Endothelial nitric oxide synthase polymorphism influences renal allograft outcome

• Published in: Clinical transplantation Vol. 28; no. 2; pp. 223 - 228
• Main Authors: Uyar, Murathan, Sezer, Siren, Ozdemir, Fatma Nurhan, Kulah, Eyup, Arat, Zubeyde, Atac, Fatma Belgin, Haberal, Mehmet
• Format: Journal Article
• Language: English
• Published: Denmark Blackwell Publishing Ltd 01-02-2014
• Subjects: Adult; eNos gene polymorphism; Female; Follow-Up Studies; Genotype; Glomerular Filtration Rate; Graft Survival - genetics; Humans; interstitial fibrosis/tubular atrophy; Kidney Failure, Chronic - genetics; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - surgery; Kidney Function Tests; Kidney Transplantation; Male; Nitric Oxide Synthase Type III - genetics; Polymerase Chain Reaction; Polymorphism, Genetic - genetics; Postoperative Complications - genetics; Prognosis; Receptor, Angiotensin, Type 1 - genetics; Receptor, Angiotensin, Type 2 - genetics; renal transplantation; Transplantation, Homologous; Treatment Outcome; eNos gene polymorphism; renal transplantation; interstitial fibrosis/tubular atrophy
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.12302

Background
Atherosclerotic lesions within the graft are considered to be a major cause of interstitial fibrosis/tubular atrophy (IF/TA). We evaluated the factors that influence the development of IF/TA and three‐ and five‐yr graft survival including nitric oxide synthase (eNOS) and angiotensin II type 1 and type 2 receptor gene polymorphism.
Methods
Seventy‐one male and 35 female patients (age: 34.9 ± 11.2 yr) who underwent living‐related renal transplantation were included. Angiotensin type 1 and type 2 receptor gene polymorphisms and eNOS intron 4 gene polymorphism were analyzed. The pre‐ and post‐transplant laboratory data, patient characteristics, acute rejection episodes, and presence of IF/TA were evaluated.
Results
Patients with the bb allele of eNOS gene had a lower prevalence of post‐transplant third year (12.6% and 38.5%, p = 0.005) and fifth year IF/TA (46.6% and 82.3%, p = 0.02) and a lower incidence of five‐yr graft failure (35.4% and 55.6%, p < 0.005). The eNOS gene polymorphism was independent and was the most prominent factor associated with third and fifth year IF/TA (p = 0.01, RR: 29.72, and p = 0.03, RR: 4.1, respectively). No significant relationship existed when angiotensin II gene polymorphisms were considered.
Conclusions
We concluded that recipient eNOS gene polymorphism can predict IF/TA, and the presence of the bb allele is associated with better graft outcome.