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HLA 等位基因对肾移植受者 COVID-19 严重程度的影响:一项单中心研究

Impact of HLA Alleles on COVID-19 Severity in Kidney Transplant Recipients: A Single-Center Study.

作者信息

Altundaş Necip, Balkan Eda, Kızılkaya Murat, Aksungur Nurhak, Kara Salih, Korkut Ercan, Sevinç Can, Öztürk Gürkan

机构信息

Department of General Surgery, Atatürk University, Erzurum, TUR.

Department of Medical Biology, Atatürk University, Erzurum, TUR.

出版信息

Cureus. 2024 Aug 26;16(8):e67881. doi: 10.7759/cureus.67881. eCollection 2024 Aug.

Abstract

Introduction The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, particularly affecting vulnerable populations, such as organ transplant recipients. Human leukocyte antigens (HLAs) play a critical role in immune response regulation, and understanding their association with COVID-19 can provide insights into disease susceptibility and severity. This study aims to explore the association between HLA allele variability and COVID-19 susceptibility and severity among kidney transplant recipients. Methods In 2023, we conducted a study on 73 kidney transplant recipients who tested positive for COVID-19 via polymerase chain reaction. This study included assessments of clinical status, immunosuppressive drug levels, HLA allele frequencies, and donor-recipient tissue compatibility. Molecular analyses were performed using sequence-specific oligonucleotide typing, and statistical analysis was conducted using IBM SPSS Statistics, version 20.0 (IBM Corp., Armonk, NY). Results Among the participants, 31 were hospitalized and 42 were treated as outpatients. Significant differences were observed in HLA allele distributions, particularly the HLA-A*11 allele, which was more prevalent in outpatient-treated patients, suggesting a potential protective effect. No significant age differences were observed between hospitalized and outpatient groups. Serum tacrolimus levels were notably higher in outpatients. Statistical analyses revealed significant associations between certain HLA groups and the severity of COVID-19 infection. Conclusions This study highlights the importance of HLA allele compatibility in influencing the clinical outcomes of COVID-19 in kidney transplant recipients. The findings suggest that specific HLA alleles may reduce susceptibility or moderate the severity of COVID-19, indicating a need for broader genetic studies across diverse populations to validate these observations and improve management strategies for transplant recipients during pandemics.

摘要

引言 2019 冠状病毒病(COVID-19)大流行对全球健康产生了重大影响,尤其影响了器官移植受者等弱势群体。人类白细胞抗原(HLA)在免疫反应调节中起关键作用,了解它们与 COVID-19 的关联有助于深入了解疾病易感性和严重程度。本研究旨在探讨肾移植受者中 HLA 等位基因变异性与 COVID-19 易感性及严重程度之间的关联。方法 2023 年,我们对 73 名经聚合酶链反应检测 COVID-19 呈阳性的肾移植受者进行了一项研究。该研究包括对临床状况、免疫抑制药物水平、HLA 等位基因频率以及供受者组织相容性的评估。使用序列特异性寡核苷酸分型进行分子分析,并使用 IBM SPSS Statistics 20.0 版本(IBM 公司,纽约州阿蒙克)进行统计分析。结果 在参与者中,31 人住院治疗,42 人门诊治疗。观察到 HLA 等位基因分布存在显著差异,尤其是 HLA-A*11 等位基因,在门诊治疗患者中更为普遍,提示可能具有保护作用。住院组和门诊组之间未观察到显著的年龄差异。门诊患者的他克莫司血清水平明显更高。统计分析显示某些 HLA 组与 COVID-19 感染的严重程度之间存在显著关联。结论 本研究强调了 HLA 等位基因相容性在影响肾移植受者 COVID-19 临床结局方面的重要性。研究结果表明,特定的 HLA 等位基因可能降低 COVID-19 的易感性或减轻其严重程度,这表明需要在不同人群中进行更广泛的基因研究,以验证这些观察结果,并改善大流行期间移植受者的管理策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31e5/11425025/7cb80e97d79e/cureus-0016-00000067881-i01.jpg

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