Association between IL-6 -174G/C polymorphism and acute rejection of renal allograft: evidence from a meta-analysis.

BACKGROUND Results from published studies on the association of donor or recipient IL-6 -174G/C (rs1800795) polymorphism with acute rejection (AR) of renal allograft are conflicting. We performed a meta-analysis to estimate the possible association. METHODS Studies were identified by searching PUBMED and EMBASE until July 1, 2011. Meta-analysis was performed in a fixed/random effects model using Revman 5.0.25 and STATA10.0. RESULTS Seven studies addressing the association between donor high producer genotype (G/G and G/C) of IL-6 -174G/C polymorphism and acute rejection of renal allograft were identified. Pooled OR based on 341 cases (whose recipient developed acute rejection) and 702 controls (whose recipient did not develop acute rejection) was 0.59 (95% CI, 0.26-1.33; p=0.20), with a strong between-study heterogeneity. No association was observed in the subgroup analysis based on ethnicity. 13 studies evaluating the association between recipient IL-6 -174G/C polymorphism and acute rejection were identified. Pooled OR based on 451 cases (patients did not develop acute rejection) and 848 controls was 1.00 (95% CI=0.72-1.37; p=0.98), with a weak between-study heterogeneity. CONCLUSIONS Donor high producer genotype (G/G and G/C) of IL-6 -174G/C polymorphism had a tendency of decreased risk for acute rejection, although it was not statistically significant. Recipient high producer genotype was not associated with acute rejection of renal allograft. Additional well designed studies with larger sample size are needed to support our findings, especially for the association between donor high producer genotype (G/G and G/C) of IL-6 -174G/C polymorphism and acute renal allograft rejection.

[1]  A. Minguela,et al.  Implication of Th1, Th2, and Th3 cytokines in liver graft acceptance. , 1999, Transplantation proceedings.

[2]  G. Sirchia,et al.  TNF-α IFN-γ IL-6, IL-10, and TGF-β1 gene polymorphisms in renal allografts , 2001 .

[3]  F. Pociot,et al.  Cytokine gene polymorphism in human disease: on-line databases , 1999, Genes and Immunity.

[4]  N. Senninger,et al.  Interleukin-6, interleukin-8, and interleukin-10 in kidney transplantation: improved risk strategy? , 2003, Transplantation proceedings.

[5]  A. Papoila,et al.  Impact of donor and recipient cytokine genotypes on renal allograft outcome. , 2004, Transplantation proceedings.

[6]  A. Barbari,et al.  Cytokine gene polymorphism in a Lebanese transplant population and its impact on graft acceptance: a single-center pilot study. , 2003, Transplantation proceedings.

[7]  M. Karczewski,et al.  Role of TH1/TH2 cytokines in kidney allograft rejection. , 2008, Transplantation proceedings.

[8]  K. Ivens,et al.  Influence of cytokine genes polymorphisms on long‐term outcome in renal transplantation , 2007, Clinical transplantation.

[9]  M. Lazarus,et al.  An investigation of polymorphism in the interleukin-10 gene promoter. , 1997, European journal of immunogenetics : official journal of the British Society for Histocompatibility and Immunogenetics.

[10]  A. Melk,et al.  Predictive indicators of rejection or infection in renal transplant patients. , 1999, Transplantation proceedings.

[11]  A. Demaine,et al.  A study of cytokine gene polymorphisms and protein secretion in renal transplantation. , 2001, Transplant immunology.

[12]  P. Mercier,et al.  TNF-α and IL-6 gene polymorphism and rejection in kidney transplantation recipients , 2001 .

[13]  J. Chudek,et al.  [The influence of selected cytokine gene polymorphisms on the occurrence of acute and chronic rejection and on kidney graft survival]. , 2009, Postepy higieny i medycyny doswiadczalnej.

[14]  S. Akira,et al.  Interleukin-6 and its receptor: a paradigm for cytokines. , 1992, Science.

[15]  J S Yudkin,et al.  The effect of novel polymorphisms in the interleukin-6 (IL-6) gene on IL-6 transcription and plasma IL-6 levels, and an association with systemic-onset juvenile chronic arthritis. , 1998, The Journal of clinical investigation.

[16]  D. Conti,et al.  TNF-α, IL-6, IFN-γ, AND IL-10 GENE EXPRESSION POLYMORPHISMS AND THE IL-4 RECEPTOR α-CHAIN VARIANT Q576R: EFFECTS ON RENAL ALLOGRAFT OUTCOME , 2001 .

[17]  P. Lansdorp,et al.  Interferon beta 2/B-cell stimulatory factor type 2 shares identity with monocyte-derived hepatocyte-stimulating factor and regulates the major acute phase protein response in liver cells. , 1987, Proceedings of the National Academy of Sciences of the United States of America.

[18]  W. Payne,et al.  THE IMPACT OF AN ACUTE REJECTION EPISODE ON LONG‐TERM RENAL ALLOGRAFT SURVIVAL (t1/2)1,2 , 1994, Transplantation.

