Characterization of HLA alleles in non-melanoma skin cancer in Renal Transplant Recipients (RTR)

• Grant number: 15/15859-2
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: November 01, 2015
• End date: October 31, 2016
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Jane Tomimori
• Grantee: Clarissa Schmidt Rogel
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Renal transplant recipients (RTR) are submitted to iatrogenic immunosuppression to prevent graft rejection, which makes them susceptible to various diseases. Furthermore, these individuals have malignant tumors more often than the general population, including non-melanoma skin cancer (NMSC). The individual genetic basis engaged in the pathogenesis of skin cancer may have protection or susceptibility factors for disease development. One of these determinants is HLA allele.Objective: To characterize the HLA alleles of RTR Consultation at the Department of Dermatology, UNIFESP-EPM and Hospital do Rim e Hipertensão, from July 2004 to July 2014.Methods: This is a cross-sectional retrospective study. The data will be consulted on existing bases. The description of HLA alleles will be consulted on the Hospital do Rim e Hipertensão database and clinical data will be consulted in electronic medical records of the Hospital São Paulo. On control group, we will use information from an existing donor database. We will be comparing three groups: RTR with a history of NMSC; RTR without a history of NMSC; not RTR (control group).Parcial results: Until now we have analyzed data from 93 RTR and 478 control subjects (not RTR). Among the RTR with NMSC, 76.3% were male, the average age was 60 years. The predominant skin phototype was II (45.2%), followed by III (25.8%). There was a higher prevalence of squamous cell carcinoma (SCC) (84.9%), followed by 36.6% of patients with SCC and basal cell carcinoma (BCC); 47.3% with viral warts and 80.6% with actinic keratosis. Etiology of chronic renal failure of 34.4% was undetermined, 19.4% by chronic glomerulonephritis, 18.3% by hypertension, 10.8% by diabetes mellitus, 10.8% by polycystic kidneys. The immunosuppressive regimen of most patients was triple. The most prescribed medications were prednisone, azathioprine, cyclosporine A, tacrolimus and mycophenolate sodium. The allelic frequencies of HLA-A gene, HLA-B and HLA-DR are according to the Hardy-Weinberg equilibrium. We have determined that alleles DRB1*04 and B*38 represent susceptibility alleles. While the HLA A*30 and B*50 are protection alleles. In view of these partial results, we intend to extend this research to the RTR without NMSC. With the new results, we can determine the alleles of susceptibility and protection comparing RTR with and without NMSC.