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Ghoneim ME, Sheashaa H, Wafa E, Awadalla A, Ahmed AE, Sobh M, Shokeir AA. Impact of CD 28, CD86, CTLA-4 and PD-1 genes polymorphisms on acute renal allograft rejection and graft survival among Egyptian recipients. Sci Rep 2024; 14:2047. [PMID: 38267522 PMCID: PMC10808544 DOI: 10.1038/s41598-024-52195-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 01/15/2024] [Indexed: 01/26/2024] Open
Abstract
To study the impact of four gene polymorphisms on acute renal allograft rejection (AR) and graft survival among Egyptian population. These 4 gene polymorphisms include: (1) CD 28 (rs3116496), (2) CD86 (rs1129055), (3) CTLA-4 (rs3087243), (4) PD-1 (rs2227982). This is a non-concurrent cohort study including 50 kidney transplant recipients diagnosed histopathologically as (AR) [study group] and another 50 matched allograft recipients without AR [control group]. Blood samples were taken from both groups and subjected to genotyping for the selected four genetic polymorphisms by TaqMan genotyping assay. The difference in genotypic distribution of CD 28: rs3116496 and CD86: rs1129055 wasn't statistically significant between the study and control groups (P = 0.22 and 0.33 respectively) and also both polymorphisms had no effect on graft survival (P = 0.36 and 0.74 respectively) while the addition of C allele to IVS3 +17T/C polymorphism in CD28 gene showed a protective effect against AR (P = 0.03). CTLA-4: rs3087243 AG genotype showed a protective effect against AR as it was more frequent in no rejection group compared to those with AR (P = 0.001) with a statistically significant impact on graft survival (P < 0.001), while PD-1: rs2227982 AG genotype was equally distributed between both groups (variant of unknown significance). There was no detected association between CD86 polymorphism: rs1129055 and CD 28 polymorphism: rs3116496 with the development of AR. However, C allele of CD 28 IVS3 +17T/C polymorphism and CTLA-4 polymorphism: rs3087243AG genotype both demonstrated a protective effect against AR.
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Affiliation(s)
- Moatasem Elsayed Ghoneim
- Nephrology and Transplant Unit, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
| | - Hussein Sheashaa
- Nephrology and Transplant Unit, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Ehab Wafa
- Nephrology and Transplant Unit, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Amira Awadalla
- Center of Excellence for Genome and Cancer Research, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Asmaa E Ahmed
- Genetics Research Unit, Faculty of Medicine, Delta University for Science and Technology, Gamasa, Egypt
| | - Mohamed Sobh
- Nephrology and Transplant Unit, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Ahmed Abdulrahman Shokeir
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
- Center of Excellence for Genome and Cancer Research, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
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Taleb A, Afshari M, Samzadeh M, Sarhangi N, Nafar M, Hasanzad M. Influence of cytotoxic T lymphocyte antigen 4 genetic variants on acute rejection in kidney transplant patients: precision medicine perspective. J Diabetes Metab Disord 2022; 21:69-75. [PMID: 35673498 DOI: 10.1007/s40200-021-00936-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/11/2021] [Indexed: 11/24/2022]
Abstract
Background The most effective and common treatment for end-stage renal disease is kidney transplantation.The personalized approach to kidney transplantation, which utilizes precision medicine principles, determines distinctive genomics characteristics of candidates/recipients that must be taken into account. Cytotoxic T lymphocyte associated protein 4 (CTLA4) may be a suitable candidate gene for studying allograft rejection. The aim of this study was to understand whether we can consider two common variants of the CTLA4 gene as a risk factor of transplant rejection in a group of Iranian population. Methods Totally, 169 kidney transplant recipients, including acute rejections (N=39) and non-rejection (N=130) groups who underwent transplantation were included in this study. The genotyping of rs5742909 (-318C/T) and rs231775 (+49A/G) variants of the CTLA4 gene were performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Results The AG genotype frequency of rs231775 variant was the same in both patients with and without a history of rejection while, none of those groups had homozygote genotype. In rs5742909, both CT and TT frequencies of patients with rejected transplant were lower than patients with a normal outcome. Conclusions The results of the presented study suggest that rs231775 and rs5742909 of CTLA4 genetic variants are not linked to acute rejection who underwent kidney transplantation. So, these variants cannot be considered as risk factors of acute allograft rejection in a group of Iranian renal transplantation recipients. However, the transplantation precision medicine may be an important area for the improvement of patients outcome as the precision medicine has already entered clinical practice in kidney transplantation.
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Affiliation(s)
- Andia Taleb
- Medical Genomics Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mahdi Afshari
- Department of Community Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Mohammad Samzadeh
- Medical Genomics Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Negar Sarhangi
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Nafar
- Urology Nephrology Research Center, Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mandana Hasanzad
- Medical Genomics Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.,Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Eiamsitrakoon T, Tharabenjasin P, Pabalan N, Jarjanazi H, Tasanarong A. Influence of polymorphisms in the vascular endothelial growth factor gene on allograft rejection after kidney transplantation: a meta-analysis. F1000Res 2022; 10:90. [PMID: 35284063 PMCID: PMC8905004 DOI: 10.12688/f1000research.27800.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Reported associations of allograft rejection in kidney transplant patients with
VEGF single nucleotide polymorphisms (SNPs) have been inconsistent between studies, which prompted a meta-analysis to obtain more precise estimates. Methods:
Using the PICO elements, kidney transplant patients (P) were compared by genotype data between rejectors (I) and non-rejectors (C) in order to determine the risk of allograft rejection (O) attributed to the
VEGF SNPs. Literature search of four databases yielded seven articles. To calculate risks for allograft rejection, four SNPs were examined. Using the allele-genotype model we compared the variant (
var) with the wild-type (
wt) and heterozygous (
var-
wt) alleles. Meta-analysis treatments included outlier and subgroup analyses, the latter was based on ethnicity (Indians/Caucasians) and rejection type (acute/chronic). Multiple comparisons were corrected with the Bonferroni test. Results: Five highly significant outcomes (P
a < 0.01) survived Bonferroni correction, one of which showed reduced risk for the
var allele (OR 0.61, 95% CI 0.45-0.82). The remaining four indicated increased risk for the
wt allele where the chronic rejection (OR 2.10, 95% CI 1.36-3.24) and Indian (OR 1.44, 95% CI 1.13-1.84) subgroups were accorded susceptibility status. Conclusions: Risk associations for renal allograft rejection were increased and reduced on account of the
wt and
var alleles, respectively. These findings could render the
VEGF polymorphisms useful in the clinical genetics of kidney transplantation.
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Affiliation(s)
- Thanee Eiamsitrakoon
- Chulabhorn International College of Medicine, Thammasat University, Rangsit, Pathumthani, 12121, Thailand
| | - Phuntila Tharabenjasin
- Chulabhorn International College of Medicine, Thammasat University, Rangsit, Pathumthani, 12121, Thailand
| | - Noel Pabalan
- Chulabhorn International College of Medicine, Thammasat University, Rangsit, Pathumthani, 12121, Thailand
| | - Hamdi Jarjanazi
- Environmental Monitoring and Reporting Branch, Ontario Ministry of the Environment, Conservation and Parks, Toronto, Ontario, M5T 3L9, Canada
| | - Adis Tasanarong
- Nephrology Unit, Faculty of Medicine, Thammasat University, Rangsit, Pathumthani, 12121, Thailand
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Hirata RDC, Genvigir FDV, Hirata TDC, Cerda A, Hirata MH. Pharmacogenomics of mycophenolic acid in kidney transplantation: Contribution of immune response-related genes. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e201188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Bogacz A, Wolek M, Sieńko J, Czerny B, Machaliński B, Olbromski P, Kotowski M. Influence of TGFB1 and CTLA4 polymorphisms on calcineurin inhibitors dose and risk of acute rejection in renal transplantation. Sci Rep 2021; 11:17531. [PMID: 34475433 PMCID: PMC8413317 DOI: 10.1038/s41598-021-96457-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/29/2021] [Indexed: 11/09/2022] Open
Abstract
Organ transplant is often the treatment of choice as it extends and improves patient life. Immunosuppressive treatment, which prevents acute rejection of the organ, is used in transplant patients to prevent the loss of transplant. The aim of the study was to determine the impact of the CTLA4 (+49A>G, rs231775) and the TGF-β1 (-800G>A, rs1800468) polymorphisms on the therapeutic effect of immunosuppressive drugs (cyclosporine-CsA, tacrolimus-TAC) and the risk of acute rejection in renal transplant patients. The analysis of the CTLA4 +49A>G and the TGF-β1 -800G>A polymorphisms was carried out in 392 patients after kidney transplant using real-time PCR. The CTLA4 +49A>G polymorphism did not affect CsA or TAC dose, ratio of drug concentration to dose (C/D), and blood concentrations. As for the TGF-β1 -800G>A polymorphism, patients with the GA genotype required lower TAC doses compared to the GG genotype (TAC 12 h: 3.63 mg vs 5.3 mg, TAC 24 h: 2.38 mg vs 3.29 mg). Comparing the C/D ratio in both groups (TAC 12 h and TAC 24 h), higher C/D ratio was observed in patients with the GA genotype. These results indicate that patients with the A allele require slightly lower doses of TAC. The results suggest that the TGF-β1 -800 G>A polymorphism may influence the TAC dose, while the +49A>G polymorphism of the CTLA4 gene does not correlate with the dose of CsA or TAC. The analysis of the biochemical parameters of the renal profile showed no impact of the CTLA4 and the TGF-β1 polymorphisms on the risk of organ rejection.
