No association of genetic variants in TLR4, TNF-α, IL10, IFN-γ, and IL37 in cytomegalovirus-positive renal allograft recipients with active CMV infection-Subanalysis of the prospective randomised VIPP study

PLoS One. 2021 Apr 16;16(4):e0246118. doi: 10.1371/journal.pone.0246118. eCollection 2021.

Abstract

Background: Cytomegalovirus (CMV) infection is amongst the most important factors complicating solid organ transplantation. In a large prospective randomized clinical trial, valganciclovir prophylaxis reduced the occurrence of CMV infection and disease compared with preemptive therapy in CMV-positive renal allograft recipients (VIPP study; NCT00372229). Here, we present a subanalysis of the VIPP study, investigating single nucleotide polymorphisms (SNPs) in immune-response-related genes and their association with active CMV infection, CMV disease, graft loss or death, rejection, infections, and leukopenia.

Methods: Based on literature research ten SNPs were analyzed for TLR4, three for IFN-γ, six for IL10, nine for IL37, and two for TNF-α. An asymptotic independence test (Cochran-Armitage trend test) was used to examine associations between SNPs and the occurrence of CMV infection or other negative outcomes. Statistical significance was defined as p<0.05 and Bonferroni correction for multiple testing was performed.

Results: SNPs were analyzed on 116 blood samples. No associations were found between the analyzed SNPs and the occurrence of CMV infection, rejection and leukopenia in all patients. For IL37 rs2723186, an association with CMV disease (p = 0.0499), for IL10 rs1800872, with graft loss or death (p = 0.0207) and for IL10 rs3024496, with infections (p = 0.0258) was observed in all patients, however did not hold true after correction for multiple testing.

Conclusion: The study did not reveal significant associations between the analyzed SNPs and the occurrence of negative outcomes in CMV-positive renal transplant recipients after correction for multiple testing. The results of this association analysis may be of use in guiding future research efforts.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / therapeutic use
  • Cytomegalovirus / isolation & purification
  • Cytomegalovirus Infections / etiology
  • Cytomegalovirus Infections / genetics*
  • Cytomegalovirus Infections / prevention & control
  • Female
  • Humans
  • Interferon-gamma / genetics*
  • Interleukin-1 / genetics*
  • Interleukin-10 / genetics*
  • Kidney Transplantation / adverse effects
  • Male
  • Middle Aged
  • Polymorphism, Single Nucleotide
  • Prospective Studies
  • Toll-Like Receptor 4 / genetics*
  • Tumor Necrosis Factor-alpha / genetics*
  • Valganciclovir / therapeutic use

Substances

  • Antiviral Agents
  • IL10 protein, human
  • IL37 protein, human
  • Interleukin-1
  • TLR4 protein, human
  • Toll-Like Receptor 4
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Interferon-gamma
  • Valganciclovir

Associated data

  • ClinicalTrials.gov/NCT00372229

Grants and funding

The authors declare that this study received funding from Roche Pharma AG. The funder provided support in the form of salaries for the authors [MZ and EMW], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific role of this author is articulated in the ‘author contributions’ section. Medical writing assistance was provided by Physicians World Europe GmbH, Mannheim, Germany, was funded by Roche Pharma AG. ES and MS are supported in part by the Robert Bosch Stiftung, Stuttgart, Germany. OW is supported by an unrestricted grant of the Rudolf-Ackermann-Stiftung (Stiftung für Klinische Infektiologie), Germany. The funders Robert Bosch Stiftung, Stuttgart, Germany and the Rudolf-Ackermann-Stiftung (Stiftung für Klinische Infektiologie) did not have any role in the study design, data collection and analysis, methodology, decision to publish, or preparation of the manuscript.