Go to The Journal of Clinical Investigation
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Transfers
  • Advertising
  • Job board
  • Contact
  • Physician-Scientist Development
  • Current issue
  • Past issues
  • By specialty
    • COVID-19
    • Cardiology
    • Immunology
    • Metabolism
    • Nephrology
    • Oncology
    • Pulmonology
    • All ...
  • Videos
  • Collections
    • In-Press Preview
    • Resource and Technical Advances
    • Clinical Research and Public Health
    • Research Letters
    • Editorials
    • Perspectives
    • Physician-Scientist Development
    • Reviews
    • Top read articles

  • Current issue
  • Past issues
  • Specialties
  • In-Press Preview
  • Resource and Technical Advances
  • Clinical Research and Public Health
  • Research Letters
  • Editorials
  • Perspectives
  • Physician-Scientist Development
  • Reviews
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Transfers
  • Advertising
  • Job board
  • Contact
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
View: Text | PDF
Research Article Transplantation

Key driver genes as potential therapeutic targets in renal allograft rejection

  • Text
  • PDF
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

×

Figure 8

Minocycline as adjunct to immunosuppression confers allograft survival benefit during treatment period.

Options: View larger image (or click on image) Download as PowerPoint
Minocycline as adjunct to immunosuppression confers allograft survival b...
(A) Minocycline and saline were compared as adjunct agents to immunosuppression, administered as a single low dose of CTLA4-Ig (250 μg) IP on POD2. First, animals were given minocycline or saline (n = 4 in each group) through to POD14 and culled; all allografts were still viable at the time. (B) Representative immunohistochemistry of Troponin I (brown staining) of POD14 allograft myocardium treated with CTLA4-Ig with adjunct saline, versus CTLA4-Ig with adjunct minocycline, respectively. Quantification using the Positive Pixel Count Algorithm (Version 9, Leica Biosystems) demonstrated significantly greater preservation of Troponin I staining of cardiomyocytes in the minocycline group, indicating less myocardial necrosis compared with the saline group. Scale bar: 300 μm. (C) Next, the effect of adjunct minocycline or adjunct saline treatment to single-dose CTLA4-Ig on allograft survival was compared, with animals receiving minocycline (n = 8) or saline (n = 11) while grafts remained viable through to POD27, after which treatment was ceased. Graft survival analysis was performed at POD28. Animals were observed thereafter without further intervention and euthanized when allografts completely rejected or when the end of the experimental period (POD100) was reached. (D) Evaluation of allograft survival at POD28 (censored for nonrejection events) immediately following the cessation of adjunct minocycline/saline treatment demonstrated superior graft survival in the minocycline group (0 out of 7 grafts lost) compared with the saline group (7 out of 11 grafts lost) (P = 0.007). Student’s 2-tailed t test was used for the comparison of IHC staining of Troponin I in the POD14 cardiac allografts between the 2 treatment groups (*P < 0.05). Kaplan-Meier survival analysis using the log-rank test was applied to compare allograft survival at POD28. CTLA4-Ig, cytotoxic T lymphocyte–associated protein 4–immunoglobulin.

Copyright © 2026 American Society for Clinical Investigation
ISSN 2379-3708

Sign up for email alerts