Avramidou E, Psatha K, St John K, Tsoulfas G, Aivaliotis M. Future of non-invasive graft evaluation: A systematic review of proteomics in kidney transplantation. World J Transplant 2025; 15(1): 96025 [DOI: 10.5500/wjt.v15.i1.96025]
Corresponding Author of This Article
Eleni Avramidou, Department of Transplantation Surgery, Center for Research and Innovation in Solid Organ Transplantation, Aristotle University of Thessaloniki, School of Medicine, 49 Konstantinoupoleos Street, Thessaloniki 54642, Greece. avramidoue@auth.gr
Research Domain of This Article
Transplantation
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Eleni Avramidou, Georgios Tsoulfas, Department of Transplantation Surgery, Center for Research and Innovation in Solid Organ Transplantation, Aristotle University of Thessaloniki, School of Medicine, Thessaloniki 54642, Greece
Konstantina Psatha, Laboratory of Medical Biology- Genetics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
Konstantina Psatha, Kallisti St John, Michalis Aivaliotis, Functional Proteomics and Systems Biology (FunPATh), Center for Interdisciplinary Research and Innovation (CIRI-AUTH), Thessaloniki GR-57001, Greece
Kallisti St John, Michalis Aivaliotis, Laboratory of Biological Chemistry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
Co-corresponding authors: Eleni Avramidou and Michalis Aivaliotis.
Author contributions: Avramidou E and Aivaliotis M conceptualized and designed the research; Avramidou E and St John K performed the research through the databases; Avramidou E and St John K analysed the data; Avramidou E, St John K and Psatha K wrote the paper; Tsoulfas G and Aivaliotis M critically reviewed the paper. All the authors have read and approved the final manuscript. Avramidou E proposed the research idea and searched the databases. Aivaliotis M provided the analysis sources. The collaboration between Avramidou E and Aivaliotis M is crucial for the publication of this manuscript and other manuscripts still in preparation.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eleni Avramidou, Department of Transplantation Surgery, Center for Research and Innovation in Solid Organ Transplantation, Aristotle University of Thessaloniki, School of Medicine, 49 Konstantinoupoleos Street, Thessaloniki 54642, Greece. avramidoue@auth.gr
Received: April 24, 2024 Revised: September 19, 2024 Accepted: October 21, 2024 Published online: March 18, 2025 Processing time: 216 Days and 13.4 Hours
Abstract
BACKGROUND
Despite the developments in the field of kidney transplantation, the already existing diagnostic techniques for patient monitoring are considered insufficient. Protein biomarkers that can be derived from modern approaches of proteomic analysis of liquid biopsies (serum, urine) represent a promising innovation in the monitoring of kidney transplant recipients.
AIM
To investigate the diagnostic utility of protein biomarkers derived from proteomics approaches in renal allograft assessment.
METHODS
A systematic review was conducted in accordance with PRISMA guidelines, based on research results from the PubMed and Scopus databases. The primary focus was on evaluating the role of biomarkers in the non-invasive diagnosis of transplant-related complications. Eligibility criteria included protein biomarkers and urine and blood samples, while exclusion criteria were language other than English and the use of low resolution and sensitivity methods. The selected research articles, were categorized based on the biological sample, condition and methodology and the significantly and reproducibly differentiated proteins were manually selected and extracted. Functional and network analysis of the selected proteins was performed.
RESULTS
In 17 included studies, 58 proteins were studied, with the cytokine CXCL10 being the most investigated. Biological pathways related to immune response and fibrosis have shown to be enriched. Applications of biomarkers for the assessment of renal damage as well as the prediction of short-term and long-term function of the graft were reported. Overall, all studies have shown satisfactory diagnostic accuracy of proteins alone or in combination with conventional methods, as far as renal graft assessment is concerned.
CONCLUSION
Our review suggests that protein biomarkers, evaluated in specific biological fluids, can make a significant contribution to the timely, valid and non-invasive assessment of kidney graft.
Core Tip: In recent years, the role of diagnostic biomarkers in kidney transplantation has been emerged, particularly with proteomics being considered a powerful investigative tool. In this review, we critically analyze the spectrum of proteins exhibiting diagnostic accuracy in early, non-invasive evaluation of kidney grafts as well as the potent biological correlations between the variation of proteins detected in recipients experiencing some type of graft dysfunction or complication.