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Affiliation(s)
- Anna Bogacz
- Department of Stem Cells and Regenerative Medicine, Institute of Natural Fibres and Medicinal Plants, Wojska Polskiego 71b, 60-630, Poznan, Poland. .,Department of Histocompatibility with Laboratory of Genetic Diagnostics, Regional Blood Center, Marcelińska 44, 60-354, Poznan, Poland.
| | - Marlena Wolek
- Department of Stem Cells and Regenerative Medicine, Institute of Natural Fibres and Medicinal Plants, Wojska Polskiego 71b, 60-630, Poznan, Poland
| | - Jerzy Sieńko
- Department of General Surgery and Transplantation, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111, Szczecin, Poland
| | - Bogusław Czerny
- Department of Stem Cells and Regenerative Medicine, Institute of Natural Fibres and Medicinal Plants, Wojska Polskiego 71b, 60-630, Poznan, Poland.,Department of General Pharmacology and Pharmacoeconomics, Pomeranian Medical University, Żołnierska 48, 71-230, Szczecin, Poland
| | - Bogusław Machaliński
- Department of General Pathology, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111, Szczecin, Poland
| | - Piotr Olbromski
- Clinic of Operational Gynecology, Poznan University of Medical Sciences, Polna 33, 60-535, Poznan, Poland
| | - Maciej Kotowski
- Department of General Surgery and Transplantation, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111, Szczecin, Poland.,Department of General Pathology, Pomeranian Medical University, Powstańców Wlkp. 72, 70-111, Szczecin, Poland
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Santiago JL, Sánchez-Pérez L, Pérez-Flores I, de la Higuera MAM, Romero NC, Querol-García J, Urcelay E, Sánchez-Fructuoso AI. Association of Polymorphisms in T-Cell Activation Costimulatory/Inhibitory Signal Genes With Allograft Kidney Rejection Risk. Front Immunol 2021; 12:650979. [PMID: 34149691 PMCID: PMC8206554 DOI: 10.3389/fimmu.2021.650979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/18/2021] [Indexed: 12/31/2022] Open
Abstract
The genes CD28, CD86 and CTLA-4 conform the costimulatory (CD28-CD86) or inhibitory (CTLA-4-CD86) signal in T-cell activation. T-cell immune response has a critical role in allograft rejection, and single nucleotide polymorphisms (SNPs) located in these genes have been widely analyzed with controversial results. We analyzed a group of SNPs located in the three genes: CD28: rs3116496; CD86: rs1129055; and CTLA-4: rs231775 and rs3087243 in a cohort of 632 consecutively recruited kidney transplanted subjects. All polymorphisms were genotyped by TaqMan chemistry and the diagnosis of rejection was confirmed by biopsy and categorized according to the Banff classification. The analyses showed a statistically significant protective effect to T cell-mediated rejection (TCMR) in carriers of the CTLA-4 rs3087243*G allele, especially in patients with TCMR Banff ≥2 in the overall cohort and in patients without thymoglobulin induction therapy. Both associations were corroborated as independent factors in the multivariate analysis. Interestingly, associations with rejection were not found for any SNP in patients with thymoglobulin induction therapy. As expected, considering the major role of these genes in T-cell activation, no effect was observed for antibody-mediated rejection (ABMR). In conclusion, the SNP rs3087243 located in the CTLA-4 gene may be considered a useful independent biomarker for TCMR risk especially for severe TCMR in patients who did no received thymoglobulin induction therapy.
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Affiliation(s)
- Jose Luis Santiago
- Lab. Genetics and Molecular Basis of Complex Diseases, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, IdISSC, Madrid, Spain
- Immunology Department, Hospital Fundación Jiménez-Díaz, Madrid, Spain
| | - Luis Sánchez-Pérez
- Lab. Genetics and Molecular Basis of Complex Diseases, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Isabel Pérez-Flores
- Nephrology Department Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense de Madrid, IdISSC, Madrid, Spain
| | | | - Natividad Calvo Romero
- Nephrology Department Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense de Madrid, IdISSC, Madrid, Spain
| | - Javier Querol-García
- Lab. Genetics and Molecular Basis of Complex Diseases, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Elena Urcelay
- Lab. Genetics and Molecular Basis of Complex Diseases, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Ana Isabel Sánchez-Fructuoso
- Nephrology Department Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense de Madrid, IdISSC, Madrid, Spain
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Eiamsitrakoon T, Tharabenjasin P, Pabalan N, Tasanarong A. Influence of Interferon Gamma +874 T>A (rs2430561) Polymorphism on Renal Allograft Rejection: A Meta-analysis. Transplant Proc 2020; 53:897-905. [PMID: 33010936 DOI: 10.1016/j.transproceed.2020.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Reported associations of the interferon gamma (IFNG) +874T/A (rs2430561) polymorphism with post-kidney transplantation allograft rejection (AR) have been inconsistent, prompting a meta-analysis to obtain more precise estimates. METHODS Eighteen articles (22 studies) were included in the meta-analysis. Operating on the hypothesis that IFNG rs2430561 either increases or reduces AR risk, we used a genetic model-free approach to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Subgrouping was based on ethnicity (white, Middle Eastern, black, and mixed) and rejection type (ACR: acute rejection and CHR: chronic rejection). Quality of the associative effects was assessed with sensitivity treatment and test for publication bias. RESULTS The overall analysis in the dominant model indicated increased risk (OR = 1.26; Pa = .02) was validated in the ACR subgroup (OR = 1.29; Pa = .01), which contrasted with the CHR subgroup, with a nonsignificant effect indicating reduced risk (OR = 0.83; Pa = .68). Only the black subgroup showed significant increased risk (OR = 2.87; Pa = .04), but the association was tenuous on account of low sample size (n = 2) and imprecise effect (95% CI, 1.07-7.73). CONCLUSIONS Increased risk associations (overall and ACR) of IFNG rs2430561 with AR is significant, robust, statistically powered, and lacking bias. Contrasting ACR (1.3-fold increased risk) and CHR (7% protective) effects may be clinically relevant in the genetics of renal transplantation.
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Affiliation(s)
- T Eiamsitrakoon
- Chulabhorn International College of Medicine, Thammasat University, Rangsit, Pathumthani, Thailand; Nephrology Unit, Faculty of Medicine, Thammasat University, Rangsit, Pathumthani, Thailand
| | - P Tharabenjasin
- Chulabhorn International College of Medicine, Thammasat University, Rangsit, Pathumthani, Thailand.
| | - N Pabalan
- Chulabhorn International College of Medicine, Thammasat University, Rangsit, Pathumthani, Thailand
| | - A Tasanarong
- Chulabhorn International College of Medicine, Thammasat University, Rangsit, Pathumthani, Thailand; Nephrology Unit, Faculty of Medicine, Thammasat University, Rangsit, Pathumthani, Thailand
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8
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El-Abd SF, Badr Eldin NM, Mahmoud Elwasif S, Ahmed NAS, El-Shafey ES, Elsherbiny E. Impact of Proinflammatory Cytokine Gene Polymorphisms and Circulating CD3 on Long-Term Renal Allograft Outcome in Egyptian Patients. Immunol Invest 2020; 50:1072-1084. [PMID: 32799719 DOI: 10.1080/08820139.2020.1804398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The extant study aimed to explore the influence of two cytokines TNF-α - 308 and IFN-γ + 874 gene polymorphism on development of renal transplant rejection and to investigate the feasibility of Th1 cytotoxic immune reaction (CD3). It includes 152 kidney recipients were divided into two subgroups: 76 stable graft functions (SGF) and 76 allograft dysfunctions (AD) compared with 56 healthy individuals as control group. TNF-α - 308 G > A and IFN-γ + 874 A > T genetic polymorphisms were characterized using ARMS-PCR technique. CD3 protein expression was measured using ELISA Kit. The effect on transplant outcome was analyzed where, statistically significant differences of TNF-a-308 G/A were observed between AD group when compared to SGF group (OR = 0.296, 95% CI = 0.091-0.965, p = .031) in AG genotype (intermediate producer genotype). Also, AD group displayed a statistically significant increase of IFN-γ + 874 TT (high producer genotype) when compared to SGF group (OR = 0.290, 95% CI = 0.127-0.665, p = .003). The expression of CD3+ T lymphocytes in recipients with allograft dysfunction was statistically higher than that with stable allograft function and control groups (732 ± 76, 235 ± 51 and 442 ± 50) respectively and (p ≤ 0.001). In conclusion, IFN-γ + 874 T and TNF-α - 308 A alleles are risk alleles for renal transplant rejection and these two single nucleotide polymorphisms (SNPs) may be implicated in the tendency of rejection after renal transplantation. CD3 may be used as non-invasive biomarker in monitoring of rejection and avoid exposing patients for biopsy risks and sampling error.
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Affiliation(s)
- Sabah Farouk El-Abd
- Molecular Biology Department, The Institute of Genetic Engineering and Biotechnology, University of Sadat City, Sadat City, Egypt
| | | | - Salwa Mahmoud Elwasif
- Renal Transplantation and Dialysis Unit, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Nora Abdel Sameaa Ahmed
- Molecular Biology Department, The Institute of Genetic Engineering and Biotechnology, University of Sadat City, Sadat City, Egypt
| | - Eman Salah El-Shafey
- Biochemistry Department, Faculty of Science, Damietta University, Damietta, Egypt
| | - Eslam Elsherbiny
- Biochemistry Department, Faculty of Science, Damietta University, Damietta, Egypt
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9
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CTLA-4 rs231775 and risk of acute renal graft rejection: an updated meta-analysis with trial sequential analysis. Sci Rep 2020; 10:12850. [PMID: 32732985 PMCID: PMC7393166 DOI: 10.1038/s41598-020-69849-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 07/21/2020] [Indexed: 01/19/2023] Open
Abstract
Contrasting results exist on the association between CTLA-4 rs231775 and acute rejection in kidney transplant recipients. We herein conducted an updated systematic review with meta-analysis and trial sequential analysis (TSA) to clarify this relationship and to establish whether the current evidence is sufficient to draw firm conclusions. In addition, noteworthiness of significant pooled odds ratios (ORs) was estimated by false positive report probability (FPRP). A comprehensive search was performed through PubMed, Web of Knowledge, Cochrane Library and Open Grey up to October 2019. Fifteen independent cohorts, including a total of 5,401 kidney transplant recipients, were identified through the systematic review. Overall, no association was detected with the allelic (OR 1.07, 95% CI 0.88-1.30, P = 0.49), dominant (OR 0.94, 95% CI 0.73-1.22, P = 0.66) or the recessive (OR 1.18, 95% CI 0.97-1.43, P = 0.096) model of CTLA-4 rs231775. In each genetic model, the cumulative Z-curve in TSA crossed the futility boundary and entered the futility area. In addition, none of the significant genetic comparisons detected in the subsequent and sensitivity analyses or in previously reported meta-analyses were found to be noteworthy by FPRP. In conclusion, this study provides strong evidence that CTLA-4 rs231775 is not a clinically-relevant genetic risk determinant of acute rejection after renal transplantation.
