Association between CTLA4 gene polymorphisms and acute rejection of kidney transplantation: a meta-analysis.

OBJECTIVE

Cytotoxic T-lymphocyte-associated protein 4 (CTLA4) has been shown to transmit an inhibitory signal to T cells, which is a therapeutic target for acute rejection of kidney transplantation, and CTLA4 polymorphisms have also been considered as a potential risk factor. However, major studies have not yielded significant results. Thus, we conducted a meta-analysis of existing studies to boost their statistical power to clarify any associations between CTLA4 gene polymorphisms and acute rejection of kidney transplantation.

METHODS

We searched for studies using PubMed, Embase and Academic Source Premier databases and checked the reference lists of all included studies for other relevant studies. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated by both dominant and recessive genetic models.

RESULTS

For CTLA4 +49A/G polymorphism, we found a marginally significant p value for A vs. G (OR=0.805, 95% CI, 0.677-0.957, p=0.014). No significant association between the -318C/T polymorphism and acute rejection risk was observed.

CONCLUSION

The results suggest that the CTLA4 gene +49A/G polymorphism may be a possible genetic susceptibility locus for acute rejection. The results of the present meta-analysis may be limited by a number of factors including inadequate total sample size and poor statistics, and should be interpreted with caution. Further confirmation in large and well-designed studies are needed.