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Published on: May 2, 2013
Association between CTLA4 gene polymorphisms and acute rejection of kidney transplantation: a meta-analysis
Zhenhua Duan1, Yujing Zhang, Faming Pan
1Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, PR China.
Objective:
Cytotoxic T-lymphocyte-associated protein 4 (CTLA4) has been shown to transmit an inhibitory signal to T cells, which is a therapeutic target for acute rejection of kidney transplantation, and CTLA4 polymorphisms have also been considered as a potential risk factor. However, major studies have not yielded significant results. Thus, we conducted a meta-analysis of existing studies to boost their statistical power to clarify any associations between CTLA4 gene polymorphisms and acute rejection of kidney transplantation.
Methods:
We searched for studies using PubMed, Embase and Academic Source Premier databases and checked the reference lists of all included studies for other relevant studies. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated by both dominant and recessive genetic models.
Results:
For CTLA4 +49A/G polymorphism, we found a marginally significant p value for A vs. G (OR=0.805, 95% CI, 0.677-0.957, p=0.014). No significant association between the -318C/T polymorphism and acute rejection risk was observed.
Conclusion:
The results suggest that the CTLA4 gene +49A/G polymorphism may be a possible genetic susceptibility locus for acute rejection. The results of the present meta-analysis may be limited by a number of factors including inadequate total sample size and poor statistics, and should be interpreted with caution. Further confirmation in large and well-designed studies are needed.
Insights
This meta-analysis suggests the Cytotoxic T-lymphocyte-associated protein 4 (CTLA4) gene +49A/G polymorphism may increase acute kidney transplant rejection risk. Further large studies are needed for confirmation.
Area of Science:
- Immunogenetics
- Transplantation immunology
- Genomic association studies
Background:
- Cytotoxic T-lymphocyte-associated protein 4 (CTLA4) plays a crucial role in T-cell inhibition.
- CTLA4 is a therapeutic target for acute kidney transplant rejection.
- CTLA4 gene polymorphisms are investigated as potential risk factors for transplant outcomes.
Purpose of the Study:
- To conduct a meta-analysis to clarify the association between CTLA4 gene polymorphisms and acute kidney transplant rejection.
- To increase statistical power by combining data from existing studies.
Main Methods:
- Systematic literature search of PubMed, Embase, and Academic Source Premier databases.
- Inclusion of reference lists from identified studies.
- Calculation of pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) using dominant and recessive genetic models.
Main Results:
- A marginally significant association was found for the CTLA4 +49A/G polymorphism (OR=0.805, p=0.014).
- No significant association was observed between the CTLA4 -318C/T polymorphism and acute rejection risk.
Conclusions:
- The CTLA4 gene +49A/G polymorphism may represent a genetic susceptibility locus for acute kidney transplant rejection.
- Findings require cautious interpretation due to potential limitations in sample size and statistical power.
- Large, well-designed studies are necessary for further validation.
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