Zhang Jian, Wang Mingxu, Liang Jun, Zhang Ming, Liu Xiao-Hong, Ma Le
The First Affiliated Hospital, Xi'an Jiaotong University College of Medicine, 277 Yanta West Road, Xi'an 710061, China.
Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China.
Int J Environ Res Public Health. 2017 May 9;14(5):500. doi: 10.3390/ijerph14050500.
The aim of this study was to determine whether anti-angiotensin type 1 receptor antibodies (AT1R-Abs) are related to acute rejection (AR) and kidney graft failure in renal transplantation. We searched electronic databases including MEDLINE, EMBASE, and the ISI Web of Science databases for all studies on the association between anti-angiotensin type 1 receptor antibodies and kidney allograft outcomes updated to November 2016. Reference lists from included articles were also reviewed. The pooled relative risks (RRs) with 95% confidence intervals (CIs) were extracted or calculated using a random-effects model. The potential sources of heterogeneity and publication bias were estimated. Nine studies enrolling 1771 subjects were retrieved in the meta-analysis. AT1R-Abs showed significant associations with increased risk of AR (RR = 1.66; 95% CI, 1.23-2.09). In addition, a significant relationship was found between AT1R-Abs and kidney graft failure compared with AR (RR = 3.02; 95% CI, 1.77-4.26). The results were essentially consistent among subgroups stratified by participant characteristics. These results demonstrated that the AT1R-Abs were associated with an elevated risk of kidney allograft outcomes, especially with kidney graft failure. Large-scale studies are still required to further verify these findings.
本研究旨在确定抗1型血管紧张素受体抗体(AT1R-Abs)是否与肾移植中的急性排斥反应(AR)及肾移植失败相关。我们检索了包括MEDLINE、EMBASE和ISI科学网数据库在内的电子数据库,以查找截至2016年11月所有关于抗1型血管紧张素受体抗体与肾移植结局之间关联的研究。还对纳入文章的参考文献列表进行了审查。使用随机效应模型提取或计算合并相对风险(RRs)及其95%置信区间(CIs)。评估了异质性和发表偏倚的潜在来源。荟萃分析中检索到9项纳入1771名受试者的研究。AT1R-Abs与AR风险增加显著相关(RR = 1.66;95% CI,1.23 - 2.09)。此外,与AR相比,发现AT1R-Abs与肾移植失败之间存在显著关系(RR = 3.02;95% CI,1.77 - 4.26)。按参与者特征分层的亚组间结果基本一致。这些结果表明,AT1R-Abs与肾移植结局风险升高相关,尤其是与肾移植失败相关。仍需要大规模研究来进一步验证这些发现。