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10
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Li HY, Zhou T, Lin S, Lin W. Relationship between TGF-β1 + 869 T/C and + 915 G/C gene polymorphism and risk of acute rejection in renal transplantation recipients. BMC MEDICAL GENETICS 2019; 20:113. [PMID: 31238890 PMCID: PMC6593503 DOI: 10.1186/s12881-019-0847-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 06/10/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND This meta-analysis was conducted to assess the relationship between the transforming growth factor-beta 1 (TGF-β1) + 869 T/C gene polymorphism, + 915 G/C gene polymorphism, and the susceptibility of acute rejection in the recipients with renal transplantation. METHODS Relevant studies were searched and identified from the Cochrane Library and PubMed, and eligible investigations were recruited and data were calculated by meta-analysis. RESULTS In this study, we found no relationship between either TGF-β1 + 869 T/C or TGF-β1 + 915 G/C gene polymorphism and acute rejection susceptibility in patients with renal transplantation. No association between either gene polymorphism and acute rejection susceptibility in patients with renal transplantation in Caucasian, Asian, or African populations individually was found. CONCLUSION The TGF-β1 + 869 T/C and + 915 G/C gene polymorphisms are not associated with acute rejection susceptibility in recipients with renal transplantation.
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Affiliation(s)
- Hong-Yan Li
- Department of Nephrology, Huadu District People’s Hospital of Guangzhou, Huadu Hospital of Southern Medical University, 510800, No 22 Baohua Road, Guangzhou, China
| | - Tianbiao Zhou
- Department of Nephrology, the Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041 China
| | - Shujun Lin
- Department of Nephrology, the Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041 China
| | - Wenshan Lin
- Department of Nephrology, the Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041 China
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11
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Yang CH, Chen XX, Chen L, Zheng DH, Liu QS, Xie WF, Zhou TB, Drummen GPC. Relationship between cytotoxic T-lymphocyte antigen 4 -318C/T (rs5742909) gene polymorphism and the risk of acute rejection in renal transplantation. Pediatr Transplant 2017; 21. [PMID: 28449371 DOI: 10.1111/petr.12920] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 01/17/2023]
Abstract
Results on the relationship between CTLA4 -318C/T (rs5742909) gene polymorphism and risk of acute rejection in renal transplantation are still conflicting. This meta-analysis was performed to update the association between CTLA4 -318C/T and risk of acute rejection in renal transplantation. The association investigations were identified from PubMed and Cochrane Library, and eligible studies were included and synthesized using meta-analysis method. Twelve reports were included in this meta-analysis for the association of CTLA4 -318C/T gene polymorphism with acute rejection risk in renal transplantation, consisting of 728 acute rejection patients and 1628 non-acute rejection controls. The association between CTLA4 -318C/T gene polymorphism and acute rejection risk in renal transplantation for overall populations was not found in this meta-analysis (T allele: OR=0.96, 95% CI: 0.60-1.54, P=.88; TT genotype: OR=0.90, 95% CI: 0.47-1.71, P=.74; CC genotype: OR=1.00, 95% CI: 0.62-1.59, P=.98). Interestingly, T allele was associated with the risk of acute rejection in renal transplantation in African population. In conclusion, CTLA4 -318C/T gene polymorphism is not associated with the risk of acute rejection in renal transplantation in overall populations.
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Affiliation(s)
- Chun-Hua Yang
- Department of Emergency, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xue-Xia Chen
- Department of Critical Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Li Chen
- Department of Critical Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dong-Hua Zheng
- Department of Critical Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiong-Shan Liu
- Department of Critical Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wen-Feng Xie
- Department of Critical Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tian-Biao Zhou
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Gregor P C Drummen
- Cellular Stress and Ageing Program, Bionanoscience and Bio-Imaging Program, Bio&Nano-Solutions, Düsseldorf, Germany
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12
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Duff CE, Simmonds MJ. Genetic predictors of long-term graft function in kidney and pancreas transplant patients. Brief Funct Genomics 2017; 16:228-237. [PMID: 28110269 DOI: 10.1093/bfgp/elw039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Kidney and pancreas transplantation have helped transform the lives of people with end-stage renal failure and individuals with type 1 diabetes who have poor glycaemic control/severe secondary complications, respectively. Despite an improvement in immunosuppressive regimes, operative techniques and decreased initial rejection rates, there has been little improvement in long-term graft survival rates over the past decade. Whilst limited progress has been made in establishing clinical markers of graft function, several genetic markers of long-term graft function have been identified. These genetic markers have the potential to (i) assist in selecting marginal donor organs for transplantation, (ii) provide better understanding of the mechanisms behind graft loss enabling identification of new, or repurposing, current treatments to extend graft function and (iii) provide a window of opportunity to identify and treat individuals before graft failure has occurred. This review will discuss the different genetic variants screened for a role in predicting transplant longevity, examine their findings and limitations and introduce where the future of genetic research within the transplantation field lies.
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Liu K, Gu S, Liu X, Sun Q, Wang Y, Meng J, Xu Z. Impact of inducible co-stimulator gene polymorphisms on acute rejection in renal transplant recipients: An updated systematic review and meta-analysis. Meta Gene 2017. [DOI: 10.1016/j.mgene.2017.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Yang CH, Chen XX, Chen L, Zheng DH, Liu QS, Xie WF. Association of cytotoxic T-lymphocyte antigen 4 +49A/G gene polymorphism with acute rejection risk in renal transplantation. Pediatr Transplant 2017; 21. [PMID: 28333403 DOI: 10.1111/petr.12916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2017] [Indexed: 12/27/2022]
Abstract
The conclusions on the association between cytotoxic T-lymphocyte antigen 4 (CTLA4) +49A/G gene polymorphism and acute rejection risk in renal transplantation are still debated. This meta-analysis was performed to update the association between CTLA4 +49A/G and acute rejection risk in renal transplantation. The association investigations were identified from PubMed and Cochrane Library, and eligible studies were included and synthesized using meta-analysis method. Fourteen reports were included into this meta-analysis for the association of CTLA4 A/G gene polymorphism and acute rejection risk in renal transplantation, consisting of 962 acute rejection patients and 2084 non-acute rejection controls. The association between CTLA4 G allele/GG genotype and acute rejection risk in renal transplantation was found in this meta-analysis (G allele: OR=1.21, 95% CI: 1.03-1.44, P=.02; GG genotype: OR=1.37, 95% CI: 1.10-1.69, P=.004). However, the AA genotype was not associated with acute rejection risk in renal transplantation. In conclusion, CTLA4 G allele/GG genotype is associated with the acute rejection risk in renal transplantation.
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Affiliation(s)
- Chun-Hua Yang
- Department of Emergency, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xue-Xia Chen
- Department of Critical Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Li Chen
- Department of Critical Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dong-Hua Zheng
- Department of Critical Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiong-Shan Liu
- Department of Critical Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wen-Feng Xie
- Department of Critical Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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The Polymorphism -308G/A of Tumor Necrosis Factor-α Gene Modulates the Effect of Immunosuppressive Treatment in First Kidney Transplant Subjects Who Suffer an Acute Rejection. J Immunol Res 2016; 2016:2197595. [PMID: 27777962 PMCID: PMC5061951 DOI: 10.1155/2016/2197595] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/01/2016] [Accepted: 09/15/2016] [Indexed: 11/17/2022] Open
Abstract
The -308G/A SNP of tumor necrosis factor-alpha (TNF-α) gene affects TNF-α production. As its impact on transplant outcome remains open to debate, we decided to genotype it in a cohort of transplant subjects. A retrospective analysis of 439 first kidney recipients randomly divided into two subgroups (discovery and validation cohorts) was performed to identify the best predictors of acute rejection (AR). The effect on transplant outcome was analyzed by an adjusted logistic regression model. Carriers of the A allele, associated with elevated TNF-α production, presented a higher risk of AR (OR = 2.78; 95% CI = 1.40-5.51). Logistic regression analyses for AR showed an interaction between the polymorphism and treatment with thymoglobulin (p-interaction = 0.03). In recipients who did not receive thymoglobulin, carriers of A allele had higher risk of AR (OR = 4.05; 95% CI = 1.76-9.28). Moreover, carriers of A allele not treated with thymoglobulin presented higher risk of AR than those who received thymoglobulin (OR = 13.74; 95% CI = 1.59-118.7). The AUC of the model in the discovery cohort was 0.70 and in the validation cohort was 0.69. Our findings indicate that the -308G/A TNF-α polymorphism is associated with AR risk and it modulates the effectiveness of thymoglobulin treatment. This pharmacogenetic effect lets us propose this SNP as a useful predictor biomarker to tailor immunosuppressive regimens.
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Stojanova J, Pouché L, Picard N. Genetic polymorphisms in the immune response: A focus on kidney transplantation. Clin Biochem 2016; 49:363-76. [DOI: 10.1016/j.clinbiochem.2015.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/04/2015] [Accepted: 07/08/2015] [Indexed: 02/06/2023]
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Hu Q, Tian H, Wu Q, Li J, Cheng X, Liao P. Interleukin-10-1082 G/a polymorphism and acute renal graft rejection: a meta-analysis. Ren Fail 2015; 38:57-64. [PMID: 26524497 DOI: 10.3109/0886022x.2015.1106770] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the association between interleukin (IL)-10-1082 (G/A) promoter polymorphism and acute rejection (AR) in renal transplant recipients. METHODS We searched MEDLINE, EMBASE, Web of Science, and Cochrane Central Register from the inception to March 2015 for relevant studies. Data concerning publication information, population characteristics, and transplant information were extracted. Odds ratios (ORs) was calculated for the association between IL-10-1082 GG genotype (or IL-10-1082 G allele) and AR risk. RESULTS This meta-analysis included 22 case-control studies including 2779 cases of renal transplant recipients. The pooled estimate showed that the IL-10-1082 GG genotype was not significantly associated with AR risk (ORrandom=1.07, 95% CI 0.80-1.43, p = 0.64). Similarly, the pooled estimate showed that the IL-10-1082 G allele was not significantly associated with AR risk (ORfixed=1.02, 95% CI 0.90-1.16, p = 0.74). None of subgroup analyses yielded significant results in the association between IL-10-1082 GG genotype (or IL-10-1082 G allele) and AR risk. Meta-regression confirmed that there was no significant correlation between the pre-selected trial characteristics and our study results. CONCLUSIONS This meta-analysis suggests that IL-10-1082 G/A polymorphism is not significantly associated with AR risk in renal transplant recipients.
