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Published on: May 5, 2014
Heat shock protein polymorphism predisposes to urinary tract malformations and renal transplantation in children
1First Department of Paediatrics, Semmelweis University, Budapest, Hungary.
Insights
The HSPA1B (1267)G allele is more common in children who received kidney transplants, particularly those with urinary tract malformations. This finding may impact pediatric nephrology and treatment strategies for end-stage renal disease.
Area of Science:
- Nephrology
- Genetics
- Immunology
Background:
- Anatomical malformations of the kidney and urinary tract are a significant cause of pediatric kidney transplantation.
- Heat shock proteins (HSPs) like HSP72 play a role in cell survival and innate immunity via toll-like receptor TLR4.
- Reduced HSP70 expression is linked to various kidney diseases in both adults and children.
Purpose of the Study:
- To investigate the prevalence of specific genetic polymorphisms (HSPA1A G(190)C, HSPA1B A(1267)G, and TLR4 A(896)G) in pediatric kidney transplant recipients.
- To determine if these polymorphisms are associated with the need for kidney transplantation in children.
Main Methods:
- Genotyping was performed using allele-specific polymerase chain reaction on 41 pediatric kidney transplant recipients.
- Allelic prevalence was compared to a control group of 65 age- and sex-matched healthy children.
- Clinical data was analyzed to identify associations between genotypes and transplant outcomes or malformations.
Main Results:
- The HSPA1B (1267)GG genotype and the HSPA1B (1267)G allele were significantly more frequent in transplant recipients than in controls.
- The HSPA1B (1267)GG genotype was more prevalent in transplant recipients with urinary tract malformations compared to those without.
- No significant differences were found for the HSPA1A G(190)C or TLR4 A(896)G polymorphisms between groups.
Conclusions:
- The study suggests a potential association between carrying the HSPA1B (1267)G allele and the presence of urinary tract malformations leading to end-stage renal disease.
- These findings highlight the potential clinical and therapeutic relevance of the HSPA1B (1267) polymorphism in pediatric nephrology.
- Further research is warranted to explore the implications of this genetic association.
Background:
Anatomical malformations of the kidney and urinary tract account for 17% of pediatric renal transplantation procedures. Heat shock proteins (HSPs) are molecular chaperones with a protective function that promotes cell survival. HSP72 is an endogenous ligand for toll-like receptor TLR4, thereby stimulating innate immunity. Both in adults and children, decreased expression of HSP70s is associated with a number of kidney diseases.
Objective:
To assess the prevalence of HSPA1A G(190)C, HSPA1B A(1267)G, and TLR4 A(896)G polymorphisms in children who had undergone kidney transplantation.
Patients And Methods:
Genotypes were analyzed using allele-specific polymerase chain reaction in 41 pediatric recipients. Allelic prevalence was related to reference values in 65 age- and sex-matched healthy children.
Results:
Clinical data did not reveal a difference between any of the groups. HSPA1B (1267)GG genotype and HSPA1B (1267)G allele were observed more frequently in the transplant recipients compared with the control group: AA vs AG: odds ratio [OR], 12.6; 95% confidence interval [CI], 1.58-100.0; P = .004; AA vs GG: OR, 20.80; 95% CI, 2.32-187.00; P = .01; and A vs G: OR, 2.10; 95% CI, 1.19-3.07; P = .01. Furthermore, the prevalence of the HSPA1B (1267)GG genotype was greater in transplant recipients with vs without urinary tract malformations: AG vs GG: OR, 0.10; 95% CI, 0.09-0.48; P = .007. No differences were observed in the other studied polymorphisms.
Conclusion:
Our findings suggest an association between the carrier status of HSPA1B (1267)G with urinary tract malformations, leading to end-stage renal disease requiring kidney transplantation. This observation raises further questions about the clinical and therapeutic relevance of this polymorphism to pediatric nephrology.
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