Division of Transplant Surgery, University of California San Francisco, 513 Parnassus Avenue, San Francisco, California 94143, USA.
Nat Rev Genet. 2017 May;18(5):309-326. doi: 10.1038/nrg.2017.12. Epub 2017 Mar 13.
Ever since the discovery of the major histocompatibility complex, scientific and clinical understanding in the field of transplantation has been advanced through genetic and genomic studies. Candidate-gene approaches and recent genome-wide association studies (GWAS) have enabled a deeper understanding of the complex interplay of the donor-recipient interactions that lead to transplant tolerance or rejection. Genetic analysis in transplantation, when linked to demographic and clinical outcomes, has the potential to drive personalized medicine by enabling individualized risk stratification and immunosuppression through the identification of variants associated with immune-mediated complications, post-transplant disease or alterations in drug-metabolizing genes.
自主要组织相容性复合体发现以来,通过遗传和基因组研究,移植领域的科学和临床认识得到了推进。候选基因方法和最近的全基因组关联研究(GWAS)使人们能够更深入地了解导致移植耐受或排斥的供体-受体相互作用的复杂相互作用。移植中的遗传分析,当与人口统计学和临床结果相关联时,通过识别与免疫介导的并发症、移植后疾病或药物代谢基因改变相关的变体,有可能通过确定与免疫介导的并发症、移植后疾病或药物代谢基因改变相关的变体,实现个体化风险分层和免疫抑制,从而推动个性化医学。