The role of IL-23/IL-17 axis in human kidney allograft rejection

J Leukoc Biol. 2018 Dec;104(6):1229-1239. doi: 10.1002/JLB.5AB0318-148R. Epub 2018 Jul 19.

Abstract

Th17 cell subset has been implicated in autoimmune diseases, tumor immunity and, transplant rejection. In order to investigate the role of IL-17/IL-23 pathway in allograft outcome, intragraft expression of IL-17 mRNA and single nucleotide polymorphisms (SNPs) of IL-17A, IL-17F, IL-17RC, and IL23R genes were evaluated with a quantification of IL-17A, IL-17F, and IL-23 plasma levels. This study revealed that recipients with acute rejection (AR) had a significant increase in IL-17A mRNA expression levels after transplantation compared to controls (P = 0.037). Moreover, IL-17A plasma levels were significantly higher in AR group; pretransplantation (Day-1 [D-1]): P = 0.00022 and posttransplantation (Day 7 [D7]): P < 10-14 . IL-17F and IL-23 plasma levels were significantly higher in AR at D7 only (47.86 vs. 22.99 pg/ml; and 33.82 vs. 18.811 pg/ml; P = 0.015 and P < 10-17 , respectively). Using receiver-operating characteristic curves, D7 IL-17A and IL-23 plasma levels exhibited excellent sensitivities and specificities for predicting AR. Genetic study revealed no association between IL-17A, IL-17F, IL-17RC, and IL23R studied SNPs and AR. Nevertheless, a significant improvement of graft survival was found in kidney transplant recipients carrying IL-17F-rs763780*A/A, IL-17RC*G/G, and *G/A genotypes. Besides, IL-17A mRNA levels were significantly higher in patients carrying the IL-23R*G/G genotype comparatively to those with *G/A genotype. Based on these findings, significant increase of IL-17A mRNA and protein levels in AR recipients that are genetically controlled highlights the role of this cytokine that can be a useful clinical biomarker to predict early acute renal allograft rejection.

Keywords: SNPs; Th17; acute rejection; mRNA; plasma level; transplantation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Area Under Curve
  • Female
  • Follow-Up Studies
  • Genotype
  • Graft Rejection / genetics
  • Graft Rejection / physiopathology*
  • Graft Rejection / prevention & control
  • Graft Survival / genetics
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Interleukin-17 / blood
  • Interleukin-17 / genetics
  • Interleukin-17 / physiology*
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Polymorphism, Single Nucleotide*
  • Postoperative Period
  • RNA, Messenger / biosynthesis
  • ROC Curve
  • Receptors, Interleukin / blood
  • Receptors, Interleukin / genetics
  • Receptors, Interleukin / physiology*
  • Retrospective Studies
  • Young Adult

Substances

  • IL17A protein, human
  • IL17F protein, human
  • IL17RC protein, human
  • IL23R protein, human
  • Immunosuppressive Agents
  • Interleukin-17
  • RNA, Messenger
  • Receptors, Interleukin