The IMBG test for evaluating the pharmacodynamic response to immunosuppressive therapy in kidney transplant patients: current evidence and future applications

Abstract

Immunosuppressive drugs are widely used to prevent rejection after kidney transplantation. However, the pharmacological response to a given immunosuppressant can vary markedly between individuals, with some showing poor treatment responses and/or experiencing serious side effects. There is an unmet need for diagnostic tools that allow clinicians to individually tailor immunosuppressive therapy to a patient’s immunological profile. The Immunobiogram (IMBG) is a novel blood-based in vitro diagnostic test that provides a pharmacodynamic readout of the immune response of individual patients to a range of immunosuppressants commonly used in kidney transplant recipients. Here, we discuss the current approaches used to measure the pharmacodynamic responses of individual patients to specific immunosuppressive drugs in vitro, which can then be correlated with patient’s clinical outcomes. We also describe the procedure of the IMBG assay, and summarize the results obtained using the IMBG in different kidney transplant populations. Finally, we outline future directions and other novel applications of the IMBG, both in kidney transplant patients and other autoimmune diseases.

The proof-of-concept and TRANSBIO (BHP-IBG-2017-01) IMBG studies were funded by a competitive grant from the European Commission (SME Instrument–Phase II). Project: TRANSBIO (Id 733248) “Cellular BIOtechnology for prognosis and monitoring in renal TRANSplantation”. See https://cordis.europa.eu/project/id/733248. Julio Pascual is supported by grants ISCIII FIS-FEDER 19/0037 and Redinren RD16/0009/0013. Marta Crespo is supported by grants ISCIII FIS-FEDER 20/0090 and Redinren RD16/0009/0013.