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Singh AD, Nagalla B, Patnam S, Satyanaryana G, Andrews R, Panigrahi AK, Mudigonda SS, Maitra S, Rengan AK, Sasidhar MV. Exploring urinary extracellular vesicles for organ transplant monitoring: A comprehensive study for detection of allograft dysfunction using immune-specific markers. Clin Chim Acta 2023; 548:117525. [PMID: 37633321 DOI: 10.1016/j.cca.2023.117525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Allograft dysfunction (AGD) is a common complication following solid organ transplantation (SOT). This study leverages the potential of urinary extracellular vesicles (UEVs) for the non-invasive detection of AGD. AIM We aimed to assess the diagnostic value of T-cell and B-cell markers characteristic of T-cell-mediated and antibody-mediated rejection in UEV-mRNA using renal transplantation as a model. MATERIALS AND METHODS UEVs were isolated from 123 participants, spanning healthy controls, functional transplant recipients, and biopsy-proven AGD patients. T-cell and B-cell marker mRNA expressions were evaluated using RT-qPCR. RESULTS We observed significant differences in marker expression between healthy controls and AGD patients. ROC analysis revealed an AUC of 0.80 for T-cell markers, 0.98 for B-cell markers, and 0.94 for combined markers. T-cell markers achieved 81.3 % sensitivity, 80 % specificity, and 80.4 % efficiency. A triad of T-cell markers (PRF1, OX40, and CD3e) increased sensitivity to 87.5 % and efficiency to 82.1 %. B-cell markers (CD20, CXCL3, CD46, and CF3) delivered 100 % sensitivity and 97.5 % specificity. The combined gene signature of T-cell and B-cell markers offered 93.8 % sensitivity and 95 % specificity. CONCLUSION Our findings underscore the diagnostic potential of UEV-derived mRNA markers for T-cells and B-cells in AGD, suggesting a promising non-invasive strategy for monitoring graft health.
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Affiliation(s)
- Anula Divyash Singh
- Apollo Hospitals Educational and Research Foundation (AHERF), Hyderabad, India; Department of Biomedical Engineering, Indian Institute of Technology Hyderabad (IITH), Kandi, Hyderabad, India
| | - Balakrishna Nagalla
- Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana, Hyderabad, India
| | - Sreekanth Patnam
- Apollo Hospitals Educational and Research Foundation (AHERF), Hyderabad, India; Department of Biomedical Engineering, Indian Institute of Technology Hyderabad (IITH), Kandi, Hyderabad, India
| | - G Satyanaryana
- Department of Nephrology, Apollo Hospitals, Hyderabad, India
| | - Ravi Andrews
- Department of Nephrology, Apollo Hospitals, Hyderabad, India
| | | | | | - Sanjay Maitra
- Department of Nephrology, Apollo Hospitals, Hyderabad, India
| | - Aravind Kumar Rengan
- Department of Biomedical Engineering, Indian Institute of Technology Hyderabad (IITH), Kandi, Hyderabad, India
| | - Manda Venkata Sasidhar
- Apollo Hospitals Educational and Research Foundation (AHERF), Hyderabad, India; Urvogelbio Private Ltd, Hyderabad, India.
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Dugbartey GJ, Juriasingani S, Zhang MY, Sener A. H 2S donor molecules against cold ischemia-reperfusion injury in preclinical models of solid organ transplantation. Pharmacol Res 2021; 172:105842. [PMID: 34450311 DOI: 10.1016/j.phrs.2021.105842] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/30/2022]
Abstract
Cold ischemia-reperfusion injury (IRI) is an inevitable and unresolved problem that poses a great challenge in solid organ transplantation (SOT). It represents a major factor that increases acute tubular necrosis, decreases graft survival, and delays graft function. This complicates graft quality, post-transplant patient care and organ transplantation outcomes, and therefore undermines the success of SOT. Herein, we review recent advances in research regarding novel pharmacological strategies involving the use of different donor molecules of hydrogen sulfide (H2S), the third established member of the gasotransmitter family, against cold IRI in different experimental models of SOT (kidney, heart, lung, liver, pancreas and intestine). Additionally, we discuss the molecular mechanisms underlying the effects of these H2S donor molecules in SOT, and suggestions for clinical translation. Our reviewed findings showed that storage of donor organs in H2S-supplemented preservation solution or administration of H2S to organ donor prior to organ procurement and to recipient at the start and during reperfusion is a novel, simple and cost-effective pharmacological approach to minimize cold IRI, limit post-transplant complications and improve transplantation outcomes. In conclusion, experimental evidence demonstrate that H2S donors can significantly mitigate cold IRI during SOT through inhibition of a complex cascade of interconnected cellular and molecular events involving microcirculatory disturbance and microvascular dysfunction, mitochondrial injury, inflammatory responses, cell damage and cell death, and other damaging molecular pathways while promoting protective pathways. Translating these promising findings from bench to bedside will lay the foundation for the use of H2S donor molecules in clinical SOT in the future.
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Affiliation(s)
- George J Dugbartey
- Department of Surgery, Division of Urology, London Health Sciences Center, Western University, London, Ontario, Canada; Matthew Mailing Center for Translational Transplant Studies, London Health Sciences Center, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, Western University, London Health Sciences Center, Western University, London, Ontario, Canada; Department of Pharmacology and Toxicology, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Smriti Juriasingani
- Department of Surgery, Division of Urology, London Health Sciences Center, Western University, London, Ontario, Canada; Matthew Mailing Center for Translational Transplant Studies, London Health Sciences Center, Western University, London, Ontario, Canada
| | - Max Y Zhang
- Matthew Mailing Center for Translational Transplant Studies, London Health Sciences Center, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, Western University, London Health Sciences Center, Western University, London, Ontario, Canada
| | - Alp Sener
- Department of Surgery, Division of Urology, London Health Sciences Center, Western University, London, Ontario, Canada; Matthew Mailing Center for Translational Transplant Studies, London Health Sciences Center, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, Western University, London Health Sciences Center, Western University, London, Ontario, Canada; Department of Microbiology & Immunology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada.
