Unveiling the Molecular Symphony: Exploring the Influence of miR-142-5p and miR-192-1 on Renal Transplant Rejection and Fibrosis.

OBJECTIVES

In the intricate symphony of molecular orchestration within the human body, microRNAs are master conductors, deftly guiding essential biological processes like immune response, inflammation, and tissue repair. Among these virtuosos, the microRNAs miR -142 -5p and miR -192 -1 emerge as stars, with melodies resonating profoundly in renal transplant pathology. We aimed to unravel the complex role of miR -142 -5p and miR -192 -1 in the fate of renal transplants.

MATERIALS AND

METHODS

We evaluated plasma levels of miR -142 -5p and miR -192 -1 using quantitative real -time polymerase chain reaction in 100 kidney transplant recipients, including 29 with stable graft function, 16 with T -cell-mediated rejection, 28 with antibody-mediated rejection, and 27 with mixed rejection. We analyzed associations between miRNA levels, histopathological features, fibrosis development (>50 % cortical involvement ), and graft outcomes.

RESULTS

Both miR -142 -5p and miR -192 -1 were significantly upregulated in patients with acute rejection and interstitial fibrosis (P < .001 ). Elevated levels correlated with interstitial inflammation, eosinophilia, plasma cell infiltration, peritubular capillaritis, glomerulitis, C4d positivity, vascular rejection, thrombotic microangiopathy, and tubular expression of the DR isotype of human leukocyte antigen. The 5 -year interstitial fibrosis incidence was 52 % in patients with high miR -142-5p and 57% with high miR -192 -1, versus 23 %and 21 %in the respective low -expression groups. Graft survival at 5 years was 64% for high miR -142 -5p and 61 % for high miR -192 -1, versus 94 % and 93 %in the respective low-expression groups (P ≤ .001 ).

CONCLUSIONS

MicroRNAs miR -142 -5p and miR -192 -1 are associated with acute rejection severity, microvascular inflammation, and fibrotic progression. The strong correlation with histological injury and graft loss suggests that these microRNAs serve as noninvasive biomarkers for immune monitoring and risk prediction in kidney transplant.