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Key driver genes as potential therapeutic targets in renal allograft rejection
Zhengzi Yi, Karen L. Keung, Li Li, Min Hu, Bo Lu, Leigh Nicholson, Elvira Jimenez-Vera, Madhav C. Menon, Chengguo Wei, Stephen Alexander, Barbara Murphy, Philip J. O’Connell, Weijia Zhang
Zhengzi Yi, Karen L. Keung, Li Li, Min Hu, Bo Lu, Leigh Nicholson, Elvira Jimenez-Vera, Madhav C. Menon, Chengguo Wei, Stephen Alexander, Barbara Murphy, Philip J. O’Connell, Weijia Zhang
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Research Article Transplantation

Key driver genes as potential therapeutic targets in renal allograft rejection

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Abstract

Acute rejection (AR) in renal transplantation is an established risk factor for reduced allograft survival. Molecules with regulatory control among immune pathways of AR that are inadequately suppressed, despite standard-of-care immunosuppression, could serve as important targets for therapeutic manipulation to prevent rejection. Here, an integrative, network-based computational strategy incorporating gene expression and genotype data of human renal allograft biopsy tissue was applied, to identify the master regulators — the key driver genes (KDGs) — within dysregulated AR pathways. A 982–meta-gene signature with differential expression in AR versus non-AR was identified from a meta-analysis of microarray data from 735 human kidney allograft biopsy samples across 7 data sets. Fourteen KDGs were derived from this signature. Interrogation of 2 publicly available databases identified compounds with predicted efficacy against individual KDGs or a key driver–based gene set, respectively, which could be repurposed for AR prevention. Minocycline, a tetracycline antibiotic, was chosen for experimental validation in a murine cardiac allograft model of AR. Minocycline attenuated the inflammatory profile of AR compared with controls and when coadministered with immunosuppression prolonged graft survival. This study demonstrates that a network-based strategy, using expression and genotype data to predict KDGs, assists target prioritization for therapeutics in renal allograft rejection.

Authors

Zhengzi Yi, Karen L. Keung, Li Li, Min Hu, Bo Lu, Leigh Nicholson, Elvira Jimenez-Vera, Madhav C. Menon, Chengguo Wei, Stephen Alexander, Barbara Murphy, Philip J. O’Connell, Weijia Zhang

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Figure 6

KDG set correlates with renal allograft survival in 2 renal allograft transcript data sets.

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KDG set correlates with renal allograft survival in 2 renal allograft tr...
(A) The Kaplan-Meier curve of death-censored graft loss with the kidney transplant recipients in GSE57387 (an internal discovery GoCAR data set composed of protocol biopsies performed 3 months posttransplant) stratified by the median fitted value of 14 key drivers from Cox regression model. (P = 1.82e-03). (B) The ROC for prediction of graft survival in the GoCAR study at 1 (black curve, AUC = 0.913) and 2 (red curve, AUC = 0.913) years posttransplant. (C) Kaplan-Meier analysis (P = 2.11e-08) and (D) ROC plot (1-year postbiopsy follow-up survival: AUC = 0.971, 2-year postbiopsy follow-up survival: AUC = 0.889) using the 14 key drivers in GSE21374 (an external independent data set composed of for-cause biopsies).

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