Serological and genetic factors in early recurrence of IgA nephropathy after renal transplantation

Clin Transplant. Nov-Dec 2007;21(6):728-37. doi: 10.1111/j.1399-0012.2007.00730.x.

Abstract

Background: The relative role of IgA anomalies and genetic factors in IgA nephropathy (IgAN) recurrence after transplantation has never been investigated in a single cohort.

Methods: Sixty-one transplanted patients who had IgAN as an original disease (30 with biopsy-proved early recurrence, median 2.9 yr post-transplant), and 120 controls, were investigated for aberrantly glycosylated IgA1, IgA binding to mesangial matrix, macromolecular IgA (IgA/fibronectin and uteroglobulin/IgA/fibronectin complexes), and polymorphisms of cytokines [tumor necrosis factor alpha (TNFalpha), interleukin 10 (IL-10), IL-6, interferon gamma and transforming growth factor beta 1] and renin-angiotensin system (angiotensinogen converting enzyme, angiotensin II receptor 1, and angiotensinogen) genes.

Results: At multivariate logistic regression analysis, recurrence showed a border-line association with aberrantly glycosylated IgA1 [odds ratio (OR) 8.172, p = 0.077], and was significantly less frequent in carriers of -308 AG/AA TNF-alpha"high producer" genotype (OR 0.125, p = 0.036) and -1082, -819, -592 ACC/ATA IL-10 "low producer" (OR 0.038, p = 0.009) genotypes.

Conclusion: High levels of aberrantly glycosylated IgA1 do not appear to play a strong crucial role in recurrence of IgAN. Polymorphisms of TNFalpha and IL-10 known to condition Th1 prevalence were associated with protection from early recurrence of IgAN.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Anti-Idiotypic / immunology*
  • Biomarkers
  • Biopsy
  • Cytokines / genetics*
  • DNA / genetics*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Glomerulonephritis, IGA / etiology*
  • Glomerulonephritis, IGA / genetics
  • Glomerulonephritis, IGA / immunology
  • Humans
  • Immunoglobulin A / immunology*
  • Kidney / pathology
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Polymorphism, Genetic*
  • Prognosis
  • Recurrence
  • Retrospective Studies
  • Time Factors

Substances

  • Antibodies, Anti-Idiotypic
  • Biomarkers
  • Cytokines
  • Immunoglobulin A
  • DNA