Genetic variation in immunoglobulin G receptor affects survival after lung transplantation.

Ruttens, D; Verleden, S E; Goeminne, P C; Vandermeulen, E; Wauters, E; Cox, B; Vos, R; Van Raemdonck, D E; Lambrechts, D; Vanaudenaerde, B M; Verleden, G M

Ruttens, D; Verleden, S E; Goeminne, P C; Vandermeulen, E; Wauters, E; Cox, B; Vos, R; Van Raemdonck, D E; Lambrechts, D; Vanaudenaerde, B M; Verleden, G M.

Afiliación

Ruttens D; Lung Transplant Unit, Laboratory of Pneumology, KU Leuven, University Hospital Gasthuisberg Leuven, Leuven, Belgium.

Am J Transplant ; 14(7): 1672-7, 2014 Jul.

Article en En | MEDLINE | ID: mdl-24802006

RESUMEN

Chronic rejection remains the most important complication after lung transplantation (LTx). There is mounting evidence that both rheumatoid arthritis and chronic rejection share similar inflammatory mechanisms. As genetic variants in the FCGR2A gene that encodes the immunoglobulin gamma receptor (IgGR) have been identified in rheumatoid arthritis, we investigated the relationship between a genetic variant in the IgGR gene and chronic rejection and mortality after LTx. Recipient DNA from blood or explant lung tissue of 418 LTx recipients was evaluated for the IgGR (rs12746613) polymorphism. Multivariate analysis was carried out, correcting for several co-variants. In total, 216 patients had the CC-genotype (52%), 137 had the CT-genotype (33%) and 65 had the TT-genotype (15%). Univariate analysis demonstrated higher mortality in the TT-genotype compared with both other genotypes (p < 0.0001). Multivariate analysis showed that the TT-genotype had worse survival compared with the CC-genotype (hazard ratio [HR] = 2.26, p = 0.0002) but no significance was observed in the CT-genotype (HR = 1.32, p = 0.18). No difference was seen for chronic rejection. The TT-genotype demonstrated more respiratory infections (total, p = 0.037; per patient, p = 0.0022) compared with the other genotypes. A genetic variant in the IgGR is associated with higher mortality and more respiratory infections, although not with increased prevalence of chronic rejection, after LTx.

Asunto(s)

Rechazo de Injerto/genética; Rechazo de Injerto/mortalidad; Trasplante de Pulmón/mortalidad; Polimorfismo Genético/genética; Receptores de IgG/genética; Femenino; Estudios de Seguimiento; Genotipo; Humanos; Trasplante de Pulmón/efectos adversos; Masculino; Persona de Mediana Edad; Reacción en Cadena de la Polimerasa; Pronóstico; Infecciones del Sistema Respiratorio/etiología; Infecciones del Sistema Respiratorio/mortalidad; Factores de Riesgo; Tasa de Supervivencia

Palabras clave

FCGR2A; IgG; genetics; lung transplantation; mortality; respiratory infections

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Polimorfismo Genético / Trasplante de Pulmón / Receptores de IgG / Rechazo de Injerto Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2014 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Estados Unidos

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