Danikiewicz Aleksander, Szkodzinski Janusz, Hudzik Bartosz, Korzonek-Szlacheta Ilona, Gąsior Mariusz, Polonski Lech, Zubelewicz-Szkodzińska Barbara
Department for the Prevention of Food-related Diseases, School of Public Health, Medical University of Silesia, Katowice, Poland.
Third Chair and Department of Cardiology, Medical University of Silesia in Katowice, School of Medicine with the Division of Dentistry in Zabrze, Silesian Center for Heart Diseases in Zabrze, Poland.
Kardiochir Torakochirurgia Pol. 2015 Mar;12(1):48-52. doi: 10.5114/kitp.2015.50568. Epub 2015 Mar 31.
Cardiovascular diseases remain the leading cause of death in Poland and other countries of the European Union. Patients with end-stage heart failure constitute a patient subgroup for whom the treatment of choice is heart transplantation. Despite advances in immunosuppressive therapy, acute or chronic graft rejection occurs in 20-30% of cases in the first six months after transplantation. The significance of the immune response and inflammation in graft rejection implies the important role of cytokines. Molecular markers are sought to facilitate risk assessment and improve patient care. At present, genetic tests are not used for this purpose, but studies aiming to rectify that have been conducted for years, including studies on single nucleotide polymorphisms of cytokine genes. This paper presents the results of research on the single nucleotide polymorphisms (SNPs) of the IL-2, IL-4, IL-6, IL-10, TGF-β1, PDGF, VEGF, and TNF-α genes in conjunction with heart transplantation. The analyzed data do not allow for reliable application of these genetic tests in clinical practice, but suggest that it is a promising direction which may improve the options of treatment individualization in the future.
心血管疾病仍然是波兰和其他欧盟国家的主要死因。终末期心力衰竭患者构成了一个患者亚组,对于他们来说,首选治疗方法是心脏移植。尽管免疫抑制治疗取得了进展,但在移植后的头六个月内,20%-30%的病例会发生急性或慢性移植物排斥反应。免疫反应和炎症在移植物排斥反应中的重要性意味着细胞因子起着重要作用。人们一直在寻找分子标志物以促进风险评估并改善患者护理。目前,基因检测尚未用于此目的,但多年来一直在进行旨在纠正这一情况的研究,包括对细胞因子基因单核苷酸多态性的研究。本文介绍了与心脏移植相关的白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、转化生长因子-β1(TGF-β1)、血小板衍生生长因子(PDGF)、血管内皮生长因子(VEGF)和肿瘤坏死因子-α(TNF-α)基因单核苷酸多态性(SNP)的研究结果。分析的数据不允许在临床实践中可靠地应用这些基因检测,但表明这是一个有前景的方向,未来可能会改善治疗个体化的选择。