PDF(Pubmed)
Abstract：
The current tools for diagnosing and monitoring native kidney diseases as well as allograft rejection in transplant patients are suboptimal. Creatinine and proteinuria are non-specific and poorly sensitive markers of injury. Tissue biopsies are invasive and carry potential complications. In this article, we overview the different techniques of liquid biopsy and discuss their potential to improve patients\' kidney health. Several diagnostic, predictive, and prognostic biomarkers have been identified with the ability to detect and monitor the activity of native kidney diseases as well as early and chronic allograft rejection, such as donor-derived cell-free DNA, exosomes, messenger RNA/microsomal RNA, proteomics, and so on. While the results are encouraging, additional research is still needed as no biomarker appears to be perfect for a routine application in clinical practice. Despite promising advancements in biomarkers, the most important issue is the lack of standardized pre-analytical criteria. Large validation studies and uniformed standard operating procedures are required to move the findings from bench to bedside. Establishing consortia such as the Liquid Biopsy Consortium for Kidney Diseases can help expedite the research process, allow large studies to establish standardized procedures, and improve the management and outcomes of kidney diseases and of kidney transplant recipients.
摘要：
目前用于诊断和监测天然肾脏疾病以及移植患者的同种异体移植排斥的工具是次优的。肌酐和蛋白尿是非特异性和敏感性差的损伤标志物。组织活检是侵入性的并且携带潜在的并发症。在这篇文章中,我们概述了液体活检的不同技术，并讨论了它们改善患者肾脏健康的潜力。几个诊断，预测性，和预后生物标志物已被确定具有检测和监测天然肾脏疾病以及早期和慢性同种异体移植物排斥的活性的能力，如供体来源的无细胞DNA，外泌体,信使RNA/微粒体RNA，蛋白质组学，等等。虽然结果令人鼓舞，目前还需要进一步的研究,因为没有生物标志物在临床实践中的常规应用似乎是完美的.尽管生物标志物取得了有希望的进展，最重要的问题是缺乏标准化的分析前标准。需要进行大型验证研究和统一的标准操作程序，才能将研究结果从工作台移至床边。建立诸如肾脏疾病液体活检协会之类的联盟可以帮助加快研究过程，允许大型研究建立标准化程序，改善肾脏疾病和肾移植受者的治疗和预后。
