细胞因子基因型多态性对肾移植效果的影响

目的：探讨细胞因子基因型多态性对肾脏移植效果的影响。方法：应用聚合酶链反应-序列特异性引物（PCR-SSP）法，检测了91例肾移植受者的细胞因子TNF-α、IL-10、TGF-β1和IL-6基因型，分析细胞因子基因型的分布频率以及不同细胞因子基因型对肾移植效果的影响。结果：在91例肾脏移植受者中，TNF-α和IL-10的基因型是以低分泌型占优势，分别达到90.1%(82/91)和79.1%(72/91),而TGF-β1和IL-6的基因型是以高分泌型占优势，分别达到79.1%(72/91)和100%（91/91）。在具有TNF-α高基因分泌型和IL-10中、高基因分泌型的肾移植受者中，移植后急性排斥发生率显著高于低基因分泌型受者（P＜0.05)，而且IL-10中、高基因分泌型受者发生的急性排斥反应是以急性血管性排斥反应为主。结论：细胞因子TNF-α和IL-10的基因型多态性对肾脏移植后急性排斥反应发生率及程度均有明显的影响；肾脏移植前检测移植受者的细胞因子基因型有助于正确预测和估价移植后效果。

Influence of cytokine gene polymorphism on renal transplantation

OBJECTIVE: To investigate the influence of cytokine gene polymorphism on renal transplantation. METHODS: The cytokine genotypes of cytokines TNF-alpha, IL-10, TGF-beta(1), and L-6 among 91 consecutive kidney recipients were detected by PCR-SSP. The distribution frequencies of different cytokine genotypes and the influence of cytokine gene polymorphism on renal transplantation were analyzed. RESULTS: Among the 91 renal recipients, the dominant genotypes of IL-10 and TNF-alpha were low producer genotype with the frequencies of 90.1% and 79.1% respectively; and the dominant genotypes of TGF-beta(1) and IL-6 were high producer genotypes (79.1% and 100% respectively). The kidney recipients with TNF-alpha high producer genotype and IL-10 high or intermediate producer genotype were associated with more acute rejection episodes than those with low producer genotypes. The acute rejection episodes in the kidney recipients with IL-10 high or intermediate producer genotype were mainly vascular acute rejection. CONCLUSION: The cytokine gene polymorphism has significant influence on incidence and severity of acute rejection after renal transplantation. Detecting the cytokine genotype before renal transplantation is beneficial to predict the outcome of transplantation accurately.