全基因组荟萃分析将供受体非hla基因不匹配与肝移植后急性细胞排斥反应联系起来。

IF 5.6 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Hepatology Communications Pub Date : 2024-12-11 eCollection Date: 2025-01-01 DOI:10.1097/HC9.0000000000000601
Lianne M Nieuwenhuis, Yanni Li, Bao-Li Loza, Annechien J A Lambeck, Shixian Hu, Ranko Gacesa, Michiel D Voskuil, Bouke G Hepkema, Bernadien H Jansen, Hans Blokzijl, Henk-Jan Verkade, Marius C van den Heuvel, Sumeet Asrani, Giuliano Testa, Goran Klintmalm, James Trotter, Kim M Olthoff, Abraham Shaked, Brendan J Keating, Rinse K Weersma, Eleonora A M Festen, Vincent E de Meijer
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引用次数: 0

摘要

背景:急性细胞排斥反应(ACR)仍然是肝移植术后常见的并发症,会导致严重的发病率。在肾移植中,非人类白细胞抗原(非 HLA)错配与急性细胞排斥反应风险增加有关。因此,我们假设供体-受体非 HLA 基因错配与肝移植后 ACR 发生率增加有关:我们在 3 个独立队列中对供体-受体肝移植配对(共 1846 对)进行了一项国际多中心病例对照全基因组关联研究。为了评估基因错配负担,我们根据所有非 HLA 功能 SNP,特别是跨膜或分泌蛋白编码的 SNP,计算了单核苷酸多态性(SNP)错配的总分,因为它们更有可能影响免疫系统。我们在每个队列的多变量考克斯回归模型中分析了非 HLA 错配得分与 ACR 之间的关系,然后进行了加权荟萃分析:结果:在移植后第一年,1-3队列中的689名受者中有90名(13%)、720名受者中有161名(22%)、437名受者中有48名(11%)出现了ACR。加权荟萃分析表明,功能性非 HLA SNPs 的错配率越高,ACR 的发生率越高(HR 5.99;95% CI:1.39-20.08;P=0.011)。此外,我们还发现编码跨膜或分泌蛋白的 SNPs 的错配对 ACR 的影响更大(HR 7.54;95% CI 1.95-28.79;p=0.003)。敏感性分析表明,估算的HLA错配不影响非HLA错配得分与ACR之间的关联:结论:供体与受体功能性非 HLA SNPs 的总体错配,尤其是编码跨膜或分泌蛋白的 SNPs 的错配与肝移植后 1 年 ACR 相关。识别配对间的高风险免疫负担可预防早期移植排斥反应,并有助于个性化免疫抑制治疗。不过,未来的研究还需要使用基因分型的 HLA 队列来验证我们的发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Genome-wide meta-analysis associates donor-recipient non-HLA genetic mismatch with acute cellular rejection post-liver transplantation.

Background: Acute cellular rejection (ACR) remains a common complication causing significant morbidity post-liver transplantation. Non-human leukocyte antigen (non-HLA) mismatches were associated with an increased risk of ACR in kidney transplantation. Therefore, we hypothesized that donor-recipient non-HLA genetic mismatch is associated with increased ACR incidence post-liver transplantation.

Methods: We conducted an international multicenter case-control genome-wide association study of donor-recipient liver transplant pairs in 3 independent cohorts, totaling 1846 pairs. To assess genetic mismatch burden, we calculated sum scores for single-nucleotide polymorphism (SNP) mismatch based on all non-HLA functional SNPs, specifically SNPs coding for transmembrane or secreted proteins as they more likely affect the immune system. We analyzed the association between the non-HLA mismatch scores and ACR in a multivariable Cox regression model per cohort, followed by a weighted meta-analysis.

Results: During the first year post-transplantation, 90 of 689 (13%), 161 of 720 (22%), and 48 of 437 (11%) recipients experienced ACR in cohorts 1-3, respectively. Weighted meta-analyses showed that higher mismatch in functional non-HLA SNPs was associated with an increased incidence of ACR (HR 5.99; 95% CI: 1.39-20.08; p=0.011). Moreover, we found a larger effect of mismatch in SNPs coding for transmembrane or secreted proteins on ACR (HR 7.54; 95% CI 1.95-28.79; p=0.003). Sensitivity analyses showed that imputed HLA mismatch did not affect the associations between both non-HLA mismatch scores and ACR.

Conclusions: Donor-recipient mismatch of functional non-HLA SNPs overall and, especially, of SNPs encoding transmembrane or secreted proteins correlated with 1-year ACR post-liver transplantation. Identifying high-risk immunological burdens between pairs may prevent early graft rejection and aid in personalizing immunosuppressive therapy. Future studies are, however, needed to validate our findings using a genotyped HLA cohort.

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来源期刊
Hepatology Communications
Hepatology Communications GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
8.00
自引率
2.00%
发文量
248
审稿时长
8 weeks
期刊介绍: Hepatology Communications is a peer-reviewed, online-only, open access journal for fast dissemination of high quality basic, translational, and clinical research in hepatology. Hepatology Communications maintains high standard and rigorous peer review. Because of its open access nature, authors retain the copyright to their works, all articles are immediately available and free to read and share, and it is fully compliant with funder and institutional mandates. The journal is committed to fast publication and author satisfaction. ​
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