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Affiliation(s)
- Qiongwen Hu
- a Chongqing Center for Clinical Laboratory, The Third People's Hospital of Chongqing , Chongqing , China and
| | - Hua Tian
- a Chongqing Center for Clinical Laboratory, The Third People's Hospital of Chongqing , Chongqing , China and
| | - Qing Wu
- a Chongqing Center for Clinical Laboratory, The Third People's Hospital of Chongqing , Chongqing , China and
| | - Jun Li
- a Chongqing Center for Clinical Laboratory, The Third People's Hospital of Chongqing , Chongqing , China and
| | - Xiaocheng Cheng
- b Department of Cardiology , Banan People's Hospital of Chongqing , Chongqing , China
| | - Pu Liao
- a Chongqing Center for Clinical Laboratory, The Third People's Hospital of Chongqing , Chongqing , China and
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Ruhi Ç, Sallakçi N, Yeğin O, Süleymanlar G, Ersoy FF. The influence of CTLA-4 single nucleotide polymorphisms on acute kidney allograft rejection in Turkish patients. Clin Transplant 2015; 29:612-8. [PMID: 25981560 DOI: 10.1111/ctr.12563] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2015] [Indexed: 01/06/2023]
Abstract
Cytotoxic T-lymphocyte antigen-4 (CTLA-4) is a cell surface protein, which down-regulates the immune response at CTLA-4/CD28/B7 pathway. We aimed to investigate the influence of the -318 C/T, +49 A/G, -1661 A/G and CT60A/G, and CTLA-4 gene polymorphisms on acute rejection of kidney allograft in Turkish patients. The study design was a case-control study that consists of three groups: Group 1 (n = 34) represented the kidney transplant (Ktx) recipients who experienced acute rejection, Group 2 (n = 47) was randomly assigned Ktx recipients without acute rejection, and Group 3 (n = 50) consisting of healthy volunteers to evaluate the normal genomic distribution. The polymerase chain reaction-restriction fragment length polymorphism technique was used to determine the polymorphisms. Genotype and allele frequencies among three groups denoted similar distributions for +49 A/G, -1661 A/G, and CT60A/G. Conversely, -318 C/T genotype was three times more frequent in the acute rejection group than in the non-rejection group (OR = 3.45; 95%CI = 1.18-10.1, p = 0.015) and two times more frequent than the healthy control group (OR = 2.45; 95% CI = 0.98 - 6.11, p = 0.047). Additionally, having a T allele at -318 position was significantly associated with acute rejection (0.147 vs. 0.043, OR = 3.45; 95% CI = 1.13-10.56, p = 0.02). 318C/T gene polymorphism and T allelic variant were found to be associated with increased acute rejection risk in Turkish kidney allograft recipients.
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Affiliation(s)
- Çağlar Ruhi
- Transplantation Center and Health Sciences Research Center, Akdeniz University Medical School, Antalya, Turkey
| | - Nilgün Sallakçi
- Transplantation Center and Health Sciences Research Center, Akdeniz University Medical School, Antalya, Turkey
| | - Olcay Yeğin
- Transplantation Center and Health Sciences Research Center, Akdeniz University Medical School, Antalya, Turkey
| | - Gültekin Süleymanlar
- Transplantation Center and Health Sciences Research Center, Akdeniz University Medical School, Antalya, Turkey
| | - F Fevzi Ersoy
- Transplantation Center and Health Sciences Research Center, Akdeniz University Medical School, Antalya, Turkey
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Xiong J, Wang Y, Zhang Y, Nie L, Wang D, Huang Y, Feng B, Zhang J, Zhao J. Lack of Association between Interleukin-10 Gene Polymorphisms and Graft Rejection Risk in Kidney Transplantation Recipients: A Meta-Analysis. PLoS One 2015; 10:e0127540. [PMID: 26035439 PMCID: PMC4452718 DOI: 10.1371/journal.pone.0127540] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 04/16/2015] [Indexed: 12/21/2022] Open
Abstract
Background Interleukin-10 (IL-10) is an important immunomodulatory cytokine. Several studies focused the association between IL-10 promoter gene polymorphisms and graft rejection risk in kidney transplantation recipients. However, the results of these studies remain inconclusive. The aim of this study was to conduct a meta-analysis to further assess the associations. Methods The PubMed, Embase, and Ovid Medline databases were searched. Two independent authors extracted data, and the effects were estimated from an odds ratio (OR) with 95% confidence intervals (CIs). Subgroup and sensitivity analyses identified sources of heterogeneity. Results A total of 16 studies including 595 rejection patients and 1239 stable graft patients were included in order to study the IL-10 -1082 (rs1800896 G/A), -819 (rs1800871 C/T), -592 (rs1800872 C/A) and IL-10 (-1082,-819,-592) polymorphisms. The -1082 G/A polymorphism was not associated with an increased graft rejection risk (OR = 1.03; 95%CI, 0.85–1.25, P = 0.74 for GA+AA vs. GG model). Moreover, all of the -819 C/T (OR = 1.06, 95%CI, 0.79–1.42, P = 0.70 for TA+TT vs. CC model), -592 C/A (OR = 1.10, 95% CI, 0.85–1.42, P = 0.47 for AC+AA vs. CC model) and IL-10 (-1082,-819,-592) polymorphisms (OR = 1.00, 95%CI, 0.79–1.27, P = 0.98 for I+L vs. H model) did not increase the graft rejection risk. In addition, we also performed subgroup analysis by ethnic group (mainly in Europeans or Asians) and rejection type (acute or chronic). There was also lack of evidence of a significant association between the IL-10 gene polymorphism and graft rejection risk. The present meta-analysis indicated that the IL-10 gene polymorphism was not associated with graft rejection risk in kidney transplantation recipients. Conclusion This meta-analysis found evidence that the IL-10 polymorphism does not increase the risk of graft rejection in kidney transplantation recipients. Further chronic rejection and other ethnic population studies are needed to confirm our results.
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Affiliation(s)
- Jiachuan Xiong
- Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Yiqin Wang
- Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Ying Zhang
- Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Ling Nie
- Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Daihong Wang
- Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Yunjian Huang
- Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Bing Feng
- Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Jingbo Zhang
- Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Jinghong Zhao
- Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China
- * E-mail:
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Are polymorphisms of the immunoregulatory factor CD40LG implicated in acute transfusion reactions? Sci Rep 2014; 4:7239. [PMID: 25430087 PMCID: PMC5384113 DOI: 10.1038/srep07239] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 11/07/2014] [Indexed: 12/11/2022] Open
Abstract
The CD40 ligand (CD40L/CD154), a member of TNF superfamily, is notably expressed on activated CD4+ T-cells and stimulated platelets. CD40L is linked to a variety of pathologies and to acute transfusion reactions (ATR). Mutations in this gene (CD40LG) lead to X-linked hyper-IgM syndrome. Some CD40LG polymorphisms are associated with variable protein expression. The rationale behind this study is that CD40L protein has been observed to be involved in ATR. We wondered whether genetic polymorphisms are implicated. We investigated genetic diversity in the CD40LG using DHPLC and capillary electrophoresis for screening and genotyping (n = 485 French and Tunisian blood donors). We identified significant difference in the CD40LG linkage pattern between the two populations. Variant minor alleles were significantly over-represented in Tunisian donors (P<0.0001 to 0.0270). We found higher heterogeneity in the Tunisian, including three novel low frequency variants. As there was not a particular pattern of CD40LG in single apheresis donors whose platelet components induced an ATR, we discuss how this information may be useful for future disease association studies on CD40LG.
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Gao JW, Zhou ZH, Guo SC, Guo YF, Guo F. A deeper understanding of the association between CTLA4 +49A/G and acute rejection in renal transplantation: an updated meta-analysis. Ren Fail 2014; 37:165-74. [PMID: 25299395 DOI: 10.3109/0886022x.2014.970470] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
To reevaluate the association between the costimulatory molecule cytotoxic T lymphocyte-associated antigen4 (CTLA4) single nucleotide polymorphism (SNP) +49A/G and acute rejection (AR) in renal transplantation, nine studies published before June 2013 were analyzed. Meta-analysis and cumulative meta-analysis (metacum) were performed for each genotype in a random/fixed effect model. The combined odds ratios (OR) with 95% confidence intervals (CI) were calculated to estimate the strength of the association. In the sensitivity analysis, a single study involved in the meta-analysis was deleted each time to investigate the influence of the individual data sets on the pooled ORs. Meta-analysis regression was used for some influence factors, such as year of publication, total number in each group (AR group and control group), ethnicity, the ratio of GG to GA + AA, the ratio of G to A in CTLA4 +49A/G. Overall, a significant correlation was noted between the CTLA4 SNP (+49A/G) and the risk of AR (for GG vs. AG + AA: OR = 1.35, 95% CI = 1.05-1.73, p = 0.02; for G vs. A: OR = 1.21, 95% CI = 1.03-1.42, p = 0.02), especially in the Asian subgroup (for GG vs. AG + AA: OR = 1.79, 95% CI = 1.15-2.78, p = 0.009; for G vs. A: OR = 1.47, 95% CI = 1.04-2.07, p = 0.03). Of the influence factors, the ratio of GG to GA+AA (p = 0.046) and the ratio of G to A (p = 0.017) were significant factors. In conclusion, our results suggest that CTLA4 +49A/G contribute to the risk of AR following renal transplantation.
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Affiliation(s)
- Jun-Wei Gao
- Department of Clinical Pharmacy, Shanghai First People's Hospital, Shanghai Jiao Tong University , Shanghai , China
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TNF receptors: signaling pathways and contribution to renal dysfunction. Kidney Int 2014; 87:281-96. [PMID: 25140911 DOI: 10.1038/ki.2014.285] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 02/28/2014] [Accepted: 03/06/2014] [Indexed: 12/19/2022]
Abstract
Tumor necrosis factor (TNF), initially reported to induce tumor cell apoptosis and cachexia, is now considered a central mediator of a broad range of biological activities from cell proliferation, cell death and differentiation to induction of inflammation and immune modulation. TNF exerts its biological responses via interaction with two cell surface receptors: TNFR1 and TNFR2. (TNFRs). These receptors trigger shared and distinct signaling pathways upon TNF binding, which in turn result in cellular outputs that may promote tissue injury on one hand but may also induce protective, beneficial responses. Yet the role of TNF and its receptors specifically in renal disease is still not well understood. This review describes the expression of the TNFRs, the signaling pathways induced by them and the biological responses of TNF and its receptors in various animal models of renal diseases, and discusses the current outcomes from use of TNF biologics and TNF biomarkers in renal disorders.
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Stromal cell-derived factor 1 gene polymorphism is associated with susceptibility to adverse long-term allograft outcomes in non-diabetic kidney transplant recipients. Int J Mol Sci 2014; 15:12495-506. [PMID: 25029540 PMCID: PMC4139856 DOI: 10.3390/ijms150712495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 06/30/2014] [Accepted: 07/01/2014] [Indexed: 11/16/2022] Open
Abstract
Although the genetic polymorphism of Stromal Cell-Derived Factor 1 (SDF-1) is associated with higher mortality of liver allograft recipients, the role of SDF-1 in the modulation of renal allograft outcomes is unclear. Between March 2000 and January 2008, we recruited 252 non-diabetic renal transplant recipients (RTRs). Baseline characteristics and blood chemistry were recorded. Genomic DNA extraction with polymerase chain reaction-restriction fragment length polymorphism was utilized to analyze the genetic polymorphisms of SDF-1 (rs1801157). The influence of SDF-1 on an adverse renal allograft outcome, defined as either a doubling of serum creatinine, graft failure, or patient death was evaluated. Sixteen patients with the SDF-1 AA/AG genotype and nine with the SDF-1 GG genotype reached an adverse outcome. According to Kaplan-Meier analysis, patients carrying the SDF-1 AA/AG genotype or A allele showed a significantly higher risk of reaching an adverse outcome than those carrying the SDF-1 GG genotype or G allele (p=0.041; p=0.0051, respectively; log rank test). Stepwise multivariate Cox proportional regression analysis revealed that patients carrying the SDF-1 AA/AG genotype and A allele had a 2.742-fold (95% CI. 1.106-6.799, p=0.03) and 2.306-fold (95% CI. 1.254-4.24, p=0.008) risk of experiencing an adverse outcome. The SDF-1 AA/AG genotype and A allele have a detrimental impact on the long-term outcome of RTRs.
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Karimi MH, Ebadi P, Pourfathollah AA. Association of cytokine/costimulatory molecule polymorphism and allograft rejection: a comparative review. Expert Rev Clin Immunol 2014; 9:1099-112. [PMID: 24168415 DOI: 10.1586/1744666x.2013.844462] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
One reason for genetic variations among human individuals is SNP which may confer diverse disease susceptibility or resistance in a population. Genetic variations in a key immunoregulatory agent can manifest various immunological responses, such as graft rejection. In fact, the outcome of organ transplantation can be impacted by several genetic causes including polymorphisms in genes encoding cytokines and costimulatory molecules in the donor or recipient. Thus, it can be helpful to contemplate the SNPs relating to these immunological determinants in order to achieve an improved transplantation therapy.
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Affiliation(s)
- Mohammad H Karimi
- Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Han FF, Fan H, Wang ZH, Li GR, Lv YL, Gong LL, Liu H, He Q, Liu LH. Association between co-stimulatory molecule gene polymorphism and acute rejection of allograft. Transpl Immunol 2014; 31:81-6. [PMID: 24952299 DOI: 10.1016/j.trim.2014.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 06/09/2014] [Accepted: 06/11/2014] [Indexed: 01/13/2023]
Abstract
Co-stimulatory molecules play important roles in T cell-mediated immune response and transplantation. Numerous epidemiological studies have evaluated the association between CD28, CTLA-4 gene variant and allograft rejection. However, the results of these studies on the association remain conflicting. The main purpose of this study was to integrate previous results and explore whether the CD28 IVS3 +17T/C variant, CTLA-4, CD86 and PDCD1 gene polymorphisms were associated with allograft rejection susceptibility. PubMed and Embase (before 2014-3-25), were searched for studies on the relationship of CD28, CTLA-4, CD86 and PDCD1 gene polymorphisms and the incidence of allograft rejection susceptibility. Eligible articles were included for data extraction. The main outcome was the frequency of co-stimulate molecule gene polymorphisms between rejection and non-rejection populations. Comparison of the distribution of SNP was mainly performed using Review Manager 5.0. The odds ratio (OR) and its 95% confidence interval (95% CI) were used to assess the strength of association. Significant associations of the CD28 IVS3 +17T/C variant with acute allograft rejection susceptibility were found (CC +CT/TT OR, 1.45; 95% CI, 1.08-1.94; P=0.01). Also we found an association of the CD28 IVS3 +17T/C variant with kidney allograft rejection cases (CC +CT/TT OR, 1.72; 95% CI, 1.19-2.49; P=0.004) and (C allele OR, 1.74; 95% CI, 1.11-2.75; P=0.02), but not established for liver allograft rejection cases (CC +CT/TT OR, 1.19; 95% CI, 0.47-2.98; P=0.72) and (C allele OR, 0.96; 95% CI, 0.67-1.39; P=0.84). And we found an association of the CD86 +1057G/A variant with non-allograft rejection cases (AA +AG/GG OR, 0.35; 95% CI, 0.14-0.85; P=0.02). This meta-analysis demonstrates that the CD28 IVS3 +17T/C variant might increase acute allograft rejection risk in kidney transplant but not in liver transplant, and there was an association between CD86 +1057G/A variant and reduced acute rejection risk. Further studies will be needed to confirm our findings.
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Affiliation(s)
- Fei-Fei Han
- Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Hua Fan
- Hepatobiliary Surgery Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Zi-Hui Wang
- Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Guang-Run Li
- Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Ya-Li Lv
- Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Li-Li Gong
- Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - He Liu
- Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Qiang He
- Hepatobiliary Surgery Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
| | - Li-Hong Liu
- Pharmacy Department of Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
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Chen Z, Bouamar R, Van schaik RH, De Fijter JW, Hartmann A, Zeier M, Budde K, Kuypers DR, Weimar W, Hesselink DA, Van Gelder T. Genetic polymorphisms inIL-2,IL-10,TGF-β1, andIL-2RBand acute rejection in renal transplant patients. Clin Transplant 2014; 28:649-55. [DOI: 10.1111/ctr.12346] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2014] [Indexed: 01/05/2023]
Affiliation(s)
- Zhigang Chen
- Department of Hospital Pharmacy; Erasmus MC; Rotterdam The Netherlands
- Department of Hospital Pharmacy; Beijing Jishuitan Hospital; Beijing China
| | - Rachida Bouamar
- Department of Hospital Pharmacy; Erasmus MC; Rotterdam The Netherlands
| | | | - Johan W. De Fijter
- Department of Nephrology; Leiden University Medical Centre; Leiden The Netherlands
| | - Anders Hartmann
- Department of Transplant Medicine; Oslo University Hospital; Rikshospitalet Norway
| | - Martin Zeier
- Department of Nephrology; University of Heidelberg; Heidelberg Germany
| | - Klemens Budde
- Department of Nephrology; Charité University; Berlin Germany
| | | | - Willem Weimar
- Department of Internal Medicine; Erasmus MC; Rotterdam The Netherlands
| | | | - Teun Van Gelder
- Department of Hospital Pharmacy; Erasmus MC; Rotterdam The Netherlands
- Department of Internal Medicine; Erasmus MC; Rotterdam The Netherlands
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Ge YZ, Wang YD, Xu Z, Xu LW, Wang YP, Gu MH, Ding AX, Zhu XB, Wu R, Li WC, Xu YD, Jia RP. Lack of association between interferon gamma +874 T/A polymorphism and cancer risk: an updated meta-analysis. Tumour Biol 2014; 35:6405-14. [PMID: 24671824 DOI: 10.1007/s13277-014-1861-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 03/18/2014] [Indexed: 01/30/2023] Open
Abstract
Interferon gamma (IFN-γ) is a potent proinflammatory cytokine which plays a pivotal role in the antiviral, antiproliferative, and antitumor activities. A T-to-A transition at the position +874 of human IFN-γ gene (IFNG) has been reported to influence the secretion of IFN-γ and affect cancer susceptibility. However, results from published studies on the association between IFNG +874 T/A polymorphism and cancer risk are inconclusive or even controversial. In order to derive a more precise estimation of the association, a meta-analysis of 38 eligible studies including 5,630 cases and 6,096 controls was conducted with odds ratio (OR) and its corresponding 95 % confidence interval (95 % CI). Overall, no significant association was detected in allelic model (A allele vs. T allele-OR = 0.96, 95 % CI, 0.86-1.08), homozygote comparison (AA vs. TT-OR = 0.97, 95 % CI, 0.79-1.21), heterozygote comparison (AT vs. TT-OR = 1.03, 95 % CI, 0.87-1.23), dominant model (AA + AT vs. TT-OR = 1.00, 95 % CI, 0.87-1.15), nor recessive model (AA vs. AT + TT-OR = 0.93, 95 % CI, 0.78-1.12). Further subgroup analyses based on ethnicity, cancer types, and Hardy-Weinberg equilibrium status failed to demonstrate any significant relationship except in African population under recessive model (AA vs. AT + TT-OR = 0.68, 95 % CI, 0.47-0.97). In conclusion, the current meta-analysis suggested that IFNG +874 T/A polymorphism may not contribute to cancer susceptibility, and further well-designed studies with large sample size are warranted to validate our conclusion.
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Affiliation(s)
- Yu-Zheng Ge
- Department of Urology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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Ge YZ, Yu P, Jia RP, Wu R, Ding AX, Li LP, Zhao Y, Feng YM, Gui ZL, Liao S. Association between transforming growth factor beta-1 +869T/C polymorphism and acute rejection of solid organ allograft: A meta-analysis and systematic review. Transpl Immunol 2014; 30:76-83. [PMID: 24486560 DOI: 10.1016/j.trim.2014.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 01/19/2014] [Accepted: 01/20/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Transforming growth factor beta-1(TGFB1) is involved in the acute rejection (AR) episodes of solid organ transplant recipients. However, results from published studies on the association between donor/recipient TGFB1 +869T/C polymorphism and AR risk are conflicting and inconclusive. METHODS PUBMED, EMBASE, CNKI and Wanfang Database were searched to identify eligible studies investigating the association between donor/recipient TGFB1 +869T/C polymorphism and AR risk. Statistical analysis was performed by using STATA 10.0. RESULTS A total of 29 studies were included. Overall, the donor TGFB1 +869T/C polymorphism was significantly associated with AR risk in heterozygote comparison (CT vs. TT: OR = 1.67, 95%CI, 1.17-2.39; P heterogeneity=0.285) and dominant model (CC vs. TC/TT OR = 1.47, 95%CI, 1.05-2.06; P heterogeneity=0.445). In addition, subgroup analysis revealed that CT variant (CT vs. TT: OR = 1.97, 95%CI, 1.20-3.25; P heterogeneity = 0.777) and CC/CT genotype (CC/CT vs. TT: OR = 1.72, 95%CI, 1.07, 2.78; P heterogeneity = 0.619) within donors contributed to higher risk of AR in recipients administrated with CsA or FK506, compared with those applied only CsA. On the other hand, no significant association between recipient TGFB1 +869T/C polymorphism and AR was detected in all genetic models. CONCLUSIONS This meta-analysis and systematic review suggested that donor TGFB1 +869T/C polymorphism was significantly associated with AR of solid organ transplant recipients, and especially among patients in CsA/FK 506 group compared with those in CsA group.
