致敏受者细胞因子基因多态性与肾移植急性排斥反应的关系  

Cytokine gene polymorphism in sensitized kidney transplant recipients and its association with acute rejection episodes

作　　者：顾新伟[1] 赵明[1] 李留洋[1] 李民[1] 钱俊[1] 

机构地区：[1]第一军医大学珠江医院器官移植科,广东广州510282

出　　处：《第一军医大学学报》2003年第11期1211-1213,共3页Journal of First Military Medical University

摘　　要：目的研究致敏受者细胞因子基因多态性与肾移植急性排斥反应的关系。方法应用序列特异性引物聚合酶链反应(PCR-SSP)对97例术前群体反应性抗体阳性肾移植受者的肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)、转化生长因子-β1(TGF-β1)、白介素-6(IL-6)、干扰素-γ(IFN-γ)的基因型进行测定,并探讨细胞因子基因型对急性排斥反应发生率的影响。结果97例致敏肾移植受者术后3个月内共有23例发生了急性排斥反应,其中TNF-α和IL-10高产量基因型组受者的急性排斥反应发生率分别高达51.9%和55.5%,显著高于相应的低产量基因型受者的12.9%和13.3%(P<0.01)。联合TNF-α和IL-10发现,高TNF-α产量基因型和高、中IL-10基因型受者的急性排斥反应发生率为62.5%,显著高于两者均为低产量基因型者的8.5%(P<0.01)。未发现TGF-β1、IL-6、IFN-γ细胞因子基因多态性与急性排斥反应的关系。结论TNF-α和IL-10基因多态性对致敏受者肾移植术后的急性排斥反应发生率有明显影响,测定TNF-α和IL-10基因型有利于制订合理的免疫抑制方案。Objective To investigate the relationship between cytokine gene polymorphism in sensitized kidney transplant recipients and acute rejection episodes. Methods PCR using sequence-specific primer (PCR-SSP) was performed to determine the cytokine genotypes of tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), transforming growth factor-β1 (TGF-β1), interleukin-6 (IL-6), interferon-γ (IFN-γ) in 97 sensitized kidney transplant recipients. The association of cytokine genotypes with early graft rejection was explored. Results Acute rejection occurred in 23 of the 97 patients during the first three months after operation. The incidence of acute rejection was higher in the recipients with high TNF-α or high IL-10 producer genotype (51.9% and 55.5% respectively) than in the recipients with low TNF-α or low to intermediate IL-10 producer genotype (12.9% and 13.3% respectively, P<0.01). The incidence of acute rejection was even higher in the recipients with high TNF-α in combination with intermediate to high IL-10 producer genotype than in the recipients with low TNF-α combined with low IL-10 producer genotype (62.5% vs 8.5%, P<0.01). No relations were identified between TGF-β1, IL-6, IFN-γ gene polymorphisms and the incidence of acute rejection. Conclusion TNF-α and IL-10 gene polymorphism may significantly influence the incidence of acute rejection episodes in sensitized kidney transplants, for whom determination of TNF-α and IL-10 genotype might help design feasible immunosuppressive protocols.

关 键 词：细胞因子 基因多态性 肾移植 急性排斥反应 肿瘤坏死因子-α 白介素-10 转化生长因子-β1 干扰素-Γ 

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