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Immune checkpoint inhibitor (ICI) use in kidney transplant patients is complicated by high rates of allograft rejection. ICI-associated T-cell mediated rejection (ICI-TCMR) is a novel, poorly understood entity exhibiting overlapping pathological features with ICI-associated acute interstitial nephritis (ICI-AIN), which poses a challenge for diagnosis and clinical management. Using biopsy-based gene expression analysis, this study describes the discovery and validation of IFI27, an interferon-alpha induced transcript, as a novel biomarker for differentiating ICI-TCMR from ICI-AIN. However, on a broader inflammatory gene expression level, it also demonstrates significant molecular overlap between and heterogeneity within these entities, both of which appear relatively more similar to non-ICI drug-induced AIN than TCMR. These results provide a novel framework for differentiating and further understanding these entities.

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This page is a summary of: Gene Expression Profiling in Kidney Transplants with Immune Checkpoint Inhibitor–Associated Adverse Events, Clinical Journal of the American Society of Nephrology, July 2021, American Society of Nephrology, DOI: 10.2215/cjn.00920121.
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