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Protein-based urine test predicts kidney transplant outcomes
Date:8/22/2013

gators led by Peter Heeger, M.D., of the Icahn School of Medicine at Mount Sinai in New York City, and Donald Hricik, M.D., of Case Western Reserve University in Cleveland, measured the urinary levels of molecules that had previously been associated with rejection. These included two proteins and nine messenger RNAs (mRNAs)intermediary molecules in the construction of proteins from genes. They identified CXCL9 protein and CXCL9 mRNA as potential biomarkersmolecules that indicate the effect or progress of a diseasefor the diagnosis of rejection.

After further testing, the researchers found that CXCL9 protein was better at ruling out rejection than any of the mRNAs tested. Low levels of the protein biomarker also could identify patients likely to have stable long-term kidney function. Transplant recipients with low urinary CXCL9 protein six months after transplantation were unlikely to experience rejection or loss of kidney function over the next 18 months. In addition, detection of the protein in the urine of transplant recipients was more straightforward than measuring mRNA levels. While proteins can be measured directly in urine, mRNAs must first be extracted from urine samples. The researchers obtained sufficient mRNA from just 76 percent of samples, highlighting the technical challenges of extraction.

"The relative ease of measuring urinary proteins suggests that developing a protein-based urine test for use in clinical practice would be less complicated than an mRNA test," said Daniel Rotrosen, M.D., director of NIAID's Division of Allergy, Immunology and Transplantation. "There is strong precedent for the development and use of tests that measure urinary proteins, such as home pregnancy tests."

CXCL9 protein levels also may be useful for predicting and monitoring transplant rejection. The investigators noted that urinary CXCL9 levels began to increase up to 30 days before clinical signs of kidney injury, which could allow doctors to i
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Contact: Hillary Hoffman
hillary.hoffman@nih.gov
301-402-1663
NIH/National Institute of Allergy and Infectious Diseases
Source:Eurekalert

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