Kłoda Karolina, Domański Leszek, Mierzecki Artur
Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland.
Independent Laboratory of Family Physician Education, Pomeranian Medical University in Szczecin, Szczecin, Poland.
Med Sci Monit. 2017 Jan 11;23:158-162. doi: 10.12659/msm.899490.
Telomeres are located at each end of eukaryotic chromosomes. Their functional role is genomic stability maintenance. The protective role of telomeres depends on various factors, including number of nucleotides repeats, telomere-binding proteins, and telomerase activity. Organ transplantation is the preferred replacement therapy in the case of chronic kidney disease and the only possibility of sustaining recipients' life in the case of advanced liver failure. While the prevalence of acute rejection is constantly decreasing, prevention of transplanted organ long-term function loss is still challenging. It has been demonstrated that post-transplant stressors accelerate aging of the allografts manifested through telomere shortening. The aim of this paper was to evaluate the importance of telomere length assessment for prediction of organ transplantation outcome. Literature review included the 10 most important studies regarding linkage between allograft function and telomere erosion, including 2 of our own reports. Telomere length assessment is useful to predict organ transplantation outcome. The importance of telomere length as a prediction marker depends on the analyzed material. To obtain reliable results, both graft cells (donor material) and lymphocytes (recipient material) should be examined. In the case of kidney transplantation, assessment of telomere length in the early post-transplant period allows prediction of the long-term function of the transplanted organ. To increase the accuracy of transplantation outcome prediction, telomere length assessment should be combined with evaluation of other aging biomarkers, like CDKN2A (p16). Large-scale clinical studies regarding telomere length measurement, including genome wide association analysis introducing relevant genetic factors, are needed for the future.
端粒位于真核生物染色体的两端。它们的功能作用是维持基因组稳定性。端粒的保护作用取决于多种因素，包括核苷酸重复序列的数量、端粒结合蛋白和端粒酶活性。器官移植是慢性肾病的首选替代疗法，也是晚期肝衰竭患者维持生命的唯一可能。虽然急性排斥反应的发生率在不断下降，但预防移植器官的长期功能丧失仍然具有挑战性。已经证明，移植后的应激源会加速同种异体移植物的衰老，表现为端粒缩短。本文的目的是评估端粒长度评估对预测器官移植结果的重要性。文献综述包括关于同种异体移植物功能与端粒侵蚀之间联系的10项最重要的研究，其中包括我们自己的2篇报告。端粒长度评估有助于预测器官移植结果。端粒长度作为预测标志物的重要性取决于所分析的材料。为了获得可靠的结果，应该检查移植细胞（供体材料）和淋巴细胞（受体材料）。在肾移植中，移植后早期端粒长度的评估可以预测移植器官的长期功能。为了提高移植结果预测的准确性，端粒长度评估应与其他衰老生物标志物（如CDKN2A（p16））的评估相结合。未来需要进行大规模的关于端粒长度测量的临床研究，包括引入相关遗传因素的全基因组关联分析。
