空间组学在移植肾活检样本分类中的应用

IF 28.6 1区 医学 Q1 UROLOGY & NEPHROLOGY Nature Reviews Nephrology Pub Date : 2024-07-04 DOI:10.1038/s41581-024-00861-x
Paola Tasca, Bernard M. van den Berg, Ton J. Rabelink, Gangqi Wang, Bram Heijs, Cees van Kooten, Aiko P. J. de Vries, Jesper Kers
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摘要

通过针对性治疗改善长期疗效是肾移植医学的首要关注点。目前,排斥反应诊断和后续治疗的验证取决于根据班夫分类系统对同种异体活检样本进行的组织学评估。然而,(早期)疾病特异性组织标记物的缺乏阻碍了准确诊断和及时干预。这一挑战主要源于对晚期同种异体移植失败的病理生理过程了解不全面。整合大规模多模态方法来研究异体移植物活检样本可能会为这一病理生理学提供新的见解,这对于确定新的治疗靶点和开发有针对性的免疫治疗干预措施十分必要。有几种全息技术--包括转录组学、蛋白质组学、脂质组学和代谢组学工具(以及多模态数据分析策略)--可应用于异体移植活检研究。然而,尽管这些技术在研究环境中得到了成功应用,并具有潜在的临床价值,但其中许多工具在临床实践中的广泛应用仍受到一些障碍的限制。在空间组学技术中,质谱成像技术在移植领域的应用不足,但它有可能实现多组学研究,从而扩展目前临床分析技术所获得的洞察力。
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Application of spatial-omics to the classification of kidney biopsy samples in transplantation
Improvement of long-term outcomes through targeted treatment is a primary concern in kidney transplant medicine. Currently, the validation of a rejection diagnosis and subsequent treatment depends on the histological assessment of allograft biopsy samples, according to the Banff classification system. However, the lack of (early) disease-specific tissue markers hinders accurate diagnosis and thus timely intervention. This challenge mainly results from an incomplete understanding of the pathophysiological processes underlying late allograft failure. Integration of large-scale multimodal approaches for investigating allograft biopsy samples might offer new insights into this pathophysiology, which are necessary for the identification of novel therapeutic targets and the development of tailored immunotherapeutic interventions. Several omics technologies — including transcriptomic, proteomic, lipidomic and metabolomic tools (and multimodal data analysis strategies) — can be applied to allograft biopsy investigation. However, despite their successful application in research settings and their potential clinical value, several barriers limit the broad implementation of many of these tools into clinical practice. Among spatial-omics technologies, mass spectrometry imaging, which is under-represented in the transplant field, has the potential to enable multi-omics investigations that might expand the insights gained with current clinical analysis technologies. Technological advances continue to enhance the clinical value of kidney biopsies. Here, the authors consider the potential of using spatial-omics in transplantation, including the use of mass spectrometry imaging, as graft monitoring and diagnostic tools, to improve patient management and outcomes.
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来源期刊
Nature Reviews Nephrology
Nature Reviews Nephrology 医学-泌尿学与肾脏学
CiteScore
39.00
自引率
1.20%
发文量
127
审稿时长
6-12 weeks
期刊介绍: Nature Reviews Nephrology aims to be the premier source of reviews and commentaries for the scientific communities it serves. It strives to publish authoritative, accessible articles. Articles are enhanced with clearly understandable figures, tables, and other display items. Nature Reviews Nephrology publishes Research Highlights, News & Views, Comments, Reviews, Perspectives, and Consensus Statements. The content is relevant to nephrologists and basic science researchers. The broad scope of the journal ensures that the work reaches the widest possible audience.
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