Heat shock protein polymorphism predisposes to urinary tract malformations and renal transplantation in children.
BACKGROUND
Anatomical malformations of the kidney and urinary tract account for 17% of pediatric renal transplantation procedures. Heat shock proteins (HSPs) are molecular chaperones with a protective function that promotes cell survival. HSP72 is an endogenous ligand for toll-like receptor TLR4, thereby stimulating innate immunity. Both in adults and children, decreased expression of HSP70s is associated with a number of kidney diseases.


OBJECTIVE
To assess the prevalence of HSPA1A G(190)C, HSPA1B A(1267)G, and TLR4 A(896)G polymorphisms in children who had undergone kidney transplantation.


METHODS
Genotypes were analyzed using allele-specific polymerase chain reaction in 41 pediatric recipients. Allelic prevalence was related to reference values in 65 age- and sex-matched healthy children.


RESULTS
Clinical data did not reveal a difference between any of the groups. HSPA1B (1267)GG genotype and HSPA1B (1267)G allele were observed more frequently in the transplant recipients compared with the control group: AA vs AG: odds ratio [OR], 12.6; 95% confidence interval [CI], 1.58-100.0; P = .004; AA vs GG: OR, 20.80; 95% CI, 2.32-187.00; P = .01; and A vs G: OR, 2.10; 95% CI, 1.19-3.07; P = .01. Furthermore, the prevalence of the HSPA1B (1267)GG genotype was greater in transplant recipients with vs without urinary tract malformations: AG vs GG: OR, 0.10; 95% CI, 0.09-0.48; P = .007. No differences were observed in the other studied polymorphisms.


CONCLUSIONS
Our findings suggest an association between the carrier status of HSPA1B (1267)G with urinary tract malformations, leading to end-stage renal disease requiring kidney transplantation. This observation raises further questions about the clinical and therapeutic relevance of this polymorphism to pediatric nephrology.
Rusai
K
K
First Department of Paediatrics, Semmelweis University, Budapest, Hungary.
Banki
N F
NF
Prokai
A
A
Podracka
L
L
Szebeni
B
B
Tulassay
T
T
Reusz
G S
GS
Sallay
P
P
Körmendy
R
R
Szabo
A J
AJ
Fekete
A
A
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D018840:HSP70 Heat-Shock Proteins / Q000235:genetics*; D050884:HSP72 Heat-Shock Proteins / Q000235:genetics / Q000378:metabolism; D006360:Heat-Shock Proteins / Q000097:blood / Q000235:genetics*; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D011110:Polymorphism, Genetic; D014551:Urinary Tract / Q000002:abnormalities*
D018840:HSP70 Heat-Shock Proteins; D050884:HSP72 Heat-Shock Proteins; C525621:HSPA1B protein, human; D006360:Heat-Shock Proteins