RESUMEN
Background: There are considerable evidences for a cytokine orchestrated chronic inflammatory response in long term hemodialysis patients. It is possible that genetically determined lower production of IL-10 might influence disease susceptibility and or severity caused by altered proinflammatory antiinflammatory cytokine balance
Aim of work: to determine the relative frequency of specific genotypes of IL-10 among a group of Egyptian patients with end stage renal disease on hemodialysis and to evaluate the relationship of specific genotypes to nutritional and biological markers and indices of function and comorbidity
Subjects and Methods: The study comprised 50 patients with end stage renal disease [ESRD] on maintenance hemodialysis. Patients were legible for inclusion into the study if they were between 18 and 80 years and had been receiving hemodialysis three times per week. Functional status was assessed by means of the Karnofsky Index [KI]. The comorbidities were categorized using the Index of CoExisting Disease [ICED]. IL-10 promotor polymorphism was detected by PCR using primers that amplified a short fragment of DNA containing the polymorphism [-1082 G/A]. Identification of the 2 alleles at the polymorphic site was performed by restriction enzyme[MnI I]
Results: Among the 50 patients included in the study,the high IL-10 producers [GG] were 6 [12%], intermediate producers[AG] were 29 [58%] while the low producers [AA] were 15 [30%] No statistical significant difference was found in serum albumin or body mass index [BMI] between the high IL-10 producers [GG] and low IL-10 producers [AA]. Patients with high IL-10 producer genotype had higher KI [better functional status [88.3+4.08]] compared with low IL-10 producers [66.67+8.16] [P<0.05]. All patients with low IL-10 producer genotype [100%] had ICED score of 2 or 3 [higher comorbidity] compared with high IL-10 producer genotype [17%][p<0.05]
Conclusion: Single nucleotide polymorphism in the regulatory monokine IL-10 is strongly associated with indices of function and comorbidity