miRNAs, dd-cf-DNA, and Chemokines as Potential Noninvasive Biomarkers for the Assessment of Clinical Graft Evolution and Personalized Immunosuppression Requirement in Solid Organ Transplantation.

IF 2.8 4区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Therapeutic Drug Monitoring Pub Date : 2024-11-05 DOI:10.1097/FTD.0000000000001276
Olga Millán, Judit Julian, Mercè Brunet
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Abstract

Abstract: The use of noninvasive biomarkers may reduce the need for biopsy and guide immunosuppression adjustments during transplantation. The scientific community in solid organ transplantation currently considers that chemokines, T- and B-cell immunophenotypes, and gene expression, among other molecular biomarkers, have great potential as diagnostic and predictive biomarkers for graft evolution; however, in clinical practice, few valid early biomarkers have emerged. This review focuses on the most relevant scientific advances in this field in the last 5 years regarding the role of 3 biomarkers: miRNAs, chemokines, and ddcf-DNA, in both adult and pediatric populations. An update was provided on the scores based on the combination of these biomarkers. The most-featured articles were identified through a literature search of the PubMed database. This review provides a comprehensive analysis of the potential clinical applications of these biomarkers in the diagnosis and prediction of graft outcomes and discusses the reasons why none have been implemented in clinical practice to date. Translating these biomarkers into routine clinical practice and combining them with pharmacogenetics and pharmacokinetic monitoring is challenging; however, it is the key to present/future individualized immunosuppressive therapies. It is essential that they be shown to be applicable and robust in real-life patient conditions and properly evaluate their added value when combined with the standard-of-care factor monitoring for graft clinical assessment. Partnership strategies among scientists, academic institutions, consortia, including expert working groups and scientific societies, and pharmaceutical and/or biotechnology companies should promote the development of prospective, randomized, multicenter intervention studies for adequate clinical validation of these biomarkers and their monitoring frequency, and their commercialization to make them available to transplant physicians.

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miRNA、dd-cf-DNA 和趋化因子是评估实体器官移植中临床移植物演变和个性化免疫抑制需求的潜在非侵入性生物标记物。
摘要:非侵入性生物标志物的使用可减少活组织检查的需要,并指导移植过程中免疫抑制的调整。目前,实体器官移植领域的科学界认为,趋化因子、T 细胞和 B 细胞免疫表型以及基因表达等分子生物标志物作为诊断和预测移植物演变的生物标志物具有巨大的潜力;然而,在临床实践中,有效的早期生物标志物却寥寥无几。本综述重点介绍了过去五年中该领域最相关的科学进展,涉及 miRNA、趋化因子和 ddcf-DNA 这三种生物标志物在成人和儿童人群中的作用。根据这些生物标志物的组合对评分进行了更新。通过对 PubMed 数据库进行文献检索,确定了最具特色的文章。本综述全面分析了这些生物标志物在诊断和预测移植物预后方面的潜在临床应用,并讨论了迄今为止尚未在临床实践中应用的原因。将这些生物标志物转化为常规临床实践并与药物遗传学和药代动力学监测相结合具有挑战性;然而,这是目前/未来个体化免疫抑制疗法的关键。至关重要的是,必须证明它们在实际患者病情中的适用性和稳健性,并适当评估它们与移植物临床评估的标准护理因子监测相结合后的附加值。科学家、学术机构、联合体(包括专家工作组和科学协会)以及制药和/或生物技术公司之间的合作战略应促进前瞻性、随机、多中心干预研究的发展,以便对这些生物标志物及其监测频率进行充分的临床验证,并促进其商业化,使移植医生能够获得这些生物标志物。
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来源期刊
Therapeutic Drug Monitoring
Therapeutic Drug Monitoring 医学-毒理学
CiteScore
5.00
自引率
8.00%
发文量
213
审稿时长
4-8 weeks
期刊介绍: Therapeutic Drug Monitoring is a peer-reviewed, multidisciplinary journal directed to an audience of pharmacologists, clinical chemists, laboratorians, pharmacists, drug researchers and toxicologists. It fosters the exchange of knowledge among the various disciplines–clinical pharmacology, pathology, toxicology, analytical chemistry–that share a common interest in Therapeutic Drug Monitoring. The journal presents studies detailing the various factors that affect the rate and extent drugs are absorbed, metabolized, and excreted. Regular features include review articles on specific classes of drugs, original articles, case reports, technical notes, and continuing education articles.
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