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甘露糖结合凝集素2和纤维胶凝蛋白2基因多态性影响肾移植受者发生血流感染的易感性。

Mannose-binding lectin 2 and ficolin-2 gene polymorphisms influence the susceptibility to bloodstream infections in kidney transplant recipients.

作者信息

Wan Q-Q, Ye Q-F, Zhou J-D

机构信息

Department of Transplant Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.

出版信息

Transplant Proc. 2013 Nov;45(9):3289-92. doi: 10.1016/j.transproceed.2013.05.008.

Abstract

INTRODUCTION

Both mannose-binding lectin (MBL) and ficolin (FCN) interact with carbohydrate structures on microbial surfaces. Polymorphisms at the promoter and exon 1 of the MBL2 gene, which are responsible for low serum levels of MBL, have been shown to play important roles to increase the risk of post-transplant infections. Three gene polymorphisms in the promoter region of FCN2 and 2 in exon 8 (+6424 G > T) are associated with serum levels of FCN2 or binding capacity toward N-acetylglucosamine on microbial surfaces.

METHODS

We prospectively analyzed 81 kidney transplant recipients for 6 well-known functional single-nucleotide polymorphisms in the MBL2 and 5 in the FCN2 gene of the recipients determined by gene sequencing. The bloodstream infections collected prospectively were associated with MBL2 and FCN2 genotypic variants over the first year after kidney transplantation.

RESULTS

Multivariate analyses only found an association of recipient QQ + PQ genotypes of MBL2 5'-UTR +4 (odds ratio [OR] = 3.677, 95% confidence intervals [CI] = 1.127-11.998, P = .031) and FCN2 exon 8 Thr 236 Met(+6359 C > T) (OR = 4.917, 95% CI = 1.229-19.667, P = .024) with the incidence of bacteremia.

CONCLUSION

Recipient QQ + PQ genotypes of MBL2 5'-UTR +4 and recipient FCN2 exon 8 Thr 236 Met(+6359 C > T) variants showed significant impacts on the risk of developing bloodstream infections after kidney transplantation.

摘要

引言

甘露糖结合凝集素(MBL)和纤维胶凝蛋白(FCN)均与微生物表面的碳水化合物结构相互作用。MBL2基因启动子和外显子1的多态性会导致血清MBL水平降低,已证明其在增加移植后感染风险方面发挥重要作用。FCN2启动子区域的三个基因多态性和外显子8中的两个多态性(+6424 G>T)与FCN2血清水平或对微生物表面N-乙酰葡糖胺的结合能力相关。

方法

我们通过基因测序对81名肾移植受者的MBL2基因中6个著名的功能性单核苷酸多态性和FCN2基因中5个多态性进行了前瞻性分析。前瞻性收集的血流感染与肾移植后第一年的MBL2和FCN2基因分型变异相关。

结果

多变量分析仅发现MBL2 5'-UTR +4的受者QQ + PQ基因型(优势比[OR]=3.677, 95%置信区间[CI]=1.127 - 11.998, P = 0.031)和FCN2外显子8苏氨酸236甲硫氨酸(+6359 C>T)(OR = 4.917, 95% CI = 1.229 - 19.667, P = 0.024)与菌血症发生率相关。

结论

MBL2 5'-UTR +4的受者QQ + PQ基因型和受者FCN2外显子8苏氨酸236甲硫氨酸(+6359 C>T)变异对肾移植后发生血流感染的风险有显著影响。

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