Allograft loss remains a severe clinical problem after kidney transplantation. The molecular
mechanism of graft loss is a complex process involving T and/or B cell activation, inflammation responses,
autophagy and apoptosis. Since these pathways are involved in immune responses in kidney
transplant rejection, application of genetic interference to inhibit specific pathways could present an
effective targeted gene therapy method. Recent studies have successfully attempted to use gene therapy
to target the key molecules involved in immune responses during transplantation. This strategy
has the potential to silence target genes associated with a variety of diseases, including those that trigger
allograft loss following organ transplantation. In this review, we have discussed evidence of the
clinical applicability of gene therapy in kidney transplantation based on known associations between
kidney diseases and genes participating in the underlying mechanisms. The molecules contributing to
immune responses and inflammatory injury are further highlighted as potential targets in future clinical
therapy for renal transplantation.
Keywords: Gene therapy, Kidney transplantation, RNAi, siRNA, ESRD, Inferior vena cava.
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