Tumour necrosis factor-alpha plus interleukin-10 low producer phenotype predicts acute kidney injury and death in intensive care unit patients

Autor(es)

Dalboni, M. A. ^[1] ; Quinto, B. M. R. ^[1] ; Grabulosa, C. C. ^[1] ; Narciso, R. ^[2] ; Monte, J. C. ^{[2, 1]} ; Durao, Jr., M. ^{[2, 1]} ; Rizzo, L. ^[2] ; Cendoroglo, M. ^{[3, 2, 1]} ; Santos, O. P. ^{[2, 1]} ; Batista, M. C. ^{[3, 2, 1]}

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Paulo, Div Nephrol, BR-04039032 Sao Paulo - Brazil

^[2] Univ Fed Sao Paulo, Hosp Israelita Albert Einstein, BR-04039032 Sao Paulo - Brazil

^[3] Tufts Univ New England Med Ctr, Boston, MA - USA

• Tipo de documento: Artigo Científico
• Fonte: CLINICAL AND EXPERIMENTAL IMMUNOLOGY; v. 173, n. 2, p. 242-249, AUG 2013.
• Citações Web of Science: 11

Resumo

Genetic polymorphism studies of cytokines may provide an insight into the understanding of acute kidney injury (AKI) and death in intensive care unit (ICU) patients. The aim of this study was to investigate whether the genetic polymorphisms of -308 G < A tumour necrosis factor (TNF)-alpha, - 174 G > C interleukin (IL)- 6 and - 1082 G > A IL- 10 may predispose ICU patients to the development of AKI and/or death. In a prospective nested case-control study, 303 ICU patients and 244 healthy individuals were evaluated. The study group included ICU patients who developed AKI (n = 139) and 164 ICU patients without AKI. The GG genotype of TNF-alpha (low producer phenotype) was significantly lower in the with AKI than without AKI groups and healthy individuals (55 versus 62 versus 73%, respectively; P = 0.01). When genotypes were stratified into four categories of TNF-alpha/IL-10 combinations, it was observed that low TNF-a plus low IL- 10 producer phenotypes were more prevalent in patients with AKI, renal replacement therapy and death (P < 0.05). In logistic regression analysis, low TNF-alpha producer plus low IL-10 producer phenotypes remained as independent risk factors for AKI and/or death {[} odds ratio (OR) = 2.37, 95% confidence interval (CI): 1.16- 4.84; P = 0.02] and for renal replacement therapy (RRT) and/or death (OR = 3.82, 95% CI: 1.19- 12.23; P = 0.02). In this study, the combination of low TNF-alpha plus low IL- 10 producer phenotypes was an independent risk factor to AKI and/or death and RRT and/or death in critically ill patients. Our results should be validated in a larger prospective study with long- term follow- up to emphasize the combination of these genotypes as potential risk factors to AKI in critically ill patients. (AU)

• Processo FAPESP: 05/59242-7 - Polimorfismo genetico de citocinas: interface lipides-inflamacao e sua influencia e na ocorrencia de insuficiencia renal aguda e no desfecho do paciente grave.
• Beneficiário: Marcelo Costa Batista
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 07/58363-0 - Polimorfismo genetico de citocinas e sua influencia na ocorrencia de insuficiencia renal aguda.
• Beneficiário: Maria Aparecida Dalboni
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado