RNA expression profiling as prognostic tool in renal XXXX : toward nephrogenomics.

@entity1 @entity8 @entity82 @entity75 @entity3808 @entity740 @entity631
Damage to the kidney generally elicits tissue repair mechanisms, but these processes themselves conversely may result in the progression of @entity740 . In a majority of @entity1 @entity740 progresses to a common histological end point, marked by the presence of a vast amount of scar tissue, that is, @entity631 and @entity82 . These lesions are the result of an excessive production of extracellular matrix (ECM) components. Studies on RNA expression in experimental @entity8 have shown that renal mRNA levels for ECM components and cytokines can function as prognostic tools. This suggests that mRNA levels potentially predict outcome and reaction to therapy in @entity1 with @entity8 . Timely detection of molecular alterations could allow early therapeutic intervention that slows down or even prevents the development of @entity3808 and @entity75 . This review first provides a short introduction on mechanisms of initiation and progression of @entity8 . Molecular techniques are available to identify renal RNA sequences potentially involved in disease progression. We discuss several molecular techniques that are being used in kidney research for quantitation and detection of mRNA. This is followed by a brief overview of investigation in experimental @entity8 , which reveal that alterations in tissue ECM mRNA levels precede histological damage and can function as predictors of clinical outcome. In particular, studies in @entity1 kidney biopsies that evaluate the prognostic value of mRNA levels with respect to renal function are examined, paying special attention to the pitfalls that potentially are encountered when interpreting the results of such studies. Then, we elaborate on ways of optimal exploitation of mRNA quantification as a prognostic tool. The potential and limitations of microarray technology in the search for genes specifically involved in progression of @entity8 are reviewed, including RNA expression profiling and large-scale DNA mutation screening. Finally, the future utilities of microarray in nephrology and renal pathology are discussed.
