Yamamoto Haruchika, Sugimoto Seiichiro, Tanaka Shin, Kurosaki Takeshi, Otani Shinji, Yamane Masaomi, Taira Naruto, Oto Takahiro, Toyooka Shinichi
Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
Department of General Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Surg Today. 2019 Mar;49(3):268-274. doi: 10.1007/s00595-018-1717-9. Epub 2018 Sep 18.
Glucocorticoids are used to prevent chronic lung allograft dysfunction (CLAD) after lung transplantation (LT). Our study was aimed at assessing the association between the glucocorticoid-induced transcript 1 gene (GLCCI1) variant, which modulates glucocorticoid sensitivity, and the postoperative lung function and development of CLAD after LT.
A total of 71 recipients of LT were genotyped for the GLCCI1 variant (rs37972) and divided into three groups: the homozygous mutant allele (TT) group, the heterozygous mutant allele (CT) group, and the wild-type allele (CC) group. The results of pulmonary function tests were compared with the postoperative baseline values.
The total lung capacity (TLC) in the TT group was significantly lower than that in the CC group at 3 years after LT (P = 0.029). In the recipients of cadaveric LT, the TLC and forced expiratory volume in 1 s in the TT group were significantly lower than those in the CC groups, resulting in a significant worse CLAD-free survival at 3 years after LT (P = 0.016).
The GLCCI1 variant was associated with a significant decrease of the TLC at 3 years after LT and the development of CLAD at 3 years, especially in patients undergoing cadaveric LT.
糖皮质激素用于预防肺移植(LT)后的慢性肺移植功能障碍(CLAD)。我们的研究旨在评估调节糖皮质激素敏感性的糖皮质激素诱导转录物1基因(GLCCI1)变异与LT术后肺功能及CLAD发生之间的关联。
对71例LT受者进行GLCCI1变异(rs37972)基因分型,并分为三组:纯合突变等位基因(TT)组、杂合突变等位基因(CT)组和野生型等位基因(CC)组。将肺功能测试结果与术后基线值进行比较。
LT术后3年,TT组的肺总量(TLC)显著低于CC组(P = 0.029)。在尸体供肺LT受者中,TT组的TLC和1秒用力呼气量显著低于CC组,导致LT术后3年无CLAD生存率显著更差(P = 0.016)。
GLCCI1变异与LT术后3年TLC显著降低及3年CLAD发生有关,尤其是在尸体供肺LT患者中。