供、受者细胞因子及其受体单核苷酸多态性对肾移植近期急性排斥反应的影响  

Impacts of donor and recipient′s SNP of cytokine and cytokine receptor on early acute renal allograft rejection

作　　者：郭义峰[1] 谭建明[1] 李荣宇 刘三震 李瑶 应康[3] 谢毅[3] 毛裕民[3] 

机构地区：[1]上海交通大学附属第一人民医院肾移植科,200080 [2]上海联合基因科技集团博星芯片研究所 [3]上海复旦大学遗传研究所

出　　处：《中华医学杂志》2005年第44期3126-3133,共8页National Medical Journal of China

基　　金：上海市科委重大课题资助项目(024919005);全军"十五"医学杰出人才基金课题资助项目(01J003)

摘　　要：目的研究肾移植供受者的细胞因子和细胞因子受体单核苷酸多态性对术后早期移植物急性排斥反应的影响.方法 (1)根据有无急性排斥发生,129例肾移植受者分成急性排斥组和无排斥组(6个月内),根据HLA-A-B-DR错配、神经钙蛋白抑制剂、肾功能延迟恢复、ATG或MAb诱导治疗、冷缺血时间等情况,对两组患者进行比较,并比较两组5种细胞因子及5种受体的21个位点的基因型分布情况.(2)根据HLA-DR配型情况分成0～1个HLA DR位点错配组(0～1MM)、HLA-DR完全错配组(2MM),比较两组基因多态性的分布情况.结果 (1)129例肾移植受者中,39例(30.2%)发生急性排斥反应.(2)急性排斥组HLA-DR错配数和无排斥组中差异有统计学意义(P<0.05).(3)细胞因子和细胞因子受体位点的多态性在急性排斥组和无排斥组中的分布有明显不同,差异有统计学意义.(4)HLA-DR完全错配组(2MM组)和0～1个位点错配组(0～1MM组)进行比较,两者多态性分布亦有不同.结论肾移植供受者不同基因多态性对预测排斥的发生有指导意义.Objective To investigate the impact of donor and recipient＇s SNP of cytokine and cytokine receptor on early acute rejection after renal transplantation. Methods （ 1 ） 129 cases of cadaveric renal allograft recipients were divided into two groups according to the presence or absence of acute graft rejection. The distribution of 21 single nucleotide polymorphisms in cytokines and cytokine receptors gene were compared between two groups as well as latent factors affecting the development of acute rejection. （2） Based on the result of HLA-DR matching between donor and recipient, the recipients with AR were stratified into two conditions, 0-1 locus mismatched （0-1MM） and completely mismatched （2MM）. By aids of SPSS 11.5 software, association analysis was assessed using Krusakal Wallis test, 2 × 2 or 2 × n contingency table, the Chi-square test. Results （ 1 ） Of 129 recipients of renal transplantation,39 developed acute graft rejection （30. 2% ）. （2） Compared with recipients without acute rejection, the number of HLA-DR mismatching was significantly higher in rejection group. （3） In rejection group and non-rejection group, the gene polymorphism distribution was significantly different. （4） 0-1MM group and 2MM group were various in the gene polymorphism distribution. Conclusions In the whole, the susceptibility of acute rejection after renal transplantation may be predicted by the donor and recipient＇s SNP of cytokine and cytokine receptor.

关 键 词：肾移植 移植物排斥 多态性 单核苷酸 寡核苷酸探针 

分 类 号：R699.2[医药卫生—泌尿科学] R394[医药卫生—外科学]