Clinical Implications and Longitudinal Alteration of Peripheral Blood Transcriptional Signals Indicative of Future Cardiac Allograft Rejection
In: The Journal of heart and lung transplantation, Jg. 27 (2008), Heft 3, S. 297-301
academicJournal
- print, 10 ref
Zugriff:
Background: We have previously demonstrated that a peripheral blood transcriptional profile using 11 distinct genes predicts onset of cardiac allograft rejection weeks to months prior to the actual event. Methods: In this analysis, we ascertained the performance of this transcriptional algorithm in a Bayesian representative population: 28 cardiac transplant recipients who progressed to moderate to severe rejection; 53 who progressed to mild rejection; and 46 who remained rejection-free. Furthermore, we characterized longitudinal alterations in the transcriptional gene expression profile before, during and after recovery from rejection. Results: In this patient cohort, we found that a gene expression score (range 0 to 40) of ≤20 represents very low risk of rejection in the subsequent 12 weeks: 0 progressed to treatable (ISHLT Grade ≥3A) rejection; 16 of 53 (30%) from the intermediate group (those who progressed to ISHLT Grade 1B or 2) and 13 of 46 (28%) controls (who remained Grade 0 or 1A) had scores ≤20. A gene score of ≥30 was associated with progression to moderate to severe rejection in 58% of cases. These two extreme scores (≤20 or ≥30) represented 44% of the cardiac transplant population within 6 months post-transplant. In addition, longitudinal gene expression analysis demonstrated that baseline scores were significantly higher for those who went on to reject, remained high during an episode of rejection, and dropped post-treatment for rejection (p < 0.01). Conclusions: The use of gene expression profiling early after transplantation allows for separation into low-, intermediate- or high-risk categories for future rejection, permitting development of discrete surveillance strategies.
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Clinical Implications and Longitudinal Alteration of Peripheral Blood Transcriptional Signals Indicative of Future Cardiac Allograft Rejection
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Autor/in / Beteiligte Person: | MEHRA, Mandeep R ; KOBASHIGAWA, Jon A ; PAULY, Daniel F ; DEDRICK, Russell ; WALKER, Michael G ; ZEEVI, Adriana ; EISEN, Howard J ; DENG, Mario C ; FANG, Kenneth C ; KLINGLER, Tod M ; LAL, Preeti G ; ROSENBERG, Steven ; UBER, Patricia A ; STARLING, Randall C ; MURALI, Srinivas ; Investigators, CARGO |
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Zeitschrift: | The Journal of heart and lung transplantation, Jg. 27 (2008), Heft 3, S. 297-301 |
Veröffentlichung: | New York, NY: Elsevier Science, 2008 |
Medientyp: | academicJournal |
Umfang: | print, 10 ref |
ISSN: | 1053-2498 (print) |
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