[19]  B. Banas,et al.  The impact of "high-producer" interleukin-6 haplotypes on cardiovascular morbidity and mortality in a kidney transplant population. , 2009, Transplantation proceedings.

[20]  J. Chudek,et al.  -174G/C interleukin-6 gene polymorphism and the risk of transplanted kidney failure or graft loss during a 5-year follow-up period. , 2011, Tissue antigens.

[21]  J. Forsythe,et al.  THE VALUE OF POSTTRANSPLANT MONITORING OF INTERLEUKIN (IL)-2, IL‐3, IL‐4, IL‐6, IL‐8, AND SOLUBLE CD23 IN THE PLASMA OF RENAL ALLOGRAFT RECIPIENTS , 1995, Transplantation.

[22]  S. Marshall,et al.  THE IMPACT OF RECIPIENT CYTOKINE GENOTYPE ON ACUTE REJECTION AFTER RENAL TRANSPLANTATION , 2000, Transplantation.

[23]  S. Dörge,et al.  Plasma levels of tumor necrosis factor (TNF) and soluble TNF receptors in kidney transplant recipients. , 1994, Transplantation.

[24]  S. Marshall,et al.  DONOR CYTOKINE GENOTYPE INFLUENCES THE DEVELOPMENT OF ACUTE REJECTION AFTER RENAL TRANSPLANTATION , 2001, Transplantation.

[25]  J. Alexander,et al.  Impact of first acute rejection episode and severity of rejection on cadaveric renal allograft survival. , 1996, Clinical transplantation.

[26]  D. Moher,et al.  Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement , 2009, BMJ : British Medical Journal.

[27]  H. Kim,et al.  Significance of IL-2, IL-2R, IL-6, and TNF-alpha as a diagnostic test of acute rejection after renal transplantation. , 1998, Transplantation proceedings.

[28]  Rama Devi Mittal,et al.  Analysis of cytokine gene polymorphisms in recipient’s matched with living donors on acute rejection after renal transplantation , 2008, Molecular and Cellular Biochemistry.

[29]  C. Bodian,et al.  The influence of acute rejection on long-term renal allograft survival: a comparison of living and cadaveric donor transplantation. , 2001, Transplantation.

[30]  H. Volk,et al.  Effect of Cytokines and Chemokines (TGF-β, TNF-α, IL-6, IL-10, MCP-1, RANTES) Gene Polymorphisms in Kidney Recipients on Posttransplantation Outcome: Influence of Donor-Recipient Match , 2005 .

[31]  L. McDaniel,et al.  Combined analysis of cytokine genotype polymorphism and the level of expression with allograft function in African-American renal transplant patients. , 2003, Transplant immunology.

[32]  Shahram Bolandparvaz,et al.  A study of the impact of cytokine gene polymorphism in acute rejection of renal transplant recipients , 2011, Molecular Biology Reports.

[33]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement , 2009, BMJ : British Medical Journal.

[34]  R. Zinkernagel,et al.  Impaired immune and acute-phase responses in interleukin-6-deficient mice , 1994, Nature.

[35]  M. Dallman,et al.  Cytokines and Peripheral Tolerance to Alloantigen , 1993, Immunological reviews.

[36]  H. Mcdevitt,et al.  Effects of a polymorphism in the human tumor necrosis factor alpha promoter on transcriptional activation. , 1997, Proceedings of the National Academy of Sciences of the United States of America.

[37]  C. Legendre,et al.  Differential in situ expression of cytokines in renal allograft rejection. , 1991, Transplantation.

[38]  S. Marshall,et al.  Cytokine polymorphisms do not influence acute rejection in renal transplantation under tacrolimus-based immunosuppression. , 2005, Transplantation proceedings.

[39]  M. Henry,et al.  Acute rejection episodes: best predictor of long-term primary cadaveric renal transplant survival. , 1993, Transplantation proceedings.

[40]  K. Salmela,et al.  Cytokine Gene Polymorphisms and Risks of Acute Rejection and Delayed Graft Function after Kidney Transplantation , 2004, Transplantation.

[41]  K. Gendzekhadze,et al.  Risk of adverse post-transplant events after kidney allograft transplantation as predicted by CTLA-4 +49 and TNF-alpha -308 single nucleotide polymorphisms: a preliminary study. , 2006, Transplant immunology.

[42]  G. Iaria,et al.  Renal allograft immune response is influenced by patient and donor cytokine genotypes. , 2007, Transplantation proceedings.

[43]  A. Ghods,et al.  The Predictive Value of HLA-DR Matching and Cytokine Gene Polymorphisms in Renal Allograft Acute Rejection: a Living-unrelated Donor (LURD) Study. , 2006, Iranian journal of immunology : IJI.

[44]  Y. Vanrenterghem Acute rejection and renal allograft outcome. , 1995, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[45]  M. Klinger,et al.  Interleukin-6 in chronic renal allograft rejection: influence of nonimmunologic risk factors. , 2001, Transplantation proceedings.

[46]  A. Kirk,et al.  Donor genomics influence graft events: the effect of donor polymorphisms on acute rejection and chronic allograft nephropathy. , 2004, Kidney international.