细胞因子基因多态性与移植肾慢性排斥反应的关系

Relationship between cytokine gene polymorphisms and chronic rejection in kidney allograft recipients and donors

目的探讨供、受者细胞因子基因多态性与移植肾慢性排斥反应的关系。方法用序列特异引物聚合酶链反应(tK2R-SSP)方法,对144例肾移植受者和65例部分供者进行5种细胞因子[肿瘤坏死因子6(TNF-α)、白细胞介素6(IL-6)、白细胞介素10(IL-10)、转化生长因子β_1(TGF-β_1)、干扰素γ(IFN-γ)]基因型检测。结果TGF-β_1高分泌型的受者与中低分泌型受者相比,移植肾慢性排斥反应发生率明显升高。差异有统计学意义(P<0.01)。TGF-β_1高分泌型的供者与中低分泌型供者相比,移植肾慢性排斥反应发生率差异无统计学意义(P>0.05)。TGF-β_1基因型为供者高分泌/受者高分泌组合时,移植肾慢性排斥反应发生率比所有其它基因型组合者高(P<0.01);而TGF-β_1基冈型为供者中低分泌/受者中低分泌组合时,移植肾慢性排斥反应发生率比所有其它基因型组合者低(P<0.01)。TNF-α、IL-6、IL-10及IFN-γ的基因型与移植肾慢性排斥反应发生率的关系不明显。结论同时检测供、受者TGF-β_1基因多态性对预测移植肾慢性排斥反应发生率有指导意义。

Objective To study the relationship between cytokine gene polymorphisms and chronic rejection in kidney allograft recipients and their donors. Methods The cytokine genotypes including TNF-α, IL-6, IL-10, TGF-β1 and IFN-7 in 144 consecutive first cadaveric kidney allograft recipients and 65 corresponding donors were detected by PCR-SSP method. The recipients were followed up for 5 years. The relationship between the TGF-β1 genotypes of the recipients and donors and the chronic renal allograft rejection was analyzed. Results The incidence of chronic rejection in the recipi- ents with TGF-131 high producer genotype （39/91, 42. 9%） was significantly higher than in those with TGF-131 middle or low producer genotype （9/53, 17. 0%, P〈0. 01）. No significant difference was found between the donors with TGF-131 high producer genotype （26/80, 32. 5%） and those with TGF-β1 middle or low producer genotypes （11/34, 32. 4%, P〈0. 05）. The incidence of chronic rejection in the recipients and donors with TGF-β1 high producer genotype （4/4） was significantly higher than in those with other genotypes （31/110, 28. 2%, P〈0. 01）. The incidence of chronic rejection in the recipients and donors with TGF-β1 meddle or low producer genotype （12/61, 19. 7%） was significantly higher than in those with other genotypes （23/53, 43. 4 %, P〈0. 01）. Conclusion Simultaneous detection of the TGF-β1 genotypes in kidney allograft recipients and their donors can predict the incidence of chronic rejection after kidney transplantation.