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HLA-G +3196 polymorphism as a risk factor for cell mediated rejection following heart transplant.
Human Immunology ( IF 3.1 ) Pub Date : 2020-01-09 , DOI: 10.1016/j.humimm.2020.01.002
Mitchell B Adamson 1 , Bennett Di Giovanni 2 , Roberto V P Ribeiro 3 , Frank Yu 4 , Julieta Lazarte 5 , Vivek Rao 3 , Diego H Delgado 2
Affiliation  

BACKGROUND Rejection is a leading cause of mortality following heart transplantation. Human leukocyte antigen-G (HLA-G) is an immune checkpoint which dampens the immune response. Reports suggest elevated HLA-G expression is associated with reduced allograft rejection. Our objective was to evaluate HLA-G polymorphisms and cell mediated rejection (CMR) development. METHODS Recipients (n = 123) were genotyped to identify relevant HLA-G polymorphisms in the 5'regulatory (-725, -201), 3'untranslated (+3197, +3187, +3142, 14-bp indel) and coding regions (haplotypes 1-6). CMR was evaluated via endomyocardial biopsy (grade ≥ 2R). Univariate/adjusted analyses were conducted via Kaplan Meier and proportional hazard models. RESULTS Mean recipient age was 48 (±12) years, with a median time to CMR of 4.6 years. 55 (45%) recipients had a biopsy grade ≥ 2R. Adjusted analysis revealed the +3196 G allele as a risk factor for CMR (p = 0.03). Compared to the minor GG genotype, CG had a 47.2% reduction in CMR risk (HR[95% CI] = 0.528 [0.235, 1.184]), while CC had a 66.9% reduction (0.331 [0.144, 0.761]). The recessive effect significantly increased CMR likelihood (2.388 [1.128, 5.059], p = 0.02). CONCLUSION The HLA-G +3196 G allele was identified as a risk factor for CMR diagnosis. HLA-G may have a role in therapeutic/diagnostic strategies against transplant rejection.

中文翻译:

HLA-G +3196基因多态性是心脏移植后细胞介导排斥反应的危险因素。

背景技术排斥是心脏移植后死亡的主要原因。人白细胞抗原-G(HLA-G)是抑制免疫反应的免疫检查点。报道表明,HLA-G表达升高与同种异体移植排斥反应减少有关。我们的目标是评估HLA-G多态性和细胞介导排斥(CMR)的发展。方法对受体(n = 123)进行基因分型,以鉴定5'调控区(-725,-201),3'非翻译区(+ 3197,+ 3187,+ 3142、14-bp indel)和编码区中的相关HLA-G多态性。 (1-6型)。通过心内膜活检(≥2R)评估CMR。通过Kaplan Meier和比例风险模型进行单变量/调整后的分析。结果平均接受者年龄为48(±12)岁,平均CMR时间为4.6年。55名(45%)接受者的活检等级≥2R。调整后的分析显示+3196 G等位基因是CMR的危险因素(p = 0.03)。与次要的GG基因型相比,CG的CMR风险降低了47.2%(HR [95%CI] = 0.528 [0.235,1.184]),而CC降低了66.9%(0.331 [0.144,0.761])。隐性效应显着增加了CMR可能性(2.388 [1.128,5.059],p = 0.02)。结论HLA-G +3196 G等位基因被确定为CMR诊断的危险因素。HLA-G可能在针对移植排斥的治疗/诊断策略中起作用。隐性效应显着增加了CMR可能性(2.388 [1.128,5.059],p = 0.02)。结论HLA-G +3196 G等位基因被确定为CMR诊断的危险因素。HLA-G可能在针对移植排斥的治疗/诊断策略中起作用。隐性效应显着增加了CMR可能性(2.388 [1.128,5.059],p = 0.02)。结论HLA-G +3196 G等位基因被确定为CMR诊断的危险因素。HLA-G可能在针对移植排斥的治疗/诊断策略中起作用。
更新日期:2020-04-21
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