J Heart Lung Transplant 2021 Jun 24;40(6):405-413. Epub 2021 Mar 24.
Lasker Clinical Research Tenure Track Investigator and Laboratory Chief, Laboratory of Applied Precision Omics, National Heart, Lung, and Blood Institute, Bethesda, Maryland; Lung Transplantation Program, Johns Hopkins School of Medicine, Baltimore, M. Electronic address:
Cell-free DNA, measured as donor-derived cell-free DNA is developed as a non-specific biomarker for allograft injury and transplant rejection. However, cell-free DNA characteristics are more specific, its fragment length, nucleotide content, and composition, as well as the tissue source of origin, are intrinsically linked to the underlying disease pathogenesis, showing distinct features in acute cellular rejection and antibody-mediated rejection for example. Further, cell-free DNA and cell-free mitochondrial DNA can directly trigger tissue injury as damage-associated molecular patterns through three major intracellular receptors, toll-like receptor 9 , cyclic guanosine monophosphate-adenosine monophosphate synthase, and inflammasomes (i. Read More