Open AccessIdentification of a gene expression profile associated with operational tolerance among a selected group of stable kidney transplant patients
Author(s) -
Brouard Sophie,
Le Bars Alice,
Dufay Alexandre,
Gosselin Morgane,
Foucher Yohann,
Guillet Marina,
CesbronGautier Anne,
Thervet Eric,
Legendre Christophe,
Dugast Emilie,
Pallier Annaick,
GuillotGueguen Cécile,
Lagoutte Laetitia,
Evanno Gwenaelle,
Giral Magali,
Soulillou JeanPaul
Publication year - 2011
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.2011.01251.x
Subject(s) - medicine , immunosuppression , kidney transplantation , toxicity , kidney , immunosuppressive drug , transplantation , immunology , intensive care medicine , oncology
Summary Despite their utility, immunosuppressive treatments have numerous side effects, including infectious complications, malignancies and metabolic disorders, all of which contribute to long‐term graft loss. In addition to the development of new pharmaceutical products with reduced toxicity and more comfortable modes of administration, tailoring immunosuppression according to the immune status of each patient would represent a significant breakthrough. Gene expression profiling has been shown to be a clinically relevant monitoring tool. In this paper, we have assessed the overall long‐term kidney transplant outcome and attempted to identify operationally tolerant‐like patients among recipients with stable clinical status at least 5 years post‐transplantation. We thus measured a combination of noninvasive blood biomarkers of operational tolerance in a cohort of 144 stable patients and showed that only 3.5% exhibited a gene expression profile of operational tolerance, suggesting that such a profile can be detected under immunosuppressive therapy but that its frequency is low in kidney transplant recipients when compared with liver transplant recipients. We suggest that a rational approach to patient selection, based on a combination of clinical and biological characteristics, may help to provide a safer method for identification of patients potentially suitable for immunosuppressive drug weaning procedures.