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Discovery and validation of a novel blood-based molecular biomarker of rejection following liver transplantation.

ABSTRACT: Noninvasive biomarker profiles of acute rejection (AR) could affect the management of liver transplant (LT) recipients. Peripheral blood was collected following LT for discovery (Northwestern University [NU]) and validation (National Institute of Allergy and Infectious Diseases Clinical Trials in Organ Transplantation [CTOT]-14 study). Blood gene profiling was paired with biopsies showing AR or ADNR (acute dysfunction no rejection) as well as stable graft function samples (Transplant eXcellent-TX). CTOT-14 subjects had serial collections prior to AR, ADNR, TX, and after AR treatment. NU cohort gene expression (46 AR, 45 TX) was analyzed using random forest models to generate a classifier training set (36 gene probe) distinguishing AR vs TX (area under the curve 0.92). The algorithm and threshold were locked and tested on the CTOT-14 validation cohort (14 AR, 50 TX), yielding an accuracy of 0.77, sensitivity 0.57, specificity 0.82, positive predictive value (PPV) 0.47, and negative predictive value (NPV) 0.87 for AR vs TX. The probability score line slopes were positive preceding AR, and negative preceding TX and non-AR (TX + ADNR) (P ? .001) and following AR treatment. In conclusion, we have developed a blood biomarker diagnostic for AR that can be detected prior to AR-associated graft injury as well a normal graft function (non-AR). Further studies are needed to evaluate its utility in precision-guided immunosuppression optimization following LT.

SUBMITTER: Levitsky J

PROVIDER: S-EPMC7496674 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Discovery and validation of a novel blood-based molecular biomarker of rejection following liver transplantation.

Levitsky Josh J Asrani Sumeet K SK Schiano Thomas T Moss Adyr A Chavin Kenneth K Miller Charles C Guo Kexin K Zhao Lihui L Kandpal Manoj M Bridges Nancy N Brown Merideth M Armstrong Brian B Kurian Sunil S Demetris Anthony J AJ Abecassis Michael M

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 20200525 8

Noninvasive biomarker profiles of acute rejection (AR) could affect the management of liver transplant (LT) recipients. Peripheral blood was collected following LT for discovery (Northwestern University [NU]) and validation (National Institute of Allergy and Infectious Diseases Clinical Trials in Organ Transplantation [CTOT]-14 study). Blood gene profiling was paired with biopsies showing AR or ADNR (acute dysfunction no rejection) as well as stable graft function samples (Transplant eXcellent-T ...[more]

PMID: 32356368

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Project description:BackgroundSubclinical acute rejection (subAR) can only be diagnosed by protocol biopsy and is correlated with worse graft outcomes. However, noninvasive biomarkers of subAR are lacked for kidney transplantation recipients in clinic. This study aims to utilize to construct a peripheral blood-based gene signature for subAR diagnosis after kidney transplantation.MethodsAfter systematically screening databases, two cohorts of high quality with 3-month blood profiles and biopsy-proven graft status from the Gene Expression Omnibus databases were employed as training and validation cohorts. Then, the support vector machine recursive feature elimination (SVM-RFE) and the least absolute shrinkage and selection operator (LASSO) logistic regression were used to identify key biomarkers for subAR. Subsequently, the stepwise logistic regression method was applied to construct a gene signature for subAR in the training cohort. Patients were divided into high-risk and low-risk groups based on the cutoff point identified by the receiver operating characteristic (ROC) curve. Then, the signature was validated in a validation cohort with fixed formula. The single-sample gene set enrichment analysis was used to estimate immune cells in the blood.ResultsFifty key biomarkers were filtered out with the machine learning algorithms. Then, a novel six-gene signature was constructed using the LASSO and stepwise logistic regression method. The signature had high accuracy in both training [area under the curve (AUC) =0.923] and validation cohort (AUC =0.855). Additionally, these six genes were found to have significant and consistent relationships with blood immune cells in both cohorts, especially for T cells subtypes.ConclusionsWe developed and validated a novel noninvasive six-gene signature based on peripheral blood to diagnose subAR, which offered a potential tool for clinical practice. The six-gene signature offered a potential method to monitor patients following transplantation and make a timely intervention.

Dataset Information

Discovery and validation of a novel blood-based molecular biomarker of rejection following liver transplantation.

Publications

Discovery and validation of a novel blood-based molecular biomarker of rejection following liver transplantation.

Similar Datasets

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