A Promoter Polymorphism in the CD59 Complement Regulatory Protein Gene in Donor Lungs Correlates With a Higher Risk for Chronic Rejection After Lung Transplantation

Am J Transplant. 2016 Mar;16(3):987-98. doi: 10.1111/ajt.13497. Epub 2015 Oct 30.

Abstract

Complement activation leads primarily to membrane attack complex formation and subsequent target cell lysis. Protection against self-damage is regulated by complement regulatory proteins, including CD46, CD55, and CD59. Within their promoter regions, single-nucleotide polymorphisms (SNPs) are present that could influence transcription. We analyzed these SNPs and investigated their influence on protein expression levels. A single SNP configuration in the promoter region of CD59 was found correlating with lower CD59 expression on lung endothelial cells (p = 0.016) and monocytes (p = 0.013). Lung endothelial cells with this SNP configuration secreted more profibrotic cytokine IL-6 (p = 0.047) and fibroblast growth factor β (p = 0.036) on exposure to sublytic complement activation than cells with the opposing configuration, whereas monocytes were more susceptible to antibody-mediated complement lysis (p < 0.0001). Analysis of 137 lung transplant donors indicated that this CD59 SNP configuration correlates with impaired long-term survival (p = 0.094) and a significantly higher incidence of bronchiolitis obliterans syndrome (p = 0.046) in the recipient. These findings support a role for complement in the pathogenesis of this posttransplant complication and are the first to show a deleterious association of a donor CD59 promoter polymorphism in lung transplantation.

Keywords: basic (laboratory) research/science; bronchiolitis obliterans (BOS); complement biology; immunobiology; lung transplantation/pulmonology; translational research/science.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • CD59 Antigens / genetics*
  • Complement Activation
  • Female
  • Follow-Up Studies
  • Graft Rejection / diagnosis*
  • Graft Rejection / etiology
  • Graft Survival
  • Humans
  • Lung Transplantation*
  • Male
  • Middle Aged
  • Monocytes / cytology
  • Monocytes / metabolism
  • Polymorphism, Genetic / genetics*
  • Postoperative Complications*
  • Prognosis
  • Promoter Regions, Genetic / genetics*
  • Survival Rate
  • Tissue Donors*
  • Young Adult

Substances

  • CD59 Antigens
  • CD59 protein, human