Objective: To investigate the relationship between cytokine gene polymorphism in sensitized kidney transplant recipients and acute rejection episodes.
Methods: PCR using sequence-specific primer (PCR-SSP) was performed to determine the cytokine genotypes of tumor necrosis factor-alpha (TNF-alpha), interleukin-10 (IL-10), transforming growth factor-beta1 (TGF-beta1), interleukin-6 (IL-6), interferon-gamma (IFN-gamma) in 97 sensitized kidney transplant recipients. The association of cytokine genotypes with early graft rejection was explored.
Results: Acute rejection occurred in 23 of the 97 patients during the first three months after operation. The incidence of acute rejection was higher in the recipients with high TNF-alpha or high IL-10 producer genotype (51.9% and 55.5% respectively) than in the recipients with low TNF-alpha or low to intermediate IL-10 producer genotype (12.9% and 13.3% respectively, P<0.01). The incidence of acute rejection was even higher in the recipients with high TNF-alpha in combination with intermediate to high IL-10 producer genotype than in the recipients with low TNF-alpha combined with low IL-10 producer genotype (62.5% vs 8.5%, P<a0.01). No relations were identified between TGF-beta1, IL-6, IFN-gamma gene polymorphisms and the incidence of acute rejection.
Conclusion: TNF-alpha and IL-10 gene polymorphism may significantly influence the incidence of acute rejection episodes in sensitized kidney transplants, for whom determination of TNF-alpha and IL-10 genotype might help design feasible immunosuppressive protocols.