Open AccessAdding Insult on Injury: Immunogenic Role for Donor-derived Cell-free DNA?
Author(s) -
Shamik Dholakia,
Iwijn De Vlaminck,
Kiran K. Khush
Publication year - 2020
Publication title -
transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.45
H-Index - 204
eISSN - 1534-6080
pISSN - 0041-1337
DOI - 10.1097/tp.0000000000003240
Subject(s) - cell free fetal dna , medicine , biomarker , transplantation , inflammation , immunology , pathology , biology , genetics , pregnancy , fetus , biochemistry , prenatal diagnosis
Donor-derived cell-free DNA (dd-cfDNA) in the blood circulation is an early marker of injury in solid organ transplantation. Here, we review recent evidence that indicates that dd-cfDNA may itself be a trigger of inflammation, thereby adding insult on injury. Early unresolving molecular allograft injury measured via changes in dd-cfDNA may be an early warning sign and may therefore enable stratification of patients who are at risk of subsequent allograft injury. Considering dd-cfDNA as a continuous and clinically significant biomarker opens up the potential for new management strategies, therapeutics, and ways to quantify interventions by considering the immunological potential of dd-cfDNA.