Organ Transplantation Center of People's Liberation Army, 309th Hospital of Chinese People's Liberation Army, Beijing 100091, China.
Chin Med J (Engl). 2012 Oct;125(19):3500-4.
Untreated human cytomegalovirus (CMV) disease (CMVD) is an identified risk factor for reduced rates of patient (and graft) survival, death or retransplantation in kidney transplant recipients due to increased immunological tolerance after transplant. Vitamin D receptor (VDR) gene polymorphisms have an obvious relationship with autoimmune diseases but the relationship between VDR gene polymorphisms and CMVD are not well understood. This study investigated the relationship between VDR FokI and ApaI gene polymorphisms and CMVD, and their value for predicting risk of CMVD.
Ninety-eight kidney transplantation recipients were randomly chosen for which peripheral blood samples and case histories for the first three months after kidney transplantation were obtained. Using polymerase chain reaction-restriction fragment length polymorphisms, 30 recipients were found to be homozygous for the FokI gene (FF), 47 heterozygous (Ff), and 21 were homozygous (ff). Likewise, similar analyses determined that 12 recipients were homozygous for the ApaI gene (AA), 36 heterozygous (Aa), and 50 homozygous (aa). Factors affecting the prognosis of the kidney transplantation were compared for all genotypes by statistical analysis before operation. Infection by CMV for all recipients was detected by immunofluorescence assay to diagnose CMVD.
No statistical significance was observed for the factors affecting the prognosis of the kidney transplantation between both genotypes; however, statistical differences in CMVD among the FokI genotypes were identified. It was determined that the risk of CMVD was significantly increased for recipients of the ff genotype than for other genotypes. There was no statistical significance observed for CMVD among ApaI genotypes.
The recessive f allelic gene of VDR can be regarded as a risk factor of CMVD while FF recipients have lower incidence of CMVD after kidney transplantation. ApaI genotypes showed no relationship with predisposition to CMVD.
未经治疗的人类巨细胞病毒（CMV）疾病（CMVD）是肾移植受者中因移植后免疫耐受增加而导致患者（和移植物）存活率降低、死亡或再次移植的已确定危险因素。维生素 D 受体（VDR）基因多态性与自身免疫性疾病有明显关系，但 VDR 基因多态性与 CMVD 的关系尚不清楚。本研究探讨了 VDR FokI 和 ApaI 基因多态性与 CMVD 的关系及其预测 CMVD 风险的价值。
随机选择 98 例肾移植受者，获取其移植后前 3 个月的外周血样本和病史。采用聚合酶链反应-限制性片段长度多态性分析，发现 30 例受者 FokI 基因纯合子（FF），47 例杂合子（Ff），21 例纯合子（ff）。同样，通过类似的分析确定 12 例受者 ApaI 基因纯合子（AA），36 例杂合子（Aa），50 例纯合子（aa）。手术前通过统计分析比较所有基因型对肾移植预后的影响因素。采用免疫荧光法检测所有受者的 CMV 感染以诊断 CMVD。
两种基因型对肾移植预后的影响因素无统计学意义；然而，FokI 基因型之间的 CMVD 存在统计学差异。ff 基因型受者的 CMVD 风险显著增加。ApaI 基因型之间的 CMVD 无统计学意义。
VDR 的隐性 f 等位基因可视为 CMVD 的危险因素，而 FF 受者肾移植后 CMVD 的发生率较低。ApaI 基因型与 CMVD 易感性无关。
