ABSTRACT
To investigate the relationship between the soluble HLA-G [sHLA-G] and the appearance of acute renal rejection [AR] episodes we have quantify in this study the level of sHLA-G by enzyme-linked immunosorbent assay in 42 kidney transplant patients classified in two groups: G1: 17 patients with acute rejection [AR+] and G2: 25 patients without AR [AR-]. To establish our normal sHLA-G ranges, serum samples from 18 healthy controls were tested. Pre-transplantation sHLA-G levels were significantly increased in patients [mean +/- standard error of the mean, 60.48 +/- 12.18 Units/ml] than healthy subjects [19.11 +/- 4.9 Units/ml] [p=0.001]. Although the difference was not statistically significant, G1 patients [AR+] revealed lower levels of sHLA-G [mean +/- standard error of the mean, 31.25 +/- 6.71 Units/ml] compared to G2 patients [AR-] [53.43 +/- 17.21 Units/ml]. Nevertheless, the course of total sHLA-G levels was nearly identical in patients with and without rejection. Nonparametric analysis revealed that pre-transplantation levels of sHLA-G < 18.00 Units/ ml [sensitivity: 87.8% and specificity of 72.2%] were not related to rejection. Also, multivariate analysis regarding anti-HLA antibody status, recipient age and gender showed that sHLA-G could not be an independent risk factor for renal graft rejection. However, a higher sera levels of sHLA-G seemed to contribute to better kidney allograft survival rate after 10 years of follow-up [significance tendency: p=0.091] as shown by the survival analysis. Because of the small number of subjects studied, these results must be treated with caution. A much larger cohort of kidney transplant patients according to acute rejection would seem necessary to confirm these findings
ABSTRACT
Crohn's disease [CD] and ulcerative colitis [UC] have complex genetic background that is characterised by more than one susceptibility locus. To detect a possible association between the functional polymorphisms of the chemokine receptors CCR5, CCR2 and MCP-1 genes and susceptibility to CD and UC in Tunisian population, polymorphisms of CCR5-delta 32, CCR5-59029-A/G, CCR2-V64I and MCP-1-2518- G/A were analysed in 194 Inflammatory bowel disease [IBD] patients and 169 healthy blood donors using PCR-RFLP and PCR-SSP methods. The patients were classified in 126 patients with CD and 68 patients with UC. The genotypic and allelic frequencies of all polymorphisms studied, did not reveal significant differences between patients and controls, and among CD and UC patients. However, analysis of CD patients revealed that those without homozygosous G/G genotype are more frequently in remission compared to those with this genotype [OR: 0.4; 95%CI: [0.174-0.928]; p=0.03]. Also, the frequency of the CCR2-64I muted allele was statistically higher in CD patients in remission disease than those in active form [OR: 0.267; 95%CI: [0.09-0.78]; p=0.01]. Adjustment for known covariates factors [age, gender and immunosuppressive regimen] confirmed these univariate findings and revealed that the CCR5-59029-A/G and CCR2-V64I genotype were associated to remission form of CD [OR: 2.63; 95%CI: [1.01-6.80]; p=0.047 and OR: 4.64; 95%CI: [1.01-21.31]; p=0.049 respectively]. In conclusion, the present study supports the involvement of chemokine receptor [CCR2 and CCR5] polymorphisms in activity degree of the IBD disease in Tunisian patients