The Implications Of Cytokines Gene Polymorphisms In Clinical Renal Transplantation

Part I: Cytokines gene polymorphism in sensitized kidney transplant recipients and relevance to acute rejection episodes Objective: To investigate the relationship between cytokines gene polymorphism in sensitized kidney transplant recipients and acute rejection episodes following transplantation.Methods: PCR-SSP using sequence -specific primer were performed to determine the cytokine genotypes of TNF- a , IL-10, TGF- B1,^ IL-6, IFN- Y in 97 sensitized kidney transplant recipients. The cytokine genotypes were analyzed with early graft rejection post-operation.Results: Acute rejection occurred in 23 of 97 patients during the first three months after operation .The incidence of acute rejection was higher in the recipients with high TNF- a or high IL-10 producer genotype than in the recipients with low TNF- a or low intermediate IL-10 producer genotype[51.9%,55.5% VS 12.9%( x 2=16.4),15.6%( x 2=17.57 ),P<0.01 respectively]. The incidence of acute rejection was even higher in the recipients with high TNF- a and high intermediate IL-10 producer genotype combination than in the recipients with low TNF- a. and low IL-10 producer genotype combination [62.5% VS 8.5%( x 2=20.13) P<0.01].No relationships were found between TGF- P 1 > IL-6> IFN- Y gene polymorphisms and the incidence of acute rejection. There were also no impacts of gene polymorphisms of TNF- a aL-10>TGF- P 1 aL-6>IFN- Y on acute rejection episodes in HLA-DR mismatched recipients.Conclusion: In this study we have shown that TNF- a and IL-10 gene polymorphism may have a significant influence on acute rejection episodes of sensitized kidney transplants. Perhaps it is beneficial for feasible immunosuppressive protocol in sensitized kidney transplant recipients by TNF- a and IL-10 genotype.