Donor ABCB1 variant associates with increased risk for kidney allograft failure
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Donor ABCB1 variant associates with increased risk for kidney allograft failure. / Moore, Jason; McKnight, Amy Jayne; Döhler, Bernd; Simmonds, Matthew J; Courtney, Aisling E; Brand, Oliver J; Briggs, David; Ball, Simon; Cockwell, Paul; Patterson, Christopher C; Maxwell, Alexander P; Gough, Stephen C L; Opelz, Gerhard; Borrows, Richard.
In: Journal of the American Society of Nephrology, Vol. 23, No. 11, 11.2012, p. 1891-9.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Donor ABCB1 variant associates with increased risk for kidney allograft failure
AU - Moore, Jason
AU - McKnight, Amy Jayne
AU - Döhler, Bernd
AU - Simmonds, Matthew J
AU - Courtney, Aisling E
AU - Brand, Oliver J
AU - Briggs, David
AU - Ball, Simon
AU - Cockwell, Paul
AU - Patterson, Christopher C
AU - Maxwell, Alexander P
AU - Gough, Stephen C L
AU - Opelz, Gerhard
AU - Borrows, Richard
PY - 2012/11
Y1 - 2012/11
N2 - The impact of variation within genes responsible for the disposition and metabolism of calcineurin inhibitors (CNIs) on clinical outcomes in kidney transplantation is not well understood. Furthermore, the potential influence of donor, rather than recipient, genotypes on clinical endpoints is unknown. Here, we investigated the associations between donor and recipient gene variants with outcome among 4471 white, CNI-treated kidney transplant recipients. We tested for 52 single-nucleotide polymorphisms (SNPs) across five genes: CYP3A4, CYP3A5, ABCB1 (MDR1; encoding P-glycoprotein), NR1I2 (encoding the pregnane X receptor), and PPIA (encoding cyclophilin). In a discovery cohort of 811 patients from Birmingham, United Kingdom, kidney donor CC genotype at C3435T (rs1045642) within ABCB1, a variant known to alter protein expression, was associated with an increased risk for long-term graft failure compared with non-CC genotype (hazard ratio [HR], 1.69; 95% confidence interval [CI], 1.20-2.40; P=0.003). No other donor or recipient SNPs were associated with graft survival or mortality. We validated this association in 675 donors from Belfast, United Kingdom (HR, 1.68; 95% CI, 1.21-2.32; P=0.002), and in 2985 donors from the Collaborative Transplant Study (HR, 1.84; 95% CI, 1.08-3.13; P=0.006). In conclusion, these data suggest that an ABCB1 variant known to alter protein expression represents an attractive candidate for future study and risk stratification in kidney transplantation.
AB - The impact of variation within genes responsible for the disposition and metabolism of calcineurin inhibitors (CNIs) on clinical outcomes in kidney transplantation is not well understood. Furthermore, the potential influence of donor, rather than recipient, genotypes on clinical endpoints is unknown. Here, we investigated the associations between donor and recipient gene variants with outcome among 4471 white, CNI-treated kidney transplant recipients. We tested for 52 single-nucleotide polymorphisms (SNPs) across five genes: CYP3A4, CYP3A5, ABCB1 (MDR1; encoding P-glycoprotein), NR1I2 (encoding the pregnane X receptor), and PPIA (encoding cyclophilin). In a discovery cohort of 811 patients from Birmingham, United Kingdom, kidney donor CC genotype at C3435T (rs1045642) within ABCB1, a variant known to alter protein expression, was associated with an increased risk for long-term graft failure compared with non-CC genotype (hazard ratio [HR], 1.69; 95% confidence interval [CI], 1.20-2.40; P=0.003). No other donor or recipient SNPs were associated with graft survival or mortality. We validated this association in 675 donors from Belfast, United Kingdom (HR, 1.68; 95% CI, 1.21-2.32; P=0.002), and in 2985 donors from the Collaborative Transplant Study (HR, 1.84; 95% CI, 1.08-3.13; P=0.006). In conclusion, these data suggest that an ABCB1 variant known to alter protein expression represents an attractive candidate for future study and risk stratification in kidney transplantation.
KW - Polymorphism, Single Nucleotide
KW - Kidney Transplantation
KW - Humans
KW - Calcineurin
KW - Genetic Association Studies
KW - Receptors, Steroid
KW - Linkage Disequilibrium
KW - Great Britain
KW - Tissue Donors
KW - Cyclophilins
KW - Kaplan-Meier Estimate
KW - P-Glycoprotein
KW - Cytochrome P-450 CYP3A
KW - Risk Factors
KW - Graft Survival
KW - Adult
KW - Cohort Studies
KW - Middle Aged
KW - Male
KW - Female
U2 - 10.1681/ASN.2012030260
DO - 10.1681/ASN.2012030260
M3 - Article
C2 - 23064017
VL - 23
SP - 1891
EP - 1899
JO - Journal of the American Society of Nephrology
JF - Journal of the American Society of Nephrology
SN - 1046-6673
IS - 11
ER -