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Affiliation(s)
- Yu-Zheng Ge
- Department of Urology & Center of Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, China
| | - Peng Yu
- Department of Urology & Center of Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, China
| | - Rui-Peng Jia
- Department of Urology & Center of Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, China.
| | - Ran Wu
- Department of Urology & Center of Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, China
| | - Ai-Xing Ding
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, China
| | - Liang-Peng Li
- Department of Cardiothoracic Surgery, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, China
| | - Yan Zhao
- Department of Urology & Center of Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, China
| | - Yu-Ming Feng
- Department of Urology & Center of Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, China
| | - Zan-Long Gui
- Department of Urology & Center of Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, China
| | - Sheng Liao
- Department of Urology & Center of Renal Transplantation, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, China
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Misra MK, Kapoor R, Pandey SK, Sharma RK, Agrawal S. Association of CTLA-4 gene polymorphism with end-stage renal disease and renal allograft outcome. J Interferon Cytokine Res 2013; 34:148-61. [PMID: 24313821 DOI: 10.1089/jir.2013.0069] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Cytotoxic T-lymphocyte antigen 4 (CTLA-4) is upregulated in effector-T-cells after activation that may alter signal transduction and subsequently cytokine production. The present study was designed to investigate the impact of CTLA-4+49 A>G (rs231775), -318 C>T (rs5742909), -658 C>T (rs11571317), -1147 C>T (rs16840252), -1661 A>G (rs4553808), +6230 A>G (rs3087243) SNPs, and microsatellite (AT)n repeat polymorphism among end-stage renal disease (ESRD), acute allograft rejection (AR), and delayed graft function (DGF) cases. In this regard, 350 ESRD patients and 350 controls were included. Polymerase chain reaction (PCR)-restriction fragment length polymorphism analysis method was used for genotyping of CTLA-4 SNPs, while PCR-polyacrylamide gel electrophoresis method was adopted for studying CTLA4 (AT)n polymorphism. The mutant genotype GG of CTLA-4+49A>G,+6230 A>G, and longer alleles of (AT)n repeats polymorphisms were risk associated with ESRD, AR, and DGF cases. The distribution of haplotype+49G:+6230G and GCTTGG (constructed by using 6 studied SNPs) showed risk association for ESRD, DGF, and AR cases. Further, linkage analysis demonstrated strong to moderate linkage disequilibrium in our study populations. The meta-analysis also revealed risk associations for AR cases against GG genotype of CTLA-4+49A>G SNP, while CTLA-4 -318C>T polymorphism showed no correlation against TT genotype among AR cases. Subsequently, no correlation was established against the CTLA-4 -318C>T, -658 C>T, -1147 C>T, and -1661 A>G SNPs in the promoter region. Survival analysis revealed risk associations against GG genotype of CTLA-4+49A>G, +6230 A>G SNP's with overall survival (OS), and higher hazard for the OS. These results suggested that CTLA-4 variants might be involved in susceptibility to ESRD, AR, and DGF.
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Affiliation(s)
- Maneesh Kumar Misra
- 1 Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow, India
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Tumor necrosis factor receptor 2: its contribution to acute cellular rejection and clear cell renal carcinoma. BIOMED RESEARCH INTERNATIONAL 2013; 2013:821310. [PMID: 24350291 PMCID: PMC3848079 DOI: 10.1155/2013/821310] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 10/15/2013] [Accepted: 10/17/2013] [Indexed: 12/26/2022]
Abstract
Tumor necrosis factor receptor 2 (TNFR2) is a type I transmembrane glycoprotein and one of the two receptors that orchestrate the complex biological functions of tumor necrosis factor (TNF, also designed TNF-α). Accumulating experimental evidence suggests that TNFR2 plays an important role in renal disorders associated with acute cellular rejection and clear cell renal carcinoma but its exact role in these settings is still not completely understood. This papers reviews the factors that may mediate TNFR2 induction in acute cellular rejection and clear cell renal carcinoma and its contribution to these conditions and discusses its therapeutic implications. A greater understanding of the function of TNFR2 may lead to the development of new anti-TNF drugs.
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Ge YZ, Wu R, Jia RP, Liu H, Yu P, Zhao Y, Feng YM. Association between interferon gamma +874 T>A polymorphism and acute renal allograft rejection: evidence from published studies. Mol Biol Rep 2013; 40:6043-51. [PMID: 24057242 DOI: 10.1007/s11033-013-2714-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 09/14/2013] [Indexed: 12/20/2022]
Abstract
Interferon gamma is involved in the acute rejection (AR) episodes of transplant recipients. However, results from published studies on the association of interferon gamma (IFNG) +874 T>A (rs2430561) polymorphism with AR of renal allograft are conflicting. To investigate the association between IFNG +874 T>A polymorphism with AR after renal transplantation, relevant studies were selected from PUBMED, EMBASE, Wanfang database and China National Knowledge Infrastructure until March 1st 2013. According the predesigned selection criteria, a total of 525 AR cases and 1,126 non-AR cases from 13 case-control studies were included to identify the strength of association with odds ratio (OR) and 95 % confidence intervals (95 % CI). Overall, a significant correlation between IFNG +874 T>A polymorphism and susceptibility to AR was detected (T allele vs. A allele: OR = 1.19, 95 % CI 1.02-1.38; TT/AT vs. AA: OR = 1.36, 95 % CI 1.07-1.73; TT vs. AA: OR = 1.42, 95 % CI 1.05-1.93; AT vs. AA: OR = 1.30, 95 % CI 1.01-1.68). In addition, ethnicity subgroup analysis revealed that high produce genotype (TT/AT) was associated with an increased risk of AR for Caucasians (TT/AT vs. AA: OR = 1.56, 95 % CI 1.14-2.12; TT vs. AA: OR = 1.64, 95 % CI 1.18-2.26). Furthermore, donor source subgroup analysis observed an increased risk for patients undergoing cadaveric kidney transplantation (TT/AT vs. AA: OR = 1.90, 95 % CI 1.12-3.24; TA vs. AA: OR = 2.16, 95 % CI 1.24-3.74). In conclusion, this meta-analysis suggested that IFNG +874 T>A polymorphism was associated with AR of renal transplant recipients, especially among Caucasians and those receiving cadaveric renal allograft. Additional well-designed studies with large sample size are warranted to validate our conclusion.
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Affiliation(s)
- Yu-Zheng Ge
- Department of Urology & Center of Renal Transplantation, Nanjing Hospital Affiliated to Nanjing Medical University, 68 Changle Road, Nanjing, 210006, China
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Chang HR, Tsai JP, Yang SF, Lin CK, Lian JD. Glutathione S-transferase M1 gene polymorphism is associated with susceptibility to impaired long-term allograft outcomes in renal transplant recipients. World J Surg 2013; 37:466-72. [PMID: 23073505 DOI: 10.1007/s00268-012-1815-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Despite improved post-transplantation care, progress in long-term kidney allograft survival of diabetic renal transplant recipients (pre-DM RTR) is worse than that of non-diabetic recipients (non-DM). We hypothesized that there are other potential risk factors, that predispose RTR to adverse renal allograft outcomes. METHODS A total of 323 transplant recipients who underwent renal transplantation between March 2000 and January 2008 were recruited. The composite end-point consisted of serum creatinine (SCr) doubling, graft failure, and death. Baseline clinical data were recorded, and polymerase chain reaction-restriction fragment length polymorphism measurements of interleukin (IL)-4, IL-10, IL-23, glutathione S-transferase (GST)A1, GSTM1, and GSTP1 polymorphisms were determined. The risk factors for developing the primary outcome were analyzed among these clinical and genetic factors. RESULTS Within a mean follow-up of 71.1 ± 24 months, there were 43 (13.3 %) patients with the primary outcome. Stepwise multivariate Cox regression analysis was used to determine the risk factors for the primary outcome of RTR. Renal transplant recipients who possessed the GSTM1 null genotype had a 2.2-fold risk (95 % CI: 1.10-4.40; P = 0.026) of developing the primary outcome. Additionally, RTR that had DM before transplantation (aHR: 3.31; 95 % CI: 1.77-6.20; P = 0.0002) or changes in SCr 6 to 12 months after transplantation (aHR: 2.83; 95 % CI: 1.29-6.19; P = 0.0095) had an increased risk of developing the primary outcome. CONCLUSIONS In addition to the adverse role played by DM, the GSTM1 null genotype also has an unfavorable influence on the long-term allograft outcome of RTR.
