The influence of innate immunity gene receptors polymorphisms in renal transplant infections.
BACKGROUND
Genetically defined deficiencies in key components of the innate immune system have been associated with a greater risk of infection. The aim of this study was to assess the influence of genetic variability of innate immune receptors (mannose-binding lectin [MBL], mannose-associated serine-protease-2 [MASP-2], and Toll-like receptors [TLR4]) in the risk of infections after a kidney transplantation.


METHODS
All patients undergoing a kidney or kidney-pancreas transplantation during a 3-year period were included. Functionally relevant mutations in MBL2, MASP2, and TLR4 genes were determined by DNA sequencing. The incidence of major bacterial infections, asymptomatic cytomegalovirus (CMV) infection, and CMV disease were compared among groups.


RESULTS
There were no differences regarding major transplant characteristics among groups. Older age, requirements for posttransplant hemodialysis, and pretransplant diabetes, but not gene polymorphisms, were associated with a greater number of bacterial infections. In univariate analysis, low-MBL genotypes were associated with CMV disease in pretransplant CMV seropositive patients (P=0.015), whereas the TLR4 mutation was associated with higher risk of CMV primary infection (P=0.024). TLR4 mutation was an independent factor associated with CMV disease (odds ratio 5.84, 95% confidence interval 1.35-25.20, P=0.018).


CONCLUSIONS
Polymorphisms of innate immunity receptors, especially TLR4 mutation, were associated with higher risk of CMV disease, while susceptibility to other infectious disorders was not observed.
Cervera
Carlos
C
Department of Infectious Diseases, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Barcelona, Spain.
Lozano
Francisco
F
Saval
Nuria
N
Gimferrer
Idoia
I
Ibañez
Ana
A
Suárez
Belen
B
Linares
Laura
L
Cofán
Federico
F
Ricart
Maria Jose
MJ
Esforzado
Nuria
N
Marcos
María Angeles
MA
Pumarola
Tomás
T
Oppenheimer
Federico
F
Campistol
Josep M
JM
Moreno
Asunción
A
D001424:Bacterial Infections / Q000209:etiology* / Q000235:genetics; D003586:Cytomegalovirus Infections / Q000209:etiology* / Q000235:genetics; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D007113:Immunity, Innate / Q000235:genetics*; D016030:Kidney Transplantation / Q000009:adverse effects*; D037601:Mannose-Binding Lectin / Q000235:genetics*; D009154:Mutation; D011110:Polymorphism, Genetic; D051197:Toll-Like Receptor 4 / Q000235:genetics*
D037601:Mannose-Binding Lectin; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4