Differential gene expression pattern in biopsies with renal allograft pyelonephritis and allograft rejection.

摘要: Differentiating acute pyelonephritis (APN) from rejection (AR) in renal allograft biopsies can sometimes be difficult because of overlapping clinical and histologic features, lack positive urine cultures,and variable response to antibiotics. We wanted study differential gene expression between AR APN using biopsy tissue. Thirty-three were analyzed NanoString multiplex platform PCR (6 transplant baseline biopsies, 8 AR, 15 [8 culture positive, 7 negative], 4 native [NP]). Additional 22 tested by validate the results. CXCL9, CXCL10, CXCL11, IDO1 top differentially expressed genes, upregulated AR. Lactoferrin (LTF) CXCL1 higher NP. No statistically significant difference transcript levels was seen culture-positive culture-negative biopsies. Comparing overall mRNA signature Ingenuity pathway analysis, interferon-gamma emerged as dominant upstream regulator APN, but not NP (which clustered separately). Our suggests that chemokine pathways graft may differ fact resemble due a component alloreactivity, resulting antibiotic treatment. Therefore, cautious addition steroids might help resistant cases APN.