title: The 14-bp deletion in the HLA-G gene indicates a low risk for acute cellular rejection in heart transplant recipients.
abstract: BACKGROUND
  Human leukocyte antigen G (HLA-G) is a non-classical Ib molecule in the major histocompatibility complex. HLA-G has important immunosuppressive properties, and in the context of cardiac transplantation, is associated with a low risk of cellular rejection. A 14-bp insertion/deletion polymorphism in exon 8 of the HLA-G gene is associated with messenger RNA (mRNA) stability and expression of HLA-G. This study analyzed the relationship between HLA-G polymorphisms and serum HLA-G levels in patients after cardiac transplantation to determine if any specific HLA-G genotype is associated with cellular rejection.
  
  
  METHODS
  Ninety-four heart transplant patients were genotyped for the 14-bp polymorphism. Serum HLA-G levels and cellular rejection grades were evaluated in all patients.
  
  
  RESULTS
  The 14-bp polymorphism was significantly associated with serum HLA-G expression. Patients with the -14-bp/-14-bp genotype had significantly higher mean serum HLA-G levels (88.2 U/ml) than those patients with the +14-bp/-14-bp (52.8 U/ml) and +14-bp/+14-bp (32.2 U/ml) genotypes (p = 0.004). The -14 bp/-14-bp genotype was significantly associated with fewer episodes of cellular rejection.
  
  
  CONCLUSIONS
  This study suggests that the 14-bp deletion in the HLA-G gene plays an important role in the expression of HLA-G and thus might be a clinically useful genetic indicator for cellular rejection risk after cardiac transplantation.
authors.affiliation: Department of Medicine, Division of Cardiology, Toronto General Hospital, Toronto, Ontario, Canada.
authors.forename: Tal
authors.initials: T
authors.lastname: Twito
authors.forename: Jemy
authors.initials: J
authors.lastname: Joseph
authors.forename: Amelia
authors.initials: A
authors.lastname: Mociornita
authors.forename: Vivek
authors.initials: V
authors.lastname: Rao
authors.forename: Heather
authors.initials: H
authors.lastname: Ross
authors.forename: Diego H
authors.initials: DH
authors.lastname: Delgado
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006084:Graft Rejection / Q000235:genetics* / Q000276:immunology; D006680:HLA Antigens / Q000097:blood / Q000235:genetics*; D059951:HLA-G Antigens; D016027:Heart Transplantation / Q000276:immunology*; D015395:Histocompatibility Antigens Class I / Q000097:blood / Q000235:genetics*; D006801:Humans; D007111:Immunity, Cellular / Q000235:genetics; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics*; D018570:Risk Assessment; D017384:Sequence Deletion / Q000235:genetics*; D016896:Treatment Outcome
chemical_list: D006680:HLA Antigens; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I