General, Visceral and Transplantation Surgery, Charité Campus Virchow, Berlin, Germany.
Transplantation. 2012 Mar 15;93(5):555-60. doi: 10.1097/TP.0b013e318242be0b.
The development of kidney dysfunction is one of the most important after liver transplantation (LT). Genetic variants of pathogenetically relevant cytokines may influence the development and course of the disease. The aim of our study was to evaluate the role of transforming growth factor-β1 (TGF-β1) polymorphism in this context.
Four hundred eighty-six liver graft recipients were genotyped for TGF-β1 codon 25 (guanine → cytosine, G → C) by polymerase chain reaction. Renal function before and after LT was characterized by estimation of glomerular filtration rate (GFR) using four-parameter-modification of diet in renal disease formula on defined dates. GFR was compared among TGF-β1-genotype groups of the entire cohort within the median observation period of 7 years. For the assessment of renal function recovery after LT, patients were divided into three groups by GFR difference (ΔGFR = ± 10 mL/min).
Mean pretransplant GFR differed significantly among TGF-β1-genotype groups (GG: 85.0 mL/min vs. GC/CC: 75.3 mL/min; P=0.016). The significance disappeared in the follow-up period. Although GG genotype demonstrated higher mean GFR levels, patients with GC/CC genotype tended to improve kidney function compared with GG genotype (P=0.013). Interestingly, lower mean GFR rates were observed among female compared with male recipients before (P=0.002), separately at all dates and cumulatively after LT (P<0.001).
Genetic variants of one of the most important cytokine TGF-β1 at codon 25 may have an impact on kidney function, suggesting an unfavorable effect of C allele in pretransplant setting and serve as marker for the recovery of renal function after LT. The identification of further confounders seems to be promising.
肾功能障碍的发展是肝移植(LT)后最重要的问题之一。与发病机制相关的细胞因子的遗传变异可能会影响疾病的发展和进程。我们的研究旨在评估转化生长因子-β1(TGF-β1)多态性在这种情况下的作用。
通过聚合酶链反应对 486 名肝移植受者的 TGF-β1 密码子 25(鸟嘌呤→胞嘧啶,G→C)进行基因分型。在特定日期使用四参数改良肾脏病饮食公式评估 LT 前后的肾小球滤过率(GFR)。在中位数为 7 年的观察期内,将整个队列中 TGF-β1 基因型组的 GFR 进行比较。为了评估 LT 后肾功能的恢复,根据 GFR 差异(ΔGFR=±10mL/min)将患者分为三组。
TGF-β1 基因型组之间的平均移植前 GFR 差异有统计学意义(GG:85.0mL/min 与 GC/CC:75.3mL/min;P=0.016)。在随访期间,这种差异消失了。尽管 GG 基因型显示出更高的平均 GFR 水平,但与 GG 基因型相比,GC/CC 基因型的患者倾向于改善肾功能(P=0.013)。有趣的是,与男性受者相比,女性受者在移植前(P=0.002)、分别在所有日期和 LT 后累积(P<0.001)时的平均 GFR 率较低。
TGF-β1 密码子 25 中最重要的细胞因子之一的遗传变异可能对肾功能有影响,提示 C 等位基因在移植前有不利影响,并可作为 LT 后肾功能恢复的标志物。进一步识别混杂因素似乎很有前景。