Abstract: Germline and somatic genomic variation represent the bulk of ‘omics data available for precision medicine research. These data, however, may fail to capture the dynamic biological processes that underlie disease development, particularly for chronic diseases of aging such as chronic kidney disease (CKD). To demonstrate the value of additional dynamic precision medicine data, we sequenced somatic T-cell receptor rearrangements, markers of the adaptive immune response, from genomic DNA collected during a clinical encounter from 15 participants with CKD and associated co-morbidities. Participants were consented as part of a larger precision medicine research project at the MetroHealth System, a large urban public hospital in Cleveland, Ohio. Despite the limited sample size, we observed reduced T-cell receptor diversity in relation to biomarkers (creatinine and BUN) of CKD status in this older and mostly African American sample. Overall, these data suggest a relationship between advanced CKD and premature aging of the adaptive immune system and highlight the potential of dynamic ‘omic data to generate novel hypotheses about disease mechanisms and unique opportunities for precision medicine applications.

Learning Objective 1: The work presented here will offer an example of uses of electronic health records for precision medicine research with an emphasis on immunosequencing and kidney diseases.


Dana Crawford (Presenter)
Case Western Reserve University

Jessica Cooke Bailey, Case Western Reserve University
Kristy Miskimen, Case Western Reserve University
Penelope Miron, Case Western Reserve University
Jacob McCauley, University of Miami
John Sedor, Case Western Reserve University
John O'Toole, Case Western Reserve University
William Bush, Case Western Reserve University

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