功能型 Fc 受体γ基因多态性与长期肾脏移植物存活。
Functional Fc Gamma Receptor Gene Polymorphisms and Long-Term Kidney Allograft Survival.
机构信息
Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria.
Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany.
出版信息
Front Immunol. 2021 Aug 23;12:724331. doi: 10.3389/fimmu.2021.724331. eCollection 2021.
The functional Fc gamma receptor (FcγR) IIIA polymorphism -V/F158 was earlier suggested to determine the potential of donor-specific HLA antibodies to trigger microcirculation inflammation, a key lesion of antibody-mediated renal allograft rejection. Associations with long-term transplant outcomes, however, have not been evaluated to date. To clarify the impact of -V/F158 polymorphism on kidney transplant survival, we genotyped a cohort of 1,940 recipient/donor pairs. Analyzing 10-year death-censored allograft survival, we found no significant differences in relation to -V/F158. There was also no independent survival effect in a multivariable Cox model. Similarly, functional polymorphisms in two other activating FcγR, -H/R131 (FcγRIIA) and -NA1/NA2 (FcγRIIIB), were not associated with outcome. There were also no significant survival differences among patient subgroups at increased risk of rejection-related injury, such as pre-sensitized recipients (> 0% panel reactivity; n = 438) or recipients treated for rejection within the first year after transplantation (n = 229). Our study results suggest that the earlier shown association of FcγR polymorphism with microcirculation inflammation may not be strong enough to exert a meaningful effect on graft survival.
功能 Fc 受体(FcγR)IIIa 多态性 -V/F158 先前被认为决定了供体特异性 HLA 抗体引发微循环炎症的潜力,而微循环炎症是抗体介导的肾移植排斥反应的关键病变。然而,迄今为止,尚未评估其与长期移植结局的关系。为了阐明 -V/F158 多态性对肾移植存活的影响,我们对 1940 对受者/供者对进行了基因分型。分析 10 年无死亡的移植物存活率,我们发现 -V/F158 与之无关。多变量 Cox 模型也没有独立的生存影响。同样,两种其他激活型 FcγR(-H/R131(FcγRIIA)和 -NA1/NA2(FcγRIIIB)的功能性多态性也与结局无关。在易发生与排斥反应相关损伤的患者亚组中,如预致敏受者(> 0% 面板反应性;n = 438)或移植后 1 年内接受排斥反应治疗的受者(n = 229)中,也没有显著的生存差异。我们的研究结果表明,先前显示的 FcγR 多态性与微循环炎症的关联可能不够强,无法对移植物存活产生有意义的影响。