title: Allograft TNFbeta and IL16 polymorphisms influence HCV recurrence and severity after liver transplantation.
abstract: Hepatitis C (HCV) recurrence after liver transplantation is universal although severity varies. We explored whether certain donor cytokine gene polymorphisms may be useful markers of susceptibility to severe recurrence. Allograft tumor necrosis factor (TNF) beta and interleukin (IL) 16 gene polymorphisms were correlated with l-yr clinical outcome among HCV+ recipients. Recipients of donor TNFbeta(2,2) (n = 8) experienced less recurrence (50% vs. 71%, P < 0.05), less fibrosis (25% vs. 76%, P < 0.01), and less rejection (25% vs. 71%, P < 0.01) than donor TNFbeta(1,1) (n = 19). Recipients of donor TNFbeta(1,2) (n = 27) demonstrated an intermediate picture with less fibrosis (56%, P < 0.01) and less rejection (37%, P < 0.01) than TNFbeta(1,1). Recipients with donor IL16(TC) (n = 22) showed less recurrence (65% vs. 78%, P = 0.05), less fibrosis (53% vs. 67%, P = 0.06), and less rejection (41% vs. 55%, P = 0.06) than IL16(TT) (n = 32) genotype. Recipients of the combination TNFbeta(2,2)/IL16(TC) donor genotype had the most benign clinical outcome with less recurrence (33% vs. 75%, P < 0.01), no fibrosis (0% vs. 50%, P < 0.001), and fewer rejections (33% vs. 75%, P < 0.01) than donor TNFbeta(1,1)/IL16(TT) genotype. In vitro production of cytokines correlated with genotype. Release of soluble TNFbeta for TNFbeta(1,1) vs. TNFbeta(1,2) and TNFbeta(2,2) was 4803 +/- 2142 pg/mL vs. 5629 +/- 3106 (P = not significant [ns]) and 7180 +/- 3005 (P = ns). Release of soluble IL16 for IL16(TT) vs. IL16(TC) was 437 +/- 86 pg/mL vs. 554 +/- 39 (P = 0.06). In conclusion, allograft TNFbeta and IL16 gene polymorphisms may be useful markers to predict the severity of disease recurrence among HCV+ patients after liver transplantation.
authors.affiliation: Department of Surgery, Medical College of Virginia Hospitals at Virginia Commonwealth University, Richmond, VA 23298, USA. pkimball@gems.vcu.edu
authors.forename: Pam
authors.initials: P
authors.lastname: Kimball
authors.forename: Melissa
authors.initials: M
authors.lastname: Baker
authors.forename: Robert A
authors.initials: RA
authors.lastname: Fisher
mesh_terms: D002478:Cells, Cultured; D005260:Female; D005819:Genetic Markers; D005838:Genotype; D006084:Graft Rejection / Q000821:virology*; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000235:genetics / Q000517:prevention & control; D006801:Humans; D066298:In Vitro Techniques; D019410:Interleukin-16 / Q000235:genetics* / Q000378:metabolism; D017093:Liver Failure / Q000235:genetics / Q000601:surgery / Q000821:virology; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008214:Lymphocytes / Q000502:physiology; D008233:Lymphotoxin-alpha; D008297:Male; D011110:Polymorphism, Genetic; D011336:Probability; D018570:Risk Assessment; D012494:Sampling Studies; D055502:Secondary Prevention; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014184:Transplantation, Homologous; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics* / Q000378:metabolism
chemical_list: D005819:Genetic Markers; D019410:Interleukin-16; D008233:Lymphotoxin-alpha; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha