Glomerular Diseases of the Kidney Allograft: Toward a Precision Medicine Approach.

Glomerular Diseases of the Kidney Allograft: Toward a Precision Medicine Approach.
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DOI:
10.1016/j.semnephrol.2022.01.005
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发表时间:
2022-01
影响因子:
3.3
通讯作者:
Batal, Ibrahim
Batal, Ibrahim
中科院分区:
医学2区
文献类型:
--
作者:
Zanoni, Francesca;Khairallah, Pascale;Kiryluk, Krzysztof;Batal, Ibrahim

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The continual development of potent immunosuppressive regimens has led to decreased incidence of acute rejection and improvement of short-term kidney allograft survival. In contrast to acute rejection, glomerular diseases of the kidney allograft are being encountered more frequently and are emerging as leading causes of late kidney allograft failure. While data on the pathogeneses of glomerular diseases in the kidney allograft are sparse, cumulative evidence suggests that post-transplant glomerular diseases may be the result of inherited predispositions and immunologic triggers. Whereas studying immunologic signals and performing genome-wide association studies are ideal approaches to tackle glomerular diseases in the kidney allograft, such studies are challenging due to the lack of adequately powered cohorts. In this review, we will focus on the most commonly encountered recurrent and de novo glomerular diseases in the kidney allograft. We will address the important advances made in understanding the immunopathology and genetic susceptibility of glomerular diseases in the native kidney and how to benefit from such knowledge to further our knowledge of post-transplant glomerular diseases. Defining genomic and immune predictors for glomerular diseases in the kidney allograft would support novel donor-recipient matching strategies and development of targeted therapies to ultimately improve long-term kidney allograft survival.
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