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Affiliation(s)
- Horng-Rong Chang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Association of genetic variation in co-stimulatory molecule genes with outcome of liver transplant in Iranian patients. Gene 2012; 504:127-32. [DOI: 10.1016/j.gene.2012.04.055] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Revised: 03/01/2012] [Accepted: 04/18/2012] [Indexed: 01/10/2023]
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Zhu CL, Huang Q, Liu CH, Xie F. Polymorphisms in the cytotoxic T-lymphocyte antigen 4 gene and acute rejection risk in transplant recipients. Mol Biol Rep 2012; 39:8701-8. [PMID: 22711308 DOI: 10.1007/s11033-012-1727-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 06/06/2012] [Indexed: 11/24/2022]
Abstract
Cytotoxic T-lymphocyte antigen 4 (CTLA-4) gene polymorphisms have been reported to influence the risk for acute rejection (AR) in transplant recipients. However, the results still remain controversial and ambiguous. The objective of the current study was to conduct a meta-analysis investigating the association between polymorphisms in the CTLA-4 gene and the risk of AR in transplant recipients. Electronic searches for all publications were conducted on associations between this variant and acute rejection in Medline and Embase databases through November 2011. Crude odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated to estimate the strength of the association. Three polymorphisms (+49 adenine/guanine [+49A/G], -318 cytosine/thymine [-318C/T], and the +6230G/A polymorphism [CT60]) in 18 case-control studies from ten articles were analyzed. This meta-analysis included 2,081 cases of transplant recipients in which 813 cases developed AR and 1,268 cases did not develop AR. The results indicated that there was no statistically significant association between the risk of AR and the +49A/G polymorphism or the -318C/T polymorphism (+49A/G: OR = 0.876, 95 % CI = 0.650-1.180 for GG vs. AA; OR = 1.121, 95 % CI = 0.911-1.379 for AG + GG vs. AA; -318C/T: OR = 0.397, 95 % CI = 0.138-1.143 for TT vs. CC; OR = 0.987, 95 %CI = 0.553-1.760 for CT + TT vs. CC). However, individuals who carried CT60 A allele might have a decreased risk of AR (AA vs. GG OR = 0.535, 95 % CI = 0.340-0.841, A vs. G OR = 0.759, 95 % CI = 0.612-0.914) in liver transplant recipients among Europeans, but because only two studies were included, so the result should be caution. In further stratified analyses for the +49A/G and the -318C/T polymorphisms, no obvious significant associations were found in subgroups of renal transplant recipients and Europeans, a reduced incidence of acute rejection was observed in liver transplant recipients that are homogenous for +49G (OR = 0.638, 95 % CI = 0.427-0.954 for GG vs. AA/AG), while this has not been observed in renal transplant recipients. Overall this meta-analysis suggests that +49A/G and the -318C/T polymorphisms in CTLA-4 may be not associated with the risk of rejection after organ transplantation, but CTLA +49A/G and +6230G/A polymorphisms may be associated with acute rejection after liver transplantation, not after renal transplantation. In future, more studies should be included to evaluate the association between +6230G/A polymorphism and AR risk.
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Affiliation(s)
- Cheng-Lin Zhu
- Department of General Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University, 17 Lujiang Road, Hefei, Anhui Province 230001, China
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Thude H, Schipler AD, Treszl A, Sterneck M, Nashan B. No association between transmembrane protein-tyrosine phosphatase receptor type C (PTPRC) exon A 77C>G transversion and liver transplant rejection. Int J Immunogenet 2012; 39:437-41. [DOI: 10.1111/j.1744-313x.2012.01119.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Gao JW, Guo YF, Fan Y, Qiu JX, Bao ED, Liu Y, Qin Y, Zhang F. Polymorphisms in cytotoxic T lymphocyte associated antigen-4 influence the rate of acute rejection after renal transplantation in 167 Chinese recipients. Transpl Immunol 2012; 26:207-11. [PMID: 22418270 DOI: 10.1016/j.trim.2012.02.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 02/12/2012] [Accepted: 02/27/2012] [Indexed: 12/30/2022]
Abstract
Gene polymorphisms of cytotoxic T lymphocyte associated antigen 4 (CTLA4) play an influential role in the graft rejection and long-term clinical outcome of organ transplantation. We investigated the associations of five CTLA4 single nucleotide polymorphisms (SNPs) (rs733618T/C, rs4553808A/G, rs5742909C/T, rs231775G/A, rs3087243G/A) on the early acute rejection (AR) of Chinese deceased donor renal transplantation recipients. Genotyping of the CTLA4 SNPs was performed in 167 deceased donor renal transplantation recipients. Each patient underwent a 6-month follow-up observation for AR. The incidence of AR during the 6 months post-transplantation was 26.9% (45 out of 167 patients). Patients experiencing AR were found to have a higher frequency of the rs733618TT genotype and T allele (p=0.000 and p=0.002, respectively). While the haplotype CACAG was merely observed in non-AR group (corrected p=0.000), the frequency of haplotype TACGG was significantly higher in AR group than in non-AR group even after 50,000 permutation tests (corrected p=0.018). In conclusion, these polymorphisms statistically significantly associated with acute renal allograft rejection may be considered as a risk factor of AR in Chinese renal transplantation recipients except for haplotype CACAG as a protective one.
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Affiliation(s)
- Jun-wei Gao
- Department of Pharmacy, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
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Hu X, Bai Y, Li S, Zeng K, Xu L, Liu Z, Song X, Lu X, Wang L, Ying B. Donor or recipient TNF-A −308G/A polymorphism and acute rejection of renal allograft: A meta-analysis. Transpl Immunol 2011; 25:61-71. [DOI: 10.1016/j.trim.2011.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 04/28/2011] [Accepted: 04/28/2011] [Indexed: 12/01/2022]
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Srivastava M, Eidelman O, Torosyan Y, Jozwik C, Mannon RB, Pollard HB. Elevated expression levels of ANXA11, integrins β3 and α3, and TNF-α contribute to a candidate proteomic signature in urine for kidney allograft rejection. Proteomics Clin Appl 2011; 5:311-21. [PMID: 21591265 DOI: 10.1002/prca.201000109] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 02/16/2011] [Accepted: 02/27/2011] [Indexed: 11/12/2022]
Abstract
PURPOSE Kidney transplantation is the treatment of choice for end stage renal disease, with long-term allograft loss being the major obstacle, and for which potential treatments are based on a histological diagnosis. The problem is that markers for predicting graft rejection are limited in number, are invasive, and are quite non-specific. We have hypothesized that protein biomarkers might be discovered in the urine of patients when acute or chronic rejection might be occurring. EXPERIMENTAL DESIGN We have established a workflow in which initial screening for candidate biomarkers is first performed using urine samples on large-scale antibody microarrays. This approach generated several dozen candidates. The next step is to qualify some of the strongest signals using the high-throughput Reverse Capture Protein Microarray platform. RESULTS Four top candidates including ANXA11, Integrin α3, Integrin β3 and TNF-α, initially identified by the antibody microarray platform, were all qualified using Reverse Capture Protein Microarrays. We also used receiver operating condition (ROC) curves to independently quantify the specificity and sensitivity of these four analytes. CONCLUSIONS AND CLINICAL RELEVANCE The present data suggest that these novel four analytes in the urine, together or independently, may contribute to a robust and quantitative urine proteomic signature for diagnosing acute or chronic rejection of renal allografts.
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Affiliation(s)
- Meera Srivastava
- Department of Anatomy, Physiology and Genetics, USU Center for Medical Proteomics, Uniformed Services University School of Medicine, Bethesda, MD, USA.
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Zibar L, Wagner J, Pavlinić D, Galić J, Pasini J, Juras K, Barbić J. The relationship between interferon-γ gene polymorphism and acute kidney allograft rejection. Scand J Immunol 2011; 73:319-24. [PMID: 21204904 DOI: 10.1111/j.1365-3083.2010.02506.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Cytokine gene polymorphisms have been associated with modified gene expression and cytokine production. Gamma interferon (IFN-γ) plays an important role in the pathogenesis of kidney transplant rejection. This study evaluated the association between IFN-γ gene polymorphisms and the history of acute allograft rejection in 53 adult first-transplant recipients receiving cadaveric kidney grafts. They were followed up in a single centre until 2006, for a median time of 4 years after transplantation (1-22 years). IFN-γ gene polymorphisms +874 T/A (rs2430561) were determined by polymerase chain reaction (PCR). T/T high IFN-γ genotype was found in 12, intermediate T/A in 29 and low A/A in 12 patients. Twenty-six acute kidney rejection episodes were evidenced in 20 patients, of which none occurred in the 12 patients with low IFN-γ genotype A/A. Age, gender, number of HLA (human leukocyte antigen) mismatches, ABO blood groups, HLA, time after transplantation, creatinine clearance and immunosuppressive regimens were excluded as confounding factors associated with IFN-γ genotype distribution between rejectors and non-rejectors. IFN-γ gene polymorphisms could be an important risk factor for acute kidney transplant rejection, whereas the low A/A IFN-γ genotype could be protective against rejection.
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Affiliation(s)
- L Zibar
- University Josip Juraj Strosmayer Faculty of Medicine Osijek, Osijek, Croatia and Clinical Hospital Center Osijek, Osijek, Croatia University Hospital Zagreb, Zagreb, Croatia
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Kocierz M, Siekiera U, Kolonko A, Karkoszka H, Chudek J, Cierpka L, Wiȩcek A. -174G/C interleukin-6 gene polymorphism and the risk of transplanted kidney failure or graft loss during a 5-year follow-up period. ACTA ACUST UNITED AC 2011; 77:283-90. [PMID: 21388350 DOI: 10.1111/j.1399-0039.2010.01623.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kim HJ, Jeong KH, Lee SH, Moon JY, Lee TW, Kang SW, Park SJ, Kim YH, Chung JH. Polymorphisms of the CTLA4 gene and kidney transplant rejection in Korean patients. Transpl Immunol 2010; 24:40-4. [PMID: 20940051 DOI: 10.1016/j.trim.2010.10.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 09/30/2010] [Accepted: 10/05/2010] [Indexed: 12/20/2022]
Abstract
Cytotoxic T-lymphocyte-associated protein 4 (CTLA4) is a member of the immunoglobulin superfamily. CTLA4, which binds to B7 molecules on antigen- presenting cells, is expressed on activated T cells, thereby delivering negative signals that down-regulate T-cell proliferation and cytokine production. Consequently, CTLA4 may be a good candidate gene to evaluate in kidney transplantation rejection. In this study, we investigated whether polymorphisms of the CTLA4 gene were associated with susceptibility to kidney transplantation rejection. We genotyped three selected SNPs in the CTLA4 gene using direct sequencing in 325 renal transplant recipients. Of the SNPs examined, one (rs231775) showed a statistical association with late acute rejection (p=0.026, odds ratio (OR)=0.48, 95% confidence interval (CI)=0.23-0.93 in the dominant model). Also, the frequency of the G allele (rs231775) was higher in late acute rejection patients (p=0.013, OR=2.02, 95% CI=1.15-3.52). One CTLA4 gene polymorphism was associated with susceptibility to late acute rejection in kidney transplantation in Korean patients.