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Jin M, Zeng L, Zhang W, Deng X, Li J, Zhang W. Clinical features of multidrug-resistant organism infections in early postoperative solid organ transplantation in a single center. Ann Palliat Med 2021; 10:4555-4562. [PMID: 33966403 DOI: 10.21037/apm-21-777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/24/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The increasing occurrence of multidrug-resistant organisms (MDROs) infections has posed major challenge to solid organ transplantation (SOT). For SOT recipients, high-dose immunosuppressants and broad-spectrum antibiotics can markedly increase the risk of early postoperative MDRO infections and thus have adverse effects on the outcomes of SOT. Here, we analyzed the incidence and clinical features of early MDRO infections after SOT, in an attempt to provide new evidence for the control and treatment of early MDROs. METHODS The clinical data of 133 patients with MDRO infections after SOT in our department from 2017 to 2020 were retrospectively collected, and clinical features including incidence, etiologies, infection sites, and complications, were analyzed. RESULTS The incidence of MDRO infections after SOT was 9.9%. Simultaneous liver and kidney transplantation patients had the highest incidence of MDRO infections, followed by the recipients of liver transplantation and simultaneous pancreas-kidney transplantation; patients undergoing renal transplantation had the lowest incidence of MDRO infections. The most common pathogen was extended spectrum beta-lactamase (ESBL)-producing organisms (n=88, 66.2%), the most common infection site was the urinary system (n=58, 43.6%), and the main postoperative complications were urinary tract infections (n=44, 33.1%) and lung infections (n=41, 30.8%). MDRO infections were cured in most cases. CONCLUSIONS A sound knowledge of the clinical features of MDRO infection after SOT is important for the successful prevention and treatment of these infections.
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Affiliation(s)
- Min Jin
- Organ Transplantation Center, Panyu Campus, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lijuan Zeng
- Organ Transplantation Center, Panyu Campus, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wanyi Zhang
- Organ Transplantation Center, Panyu Campus, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xuanying Deng
- Organ Transplantation Center, Panyu Campus, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiali Li
- Organ Transplantation Center, Panyu Campus, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Weiting Zhang
- Organ Transplantation Center, Panyu Campus, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Abstract
Cytomegaloviruses (CMVs), members of the β-subfamily of the herpesvirus family, have co-speciated with their respective mammalian hosts resulting in a mutual virus-host adaptation reflected by sets of 'private' viral genes that a particular CMV species does not share with other CMVs and that define the host-species specificity of CMVs. Nonetheless, based on "biological convergence" in evolution, fundamental rules in viral pathogenesis and immune control are functionally analogous between different virus-host pairs. Therefore, the mouse model of infection with murine CMV (mCMV) has revealed generally valid principles of CMV-host interactions. Specifically, the mouse model has paved the way to cellular immunotherapy of CMV disease in immunocompromised recipients of hematopoietic cell transplantation (HCT). Precisely in the context of HCT, however, current view assumes that there exists a major difference between hCMV and mCMV regarding "latent virus reservoirs" in that only hCMV establishes latency in hematopoietic lineage cells (HLCs), whereas mCMV establishes latency in endothelial cells. This would imply that only hCMV can reactivate from transplanted HLCs of a latently infected donor. In addition, as viral transcriptional activity during latency is discussed as a driver of clonal T-cell expansion over lifetime, a phenomenon known as "memory inflation", it is important to know if hCMV and mCMV establish latency in the same cell type(s) for imprinting the immune system. Here, we review the currently available evidence to propose that the alleged difference in latent virus reservoirs between hCMV and mCMV may rather relate to a difference in the focus of research. While studies on hCMV latency in HLCs likely described a non-canonical, transient type-2 latency, studies in the mouse model focussed on canonical, lifelong type-1 latency.
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Affiliation(s)
- Matthias J Reddehase
- Institute for Virology and Research Center for Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg-University Mainz, Obere Zahlbacher Strasse 67, Hochhaus am Augustusplatz, 55131, Mainz, Germany.
| | - Niels A W Lemmermann
- Institute for Virology and Research Center for Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg-University Mainz, Obere Zahlbacher Strasse 67, Hochhaus am Augustusplatz, 55131, Mainz, Germany.
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Abstract
Cryptococcosis is an invasive mycosis caused by pathogenic encapsulated yeasts in the genus Cryptococcus. Cryptococcus gained prominence as a pathogen capable of widespread disease outbreaks in vulnerable populations. We have gained insight into the pathobiology of Cryptococcus, including the yeast' s capacity to adapt to environmental pressures, exploit new geographic environments, and cause disease in both immunocompromised and apparently immunocompetent hosts. Inexpensive, point-of-care testing makes diagnosis more feasible than ever. The associated worldwide burden and mortality remains unacceptably high. Novel screening strategies and preemptive therapy offer promise at making a sustained and much needed impact on this sugar-coated opportunistic mycosis.
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Affiliation(s)
- Eileen K Maziarz
- Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, DUMC Box 102359, 315 Trent Drive, Durham, NC 27710, USA.
| | - John R Perfect
- Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, DUMC Box 102359, 315 Trent Drive, Durham, NC 27710, USA
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