Urine mRNA profile and acute dysfunction of kidney allograft
Non-invasive methods for detecting, predicting, and/or monitoring differential diagnosis of kidney transplant dysfunction in kidney transplant patients are described.
1. A method comprising:
(a) measuring urinary RNA expression levels of the following genes: CD3ϵ, CD105, TLR4, CD14, complement factor B, and vimentin as copies of RNA per microgram of total RNA using at least one probe or primer with a sequence selected from SEQ ID NO: 10, 11, 12, 25, 26, 27, 43, 44, 45, 46, 47, 48, 58, 59, or 60, in a test urinary cell sample from a subject with a kidney transplant to provide measured CD3ϵ, CD105, TLR4, CD14, Complement factor B, and Vimentin mRNA expression levels; and
(b) determining a six-gene diagnostic signature for the subject from natural log (ln) values of measured CD3ϵ, CD105, TLR4, CD14, Complement factor B, and Vimentin mRNA expression levels using the following formula:
(0.52*ln CD3ϵ)+(1.02*ln CD105)+(0.81*ln TLR4)+(−1.16*ln CD14)+(0.28*ln Complement Factor B)+(−0.79*ln Vimentin); and
identifying a subject whose test urinary cell sample has a six-gene diagnostic signature of greater than −0.24 as having an increased likelihood that the transplanted kidney is undergoing acute rejection; or
identifying a subject whose test urinary cell sample has a six-gene diagnostic signature of less than −0.24 as having an increased likelihood of acute tubular injury of a kidney transplant in the subject.
2. The method of claim 1 , wherein the method distinguishes subjects undergoing acute rejection from subjects with acute tubular injury.
3. The method of claim 1 , further comprising treatment of a subject for acute rejection of a kidney transplant with a six-gene diagnostic signature greater than −0.24.
4. The method of claim 1 , further comprising treatment of a subject for acute tubular injury with a six-gene diagnostic signature less than −0.24.