Such a test is sorely needed to help improve the longevity of kidney transplants and the lives of patients who receive these organs, says study co-author Dr. Darshana Dadhania, associate professor of medicine and medicine in surgery at Weill Cornell Medical College and associate attending physician at NewYork-Presbyterian Hospital.
Dr. Dadhania says that the primary blood test now used to help identify rejection -- creatinine, which measures kidney function -- is much less specific than the three-gene signature.
"Creatinine can go up for many reasons, including simple dehydration in a patient, and when this happens we then need to do a highly invasive needle-stick biopsy to look at the kidney and determine the cause. Our goal is to provide the most effective care possible for our transplant patients, and that means individualizing their post transplant care," she says. "Using an innovative biomarker test like this will eliminate unnecessary biopsies and provide a yardstick to measure adequate immunosuppression to keep organs -- and our patients -- healthy."
Although a number of researchers have tried to develop blood or urine-based tests to measure genes or proteins that signify kidney organ rejection, Dr. Suthanthiran and his research team were the first to create a gene expression profile urine test -- an advance that was reported in NEJM in 2001 and, with an update also in NEJM, in 2005.
The research team measured the levels of messenger RNA (mRNA) molecules produced as genes are being expressed, or activated, to make proteins. To do this, they developed a number of sophisticated tools to measure this genetic material. "We were told we would never be able to isolate good quality mRNA from urine," he says. "Never say never."
He and his co
|Contact: Linda Kamateh|
Weill Cornell Medical College