摘要
目的探讨肾移植受者转化生长因子β1（TGF-β1）基因多态性与慢性移植肾肾病（CAN）的关系。方法选取本医院经临床表现及病理确诊为CAN的50例患者作为CAN组，50例肾移植术后移植肾功正常者为对照组。用全血DNA提取试剂盒自两组静脉血标本中提取DNA模板，应用微量序列特异性引物聚合酶链反应（PCR-SSP）对两组患者的TGF-β1“＋869”和“＋915”遗传突变位点的基因型进行测定比较。依据文献中基因型与血清细胞因子水平的关系，划分患者TGF-β1表现型为高产量及中低产量，为在研究TGF-β1基因多态性对CAN的影响时剔除干扰因素，同时对可能影响CAN的临床因素进行筛选分析。结果CAN组中TGF-β1基因表现型为高产量者为70％（35／50），对照组高产量者为38％（19／50），两组相比有显著差异（Х^2=10．306，P=0．001）。对发生CAN的可能影响因素的比较显示，急性排斥反应在两组间有差异，进行再次分组比较，显示有无急性排斥反应对CAN组及对照组中TGF-β1的高产量率无影响，CAN组中高产量率明显高于对照组。结论CAN中TGF-β1基因的表现型以高产量为主，高产量率显著高于移植肾功正常患者，提示TGF-β1高产量型与慢性移植肾肾病具有相关性。受者TGF-β1基因型可作为预测肾移植后发生CAN危险程度的一个指标。
Objective To investigate the association between transforming growth factor beta-1 （TGF-β1） gene polymorphism and chronic allograft nephropathy （CAN）. Methods Fifty patients with failed renal allografts and clinically and histopathologically confirmed CAN were enrolled in this study along with another 50 renal transplant recipients with normal graft function. The DNA extracted from whole blood of the patients was amplified with PCR with sequence-specific primers for determining TGF-β1 genotypes （position ＋869, codon 10 and position ＋915, codon 25）. According to documented descriptions, the patients were classified into high and moderate-to-low cytokine production genotypes. The distribution frequencies of high production genotypes was then compared between CAN and non-CAN groups. To eliminate interference in the analysis of the association between TGF-β1 polymorphism and CAN, other possible risk factors for CAN were screened, including the patients＇ gender, age, HLA match, delayed graft function, acute rejection, immunosuppressive regimen, cytomegalovirus infection, hypertension, and high cholesterol. Results CAN patients showed significantly greater proportion of high cytokine production genotype than the non-CAN group [70% （35/50） vs 38% （19/50）, Х^2=10.306, P=0.001）. Of the screened risk factors for CAN, only acute rejection showed some difference between the two groups, but analysis after subgrouping according to acute rejection did not suggest its influence on CAN, which supports the result that the rate of high production genotype was significantly higher in CAN group than in the non-CAN group. Conclusion Most CAN patients have high TGF-β1 production genotype, which might be a risk factor for CAN after renal transplantation. TGF-β1 genotyping can be of value in predicting the risk of CAN after renal transplantation.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2007年第4期535-537,共3页
Journal of Southern Medical University
关键词
转化生长因子Β1
肾移植
慢性移植肾肾病
基因多态性
transforming growth factor beta-1
kidney transplantation
chronic allograft nephropathy
gene polymorphism