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Affiliation(s)
- Hak-Jae Kim
- Soonchunhyang Medical Research Institute, College of Medicine, Soonchunhyang University, Chunan, Republic of Korea
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Kalil AC, Mattei J, Florescu DF, Sun J, Kalil RS. Recommendations for the assessment and reporting of multivariable logistic regression in transplantation literature. Am J Transplant 2010; 10:1686-94. [PMID: 20642690 PMCID: PMC2909008 DOI: 10.1111/j.1600-6143.2010.03141.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Multivariable logistic regression is an important method to evaluate risk factors and prognosis in solid organ transplant literature. We aimed to assess the quality of this method in six major transplantation journals. Eleven analytical criteria and four documentation criteria were analyzed for each selected article that used logistic regression. A total of 106 studies (6%) out of 1,701 original articles used logistic regression analyses from January 1, 2005 to January 1, 2006. The analytical criteria and their respective reporting percentage among the six journals were: Linearity (25%); Beta coefficient (48%); Interaction tests (19%); Main estimates (98%); Ovefitting prevention (84%); Goodness-of-fit (3.8%); Multicolinearity (4.7%); Internal validation (3.8%); External validation (8.5%). The documentation criteria were reported as follows: Selection of independent variables (73%); Coding of variables (9%); Fitting procedures (49%); Statistical program (65%). No significant differences were found among different journals or between general versus subspecialty journals with respect to reporting quality. We found that the report of logistic regression is unsatisfactory in transplantation journals. Because our findings may have major consequences for the care of transplant patients and for the design of transplant clinical trials, we recommend a practical solution for the use and reporting of logistic regression in transplantation journals.
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Affiliation(s)
- Andre C. Kalil
- Infectious Diseases Division, University of Nebraska Medical Center, Omaha, NE
| | - Jane Mattei
- Hospital Nossa Senhora da Conceicao, Porto Alegre, Brazil
| | - Diana F. Florescu
- Infectious Diseases Division, University of Nebraska Medical Center, Omaha, NE
| | - Junfeng Sun
- Critical Care Medicine Department, National Institutes of Health, Bethesda, MD
| | - Roberto S. Kalil
- Nephrology Division, University of Iowa Hospitals and Clinics, Iowa City, IA
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The influence of CTLA-4 gene polymorphism on long-term kidney allograft function in Caucasian recipients. Transpl Immunol 2010; 23:121-4. [PMID: 20470888 DOI: 10.1016/j.trim.2010.05.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2009] [Revised: 02/15/2010] [Accepted: 05/04/2010] [Indexed: 11/22/2022]
Abstract
The aim of the study was to examine whether CTLA-4 (CD152) and CD28 gene polymorphisms affect the outcome of kidney transplantation (KTx). Polymorphisms of the CTLA-4 gene (-318 C>T, +49 A>G, and the microsatellite polymorphism in the 3'UTR of exon 4 (AT)(n)) and a CD28 gene (IVS3 +17T>C) were investigated in 314 allograft recipients with a mean age of 41.9+/-12 years. The median time since KTx was 97.5 months. The genotypes of the SNPs were determined by SSP-PCR and (AT)(n) genotype by PCR and capillary electrophoresis (ABI Prism 310). In general, no relationship was found between the allele variants and acute rejection or graft function. Univariate and multivariate analyses showed no influence of CTLA-4 or CD28 polymorphism on graft/patient survival. In the individuals bearing the combination of the homozygous variant of low AT repeat number (82 bp) and the homozygous variant A (adenine) in CTLA-4 +49 A>G, higher eGFR was observed at one year after KTx, which was also maintained at 10 years. In summary, 24.2% of the studied patients carrying the "favorable" CTLA-4 genotype exhibited significantly higher allograft function than the 16.9% recipients with the "unfavorable" genotype up to 10 years post transplantation.
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Keown PA, McMaster WR, McManus BM. Tools to identify organ rejection and immune quiescence for biological understanding and personalized medical care. Biomark Med 2010; 4:115-21. [PMID: 20387307 DOI: 10.2217/bmm.09.73] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Abstract
PURPOSE OF REVIEW A fundamental goal in transplantation is the establishment of allograft function without ongoing immunosuppression. Robust allograft tolerance has been established in experimental transplantation models, whereas clinical operational tolerance has been described most frequently following human liver transplantation. RECENT FINDINGS Clinical assessment of tolerance has been limited to laboratory evaluation of organ function. Additional tools include graft monitoring through biopsy and blood sampling for biomarker analysis. Current biomarkers under assessment in recent years include dendritic cell subsets, regulatory T cells, antidonor antibodies, and gene polymorphisms. Emerging microarray analysis that is being prospectively validated will also be reviewed. A further tool in the characterization of the tolerant patient will be the accurate enrollment of such patients into a multicenter registry that will prospectively follow the natural history of the patient withdrawn from immunosuppression and help facilitate the entry of interested patients to mechanistic and immune monitoring trials. The International Solid Organ Transplant Tolerance Registry (www.transplant-tolerance.org) will be briefly described. SUMMARY Effective biomarker characterization of the operationally tolerant liver allograft recipient would allow earlier, well tolerated, prospective drug withdrawal with the goal of extending the potential benefits of drug minimization to an increasing number of patients in a more predictable fashion.
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Goldfarb-Rumyantzev AS, Naiman N. Genetic predictors of acute renal transplant rejection. Nephrol Dial Transplant 2010; 25:1039-47. [DOI: 10.1093/ndt/gfp782] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Manchanda PK, Kumar A, Sharma RK, Goel H, Mittal RD. Association of pro/anti-inflammatory cytokine gene variants in renal transplant patients with allograft outcome and cyclosporine immunosuppressant levels. Biologics 2009; 2:875-84. [PMID: 19707465 PMCID: PMC2727909 DOI: 10.2147/btt.s2459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
T-helper (Th) type 1/Th2 cytokines are key mediators in induction/effecter phases of all immune and inflammatory responses playing role in acute/chronic renal allograft rejection. Association studies lead to identification of patient risk profiles enabling individualization of level of immunosuppressions. We investigated the association of allograft rejection with interleukin-2 (IL-2), IL-4, IL-6, tumor necrosis factor-α (TNF-α) −308, transforming growth factor-β (TGF-β) (C-del, codon 10 and 25) gene variants in 184 renal transplant recipients and 180 controls. These cytokine genotypes were also evaluated with cyclosporine levels (C2) at one month in 135 stable recipients. High producing genotypes B1B1 of IL-4 and AA of TNF-α α308 showed significant association with rejection of allograft. The dose-adjusted C2 levels were significantly lower in patients with the high producing genotype T/T of IL-2 and heterozygous G/C of TGF-β codon 25 (P = 0.012 and 0.010, respectively). Haplotype frequencies were comparable in subjects for TGF-β codon-10 and 25. Combined inter-gene interaction showed high risk for rejection in recipients with high producing genotype B1B1 of IL-4 and AA of TNF-α and high TNF-α (AA) with low TGF-β (CC or Pro/Pro). In conclusion, association of IL-4 VNTR and TNF-α −308 suggested the involvement of these cytokines contributing to pathogenesis of allograft rejection. Recipients with TT genotype of IL-2 and GC of TGF-β codon 25 having low C2 levels may require higher cyclosporine dosage. Combined analysis of gene-gene interaction demonstrated synergistic effect of cytokines increasing risk for rejection. Thus, this information may help in pre-assessment of allograft outcome and to optimize cyclosporine therapy in post-transplant patients.
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Affiliation(s)
- Parmeet Kaur Manchanda
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, Uttar Pradesh, India
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Ernandez T, Mayadas TN. Immunoregulatory role of TNFalpha in inflammatory kidney diseases. Kidney Int 2009; 76:262-76. [PMID: 19436333 DOI: 10.1038/ki.2009.142] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Tumor necrosis factor alpha (TNFalpha), a pleiotropic cytokine, plays important inflammatory roles in renal diseases such as lupus nephritis, anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis and renal allograft rejection. However, TNFalpha also plays critical immunoregulatory roles that are required to maintain immune homeostasis. These complex biological functions of TNFalpha are orchestrated by its two receptors, TNFR1 and TNFR2. For example, TNFR2 promotes leukocyte infiltration and tissue injury in an animal model of immune complex-mediated glomerulonephritis. On the other hand, TNFR1 plays an immunoregulatory function in a murine lupus model with a deficiency in this receptor that leads to more severe autoimmune symptoms. In humans, proinflammatory and immunoregulatory roles for TNFalpha are strikingly illustrated in patients on anti-TNFalpha medications: These treatments are greatly beneficial in certain inflammatory diseases such as rheumatoid arthritis but, on the other hand, are also associated with the induction of autoimmune lupus-like syndromes and enhanced autoimmunity in multiple sclerosis patients. The indication for anti-TNFalpha treatments in renal inflammatory diseases is still under discussion. Ongoing clinical trials may help to clarify the potential benefit of such treatments in lupus nephritis and ANCA-associated glomerulonephritis. Overall, the complex biology of TNFalpha is not fully understood. A greater understanding of the function of its receptors may provide a framework to understand its contrasting proinflammatory and immunoregulatory functions. This may lead the development of new, more specific anti-inflammatory drugs.
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Affiliation(s)
- Thomas Ernandez
- Department of Pathology, Center for Excellence in Vascular Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
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Association of genetic variation in inducible costimulator gene with outcome of kidney transplantation. Transplantation 2009; 87:393-6. [PMID: 19202444 DOI: 10.1097/tp.0b013e318192897a] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The closely-linked genes of CD28, cytotoxic T-lymphocyte associated antigen 4 (CTLA4), inducible costimulator (ICOS), and programmed cell death 1 on chromosome 2q encode costimulatory molecules, which are regulators of the T-cell activity. The T-cell mediated immune response has a major role in allograft rejection. Hence, the variation in these genes may have an effect on graft survival and the amount of immunosuppression needed, but so far the studies have restricted solely to the CTLA4 gene. METHODS We determined 13 single nucleotide polymorphisms in CD28, CTLA4, ICOS, and PPCD1 genes in 678 adult patients who received a kidney from deceased donor. The effect of genetic variation on the outcome of renal transplantation was analyzed. RESULTS Two markers on the ICOS gene, rs10183087 and rs4404254, were associated with delayed graft function (odds ratio=5.8; P=0.020 and odds ratio=5.8; P=0.019, respectively). Interestingly, the same ICOS variation has been shown to regulate the expression level of ICOS. We also demonstrated an association of the ICOS polymorphism rs10932037 with the graft survival (P=0.026). CONCLUSIONS The present results indicate that potentially functional genetic variation in T-cell costimulatory molecule ICOS has an effect on the outcome of kidney transplantation.
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