Propuesta de un nuevo biomarcador para los trasplantados renales sobre la base del estudio de tecnologias de salud codependientes

Resumo

The research work presented by this PhD thesis proposes a new biomarker, the number of T regulatory lymphocytes (Treg) in the peripheral blood, which constitutes a "surrogate" endpoint for a relevant health outcome for kidney transplant recipients, the stability of kidney graft function, defined as a low frequency of acute allograft dysfunction (AAD) events. To date, only serum creatinine measurement is available for the evaluation of kidney graft function. Our findings affirm that the number of Tregs in the peripheral blood in kidney transplant recipients varies as the effect of treatment with mammalian target of rapamycin (mTOR) inhibitors alone or in combination with belatacept on kidney graft function varies. Our findings therefore suggest the use of Treg counts as a companion diagnostic test for the treatment with mTOR inhibitors (mTORi) alone or in combination with belatacept. Flow cytometry is a simple technique with reliable results that can allow the follow-up of kidney transplant recipients. Drug-test codependency can be concluded in view of our findings and considering the design of the included trials that evaluated the effect of treatment with mTORi with/without belatacept on the number of Tregs in the peripheral blood, which they carried out through the stratification of their participants by this exposure.