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供体与受体血管紧张素转换酶插入/缺失基因多态性与同种异体肾移植急性排斥反应的相关性研究。

Study of the association between the donors and recipients angiotensin-converting enzyme insertion/deletion gene polymorphism and the acute renal allograft rejection.

作者信息

Azmandian Jalal, Mohamadifar Mohamadamir, Rahmanian-Koshkaki Sara, Mehdipoor Mohammad, Nematollahi Mohamad-Hadi, Saburi Amin, Mandegary Ali

机构信息

Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran ; Department of Nephrology, Urology and Renal Transplantation, Afzalipoor Hospital, University of Medical Sciences, Kerman, Iran.

Department of Nephrology, Urology and Renal Transplantation, Afzalipoor Hospital, University of Medical Sciences, Kerman, Iran.

出版信息

J Nephropathol. 2015 Jul;4(3):62-8. doi: 10.12860/jnp.2015.13. Epub 2015 Jul 1.

Abstract

BACKGROUND

Angiotensin converting enzyme (ACE) is involved in various pathophysiological conditions including renal function. ACE levels are under genetic control.

OBJECTIVES

This study was designed to investigate the association between the donors and recipients ACE-I/D gene polymorphism and risk of acute rejection outcome in renal allograft recipients.

PATIENTS AND METHODS

ACE-I/D polymorphism was determined in 200 donor-recipient pairs who had been referred to Afzalipour hospital in Kerman. ACE-I/D polymorphism was detected using polymerase chain reaction (PCR). Acute rejection (AR) during at least six months post-transplantation was defined as a 20% increase in creatinine level from the postoperative baseline in the absence of other causes of graft dysfunction which responded to antirejection therapy.

RESULTS

The observed allele frequencies were II 9.8%, ID 35.6% and DD 44.4% in donors and II 9.8%, ID 35.1% and DD 52.7% in recipients. There were no significant association between ACE genotypes and AR episodes (ORID=0.96 [0.18-5.00] and ORDD: 1.24 [0.25-6.07] for the donors) and (ORID: 0.29 [0.06-1.45] and ORDD: 0.75 [0.19-2.90] for the recipients).

CONCLUSIONS

It seems that donor and recipient ACE-I/D genotype might not be a risk factor for acute renal allograft rejection. However, due to conflicting results from this and other studies, multicenter collaborative studies with more participants and concomitant evaluation of ACE polymorphism with other polymorphisms in renin-angiotensin system (RAS) are suggested to determine whether ACE genotypes are significant predictors of renal allograft rejection.

摘要

背景

血管紧张素转换酶(ACE)参与包括肾功能在内的各种病理生理过程。ACE水平受基因控制。

目的

本研究旨在调查肾移植受者中供体和受体ACE-I/D基因多态性与急性排斥反应结局风险之间的关联。

患者和方法

对转诊至克尔曼省阿夫扎利普尔医院的200对供体-受体进行ACE-I/D多态性检测。采用聚合酶链反应(PCR)检测ACE-I/D多态性。移植后至少六个月内的急性排斥反应(AR)定义为肌酐水平较术后基线升高20%,且不存在其他导致移植功能障碍的原因,且对抗排斥治疗有反应。

结果

供体中观察到的等位基因频率为II型9.8%,ID型35.6%,DD型44.4%;受体中II型9.8%,ID型35.1%,DD型52.7%。ACE基因型与AR发作之间无显著关联(供体中ORID = 0.96 [0.18 - 5.00],ORDD = 1.24 [0.25 - 6.07])以及(受体中ORID = 0.29 [0.06 - 1.45],ORDD = 0.75 [0.19 - 2.90])。

结论

供体和受体的ACE-I/D基因型似乎不是肾移植急性排斥反应的危险因素。然而,由于本研究和其他研究结果相互矛盾,建议开展更多参与者的多中心合作研究,并同时评估ACE多态性与肾素 - 血管紧张素系统(RAS)中的其他多态性,以确定ACE基因型是否为肾移植排斥反应的重要预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7566/4544556/39cc1a3343fe/JNP-4-62-g001.jpg

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