糖皮质激素受体基因的三个多态性与肾移植患者早期临床结局的关系。
Association between the Three Polymorphisms of the Glucocorticoid Receptor Gene and the Early Clinical Outcome in Kidney Transplantation Patients.
机构信息
Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
Nephrology-Urology Research Center and Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
Iran J Med Sci. 2021 Nov;46(6):444-453. doi: 10.30476/ijms.2020.85872.1550.
BACKGROUND
Glucocorticoids are pivotal components of immunosuppressive regimens in solid organ transplantations. This study aimed to assess the possible association between the ER22/23EK, N363S, and Bcl1 polymorphisms, and short-term clinical outcomes, including acute rejection and delayed graft function (DGF), in kidney transplantation recipients.
METHODS
A case-control study was conducted in a two-year period on adults with transplanted kidneys, comprised of subjects without rejection (n=50, control) and those with documented rejection within one year after transplantation (n=50, case), between April 2017 and September 2018, in Shiraz, Iran. Demographic characteristics and clinical and paraclinical findings were gathered. The genotyping of the ER22/23EK, N363S, and Bcl1 polymorphisms was carried out via polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The association between the genotypes and DGF as well as rejection types was evaluated using either the Chi square test or Fisher exact test. A stepwise logistic regression analysis was conducted to determine the independent factors of acute rejection within the first year after transplantation.
RESULTS
The study population consisted of 64 men and 36 women. The frequency of mutated alleles was 0.32 for G (Bcl1), 0.02 for S (N363S), and 0.065 for A (ER22/23EK). There was no significant association either between the studied polymorphisms and acute rejection or between the Bcl1 (P=0.17), N363S (P=0.99), and ER22/23EK (P=0.99) genotypes and DGF. The length of hospital stay after kidney transplantation was slightly more in N363N and ER22/23EK wild allele carriers. However, this difference was not statistically significant.
CONCLUSION
Our data suggested no statistically significant association between the genotypes of the studied polymorphisms and early clinical outcomes after kidney transplantation.
背景
糖皮质激素是实体器官移植中免疫抑制方案的关键组成部分。本研究旨在评估 ER22/23EK、N363S 和 Bcl1 多态性与短期临床结局（包括急性排斥和延迟移植物功能障碍（DGF））之间的可能关联，在接受肾移植的患者中。
方法
在 2017 年 4 月至 2018 年 9 月期间，在伊朗设拉子进行了一项为期两年的成人肾移植患者病例对照研究，包括无排斥组（n=50，对照组）和移植后一年内发生排斥的患者（n=50，病例组）。收集了人口统计学特征、临床和临床前发现。通过聚合酶链反应-限制性片段长度多态性（PCR-RFLP）进行 ER22/23EK、N363S 和 Bcl1 多态性的基因分型。使用卡方检验或 Fisher 确切检验评估基因型与 DGF 以及排斥类型之间的关系。采用逐步逻辑回归分析确定移植后第一年发生急性排斥的独立因素。
结果
研究人群包括 64 名男性和 36 名女性。G（Bcl1）突变等位基因的频率为 0.32，S（N363S）为 0.02，A（ER22/23EK）为 0.065。研究多态性与急性排斥或 Bcl1（P=0.17）、N363S（P=0.99）和 ER22/23EK（P=0.99）基因型与 DGF 之间均无显著关联。肾移植后住院时间稍长，但 N363N 和 ER22/23EK 野生等位基因携带者的差异无统计学意义。
结论
我们的数据表明，在肾移植后早期临床结局中，研究多态性的基因型与统计学上无显著关联。
Zotero 插件