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与实体器官移植受者糖尿病相关的遗传免疫和炎症标志物。

Genetic immune and inflammatory markers associated with diabetes in solid organ transplant recipients.

机构信息

Unit of Pharmacogenetics and Clinical Psychopharmacology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland.

Service of Infectious Diseases, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.

出版信息

Am J Transplant. 2019 Jan;19(1):238-246. doi: 10.1111/ajt.14971. Epub 2018 Jul 13.

Abstract

New-onset diabetes mellitus after transplantation (NODAT) is a complication following solid organ transplantation (SOT) and may be related to immune or inflammatory responses. We investigated whether single nucleotide polymorphisms (SNPs) within 158 immune- or inflammation-related genes contribute to NODAT in SOT recipients. The association between 263 SNPs and NODAT was investigated in a discovery sample of SOT recipients from the Swiss Transplant Cohort Study (STCS, n  = 696). Positive results were tested in a first STCS replication sample (n  = 489) and SNPs remaining significant after multiple test corrections were tested in a second SOT replication sample (n  = 156). Associations with diabetic traits were further tested in several large general population-based samples (n > 480 000). Only SP110 rs2114592C>T remained associated with NODAT in the STCS replication sample. Carriers of rs2114592-TT had 9.9 times (95% confidence interval [CI]: 3.22-30.5, P = .00006) higher risk for NODAT in the combined STCS samples (n = 1184). rs2114592C>T was further associated with NODAT in the second SOT sample (odds ratio: 4.8, 95% CI: 1.55-14.6, P = .006). On the other hand, SP110 rs2114592C>T was not associated with diabetic traits in population-based samples, suggesting a specific gene-environment interaction, possibly due to the use of specific medications (ie, immunosuppressants) in transplant patients and/or to the illness that may unmask the gene effect.

摘要

移植后新发糖尿病(NODAT)是实体器官移植(SOT)后的一种并发症,可能与免疫或炎症反应有关。我们研究了 158 个免疫或炎症相关基因中的单核苷酸多态性(SNP)是否与 SOT 受者的 NODAT 有关。在瑞士移植队列研究(STCS)的 SOT 受者发现样本中(n = 696),对 263 个 SNP 与 NODAT 的相关性进行了研究。阳性结果在 STCS 的第一个复制样本中进行了测试(n = 489),并在第二个 SOT 复制样本中测试了经过多次测试校正后仍然显著的 SNP(n = 156)。在几个大型基于一般人群的样本(n > 480 000)中进一步测试了与糖尿病特征的关联。在 STCS 复制样本中,只有 SP110 rs2114592C>T 与 NODAT 仍然相关。rs2114592-TT 携带者在合并的 STCS 样本(n = 1184)中发生 NODAT 的风险增加了 9.9 倍(95%置信区间 [CI]:3.22-30.5,P =.00006)。rs2114592C>T 与第二个 SOT 样本中的 NODAT 进一步相关(优势比:4.8,95% CI:1.55-14.6,P =.006)。另一方面,SP110 rs2114592C>T 与基于人群的样本中的糖尿病特征无关,表明存在特定的基因-环境相互作用,可能是由于移植患者使用了特定的药物(即免疫抑制剂)和/或疾病可能揭示了基因的作用。

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