Gene expression in kidney transplants with drug-related injury

What is it about?

Immune checkpoint inhibitor (ICI) use in kidney transplant patients is complicated by high rates of allograft rejection. ICI-associated T-cell mediated rejection (ICI-TCMR) is a novel, poorly understood entity exhibiting overlapping pathological features with ICI-associated acute interstitial nephritis (ICI-AIN), which poses a challenge for diagnosis and clinical management. Using biopsy-based gene expression analysis, this study describes the discovery and validation of IFI27, an interferon-alpha induced transcript, as a novel biomarker for differentiating ICI-TCMR from ICI-AIN. However, on a broader inflammatory gene expression level, it also demonstrates significant molecular overlap between and heterogeneity within these entities, both of which appear relatively more similar to non-ICI drug-induced AIN than TCMR. These results provide a novel framework for differentiating and further understanding these entities.

Featured Image

Photo by Myriam Zilles on Unsplash

Photo by Myriam Zilles on Unsplash