries high costs and risks associated with such invasive procedures. Furthermore, the routine clinical monitoring, based on urine volume, proteinuria, and serum creatinine, usually only detects alterations after graft histologic damage and does not differentiate between the diverse etiologies. Therefore, there is an urgent need for new biomarkers enabling to predict, with high sensitivity and specificity, the rejection processes and the underlying mechanisms obtained from minimally invasive procedures to be implemented in routine clinical surveillance. These new biomarkers should also detect the rejection processes as early as possible, ideally before the 78 clinical outputs, while enabling balanced immunotherapy in order to minimize rejections and reducing the high toxicities associated with these drugs. Proteomics of biofluids, collected through non-invasive or minimally invasive analysis, e.g., blood or urine, present inherent characteristics that may provide biomarker candidates. The current manuscript reviews biofluids proteomics toward biomarkers discovery that specifically identify subclinical, acute, and chronic immune rejection processes while allowing for the discrimination between cell-mediated or antibody-mediated processes. In time, these biomarkers will lead to patient risk stratification, monitoring, and personalized and more efficient immunotherapies toward higher graft survival and patient quality of life. |
| first_indexed | 2024-03-09T22:40:30Z |
| format | Article |
| id | doaj.art-4fc311c06b414f78a251295b9738999d |
| institution | Directory Open Access Journal |
| issn | 2227-7382 |
| language | English |
| last_indexed | 2024-03-09T22:40:30Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Proteomes |
| spelling | doaj.art-4fc311c06b414f78a251295b9738999d2023-11-23T18:39:08ZengMDPI AGProteomes2227-73822022-07-011032410.3390/proteomes10030024Proteomics for Biomarker Discovery for Diagnosis and Prognosis of Kidney Transplantation RejectionLuís M. Ramalhete0Rúben Araújo1Aníbal Ferreira2Cecília R. C. Calado3Blood and Transplantation Center of Lisbon, Instituto Português do Sangue e da Transplantação, Alameda das Linhas de Torres, n° 117, 1769-001 Lisbon, PortugalNOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisbon, PortugalNOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, 1169-056 Lisbon, PortugalISEL-Instituto Superior de Engenharia de Lisboa, Instituto Politécnico de Lisboa, R. Conselheiro Emídio Navarro 1, 1959-007 Lisbon, PortugalRenal transplantation is currently the treatment of choice for end-stage kidney disease, enabling a quality of life superior to dialysis. Despite this, all transplanted patients are at risk of allograft rejection processes. The gold-standard diagnosis of graft rejection, based on histological analysis of kidney biopsy, is prone to sampling errors and carries high costs and risks associated with such invasive procedures. Furthermore, the routine clinical monitoring, based on urine volume, proteinuria, and serum creatinine, usually only detects alterations after graft histologic damage and does not differentiate between the diverse etiologies. Therefore, there is an urgent need for new biomarkers enabling to predict, with high sensitivity and specificity, the rejection processes and the underlying mechanisms obtained from minimally invasive procedures to be implemented in routine clinical surveillance. These new biomarkers should also detect the rejection processes as early as possible, ideally before the 78 clinical outputs, while enabling balanced immunotherapy in order to minimize rejections and reducing the high toxicities associated with these drugs. Proteomics of biofluids, collected through non-invasive or minimally invasive analysis, e.g., blood or urine, present inherent characteristics that may provide biomarker candidates. The current manuscript reviews biofluids proteomics toward biomarkers discovery that specifically identify subclinical, acute, and chronic immune rejection processes while allowing for the discrimination between cell-mediated or antibody-mediated processes. In time, these biomarkers will lead to patient risk stratification, monitoring, and personalized and more efficient immunotherapies toward higher graft survival and patient quality of life.https://www.mdpi.com/2227-7382/10/3/24kidney allograftproteomicsbiomarkerrejectionbiofluidsexosomes |
| spellingShingle | Luís M. Ramalhete Rúben Araújo Aníbal Ferreira Cecília R. C. Calado Proteomics for Biomarker Discovery for Diagnosis and Prognosis of Kidney Transplantation Rejection Proteomes kidney allograft proteomics biomarker rejection biofluids exosomes |
| title | Proteomics for Biomarker Discovery for Diagnosis and Prognosis of Kidney Transplantation Rejection |
| title_full | Proteomics for Biomarker Discovery for Diagnosis and Prognosis of Kidney Transplantation Rejection |
| title_fullStr | Proteomics for Biomarker Discovery for Diagnosis and Prognosis of Kidney Transplantation Rejection |
| title_full_unstemmed | Proteomics for Biomarker Discovery for Diagnosis and Prognosis of Kidney Transplantation Rejection |
| title_short | Proteomics for Biomarker Discovery for Diagnosis and Prognosis of Kidney Transplantation Rejection |
| title_sort | proteomics for biomarker discovery for diagnosis and prognosis of kidney transplantation rejection |
| topic | kidney allograft proteomics biomarker rejection biofluids exosomes |
| url | https://www.mdpi.com/2227-7382/10/3/24 |
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