title: Relevance of KIR gene polymorphisms in bone marrow transplantation outcome.
abstract: Natural Killer (NK) cells may be involved both in allogeneic bone marrow transplantation (BMT) rejection and graft-versus-host disease (GVHD). The physiologic functions of NK cells appear to be regulated by diverse non-inhibitory and inhibitory receptors including the killer cell immunoglobulin-like receptors (KIR). Although human leukocyte antigen (HLA) epitope mismatches are well-known causes of NK alloreactivity, the role of KIR genes in transplantation remains to be further investigated. In this study, we have evaluated whether KIR genotype differences between donors and recipients of HLA identical (related and unrelated) compared with HLA non-identical unrelated BMT, had an impact on transplantation outcome. Our results show that 5 of 15 KIR genes were always identical in donors and recipients and most variations were observed in the number and specificity of noninhibitory KIR genes. Based on the presence or absence of particular KIR genes, 70 different genotypes were obtained from all individuals. According to the donor or recipient KIR genotype, different combination patterns were described. Interestingly, when the recipient KIR genotype was "included" in the donor KIR genotype, 100% (11/11 pairs) of unrelated BMT developed GVHD compared with 60% (18/30) in all other combinations (p = 0.012). In contrast, no GVHD was observed in related BMT when the recipient KIR genotype was "included" in the donor KIR genotype (p = 0.0001). In conclusion, our results reveal a great diversity for KIR genotypes in donors and recipients of BMT and that the risk of GVHD was maximum in unrelated BMT when the recipient KIR genotype was "included" in the donor KIR genotype.
authors.affiliation: Laboratoire d'Histocompatibilité Immunogénétique, EFS Pays de la Loire, Nantes Cedex, France.
authors.forename: Katia
authors.initials: K
authors.lastname: Gagne
authors.forename: Géraldine
authors.initials: G
authors.lastname: Brizard
authors.forename: Brigitte
authors.initials: B
authors.lastname: Gueglio
authors.forename: Noël
authors.initials: N
authors.lastname: Milpied
authors.forename: Patricia
authors.initials: P
authors.lastname: Herry
authors.forename: Françoise
authors.initials: F
authors.lastname: Bonneville
authors.forename: Mary Luce
authors.initials: ML
authors.lastname: Chéneau
authors.forename: Nicolas
authors.initials: N
authors.lastname: Schleinitz
authors.forename: Anne
authors.initials: A
authors.lastname: Cesbron
authors.forename: Gilles
authors.initials: G
authors.lastname: Folléa
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Harrousseau
authors.forename: Jean Denis
authors.initials: JD
authors.lastname: Bignon
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D005787:Gene Frequency; D006801:Humans; D007223:Infant; D007694:Killer Cells, Natural; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011971:Receptors, Immunologic / Q000235:genetics*; D054340:Receptors, KIR; D016896:Treatment Outcome
chemical_list: D011971:Receptors, Immunologic; D054340:Receptors, KIR