Abstract
We investigated the polymorphism of human leukocyte antigens (HLA) and Duffy erythrocyte antigens in chronic kidney disease (CKD) patients in southern Brazil. One hundred and eighty-three CKD patients, over 18 years old, on hemodialysis, were included. HLA-A, -B and -DRB1 typing was performed using the LABType®SSO (One Lambda, Inc.). Duffy phenotypes were determined by gel column agglutination using anti-Fya and anti-Fyb monoclonal anti-sera. The patients' predominant ages ranged between 51 and 70 years (43%) and the predominant gender, ethnic group and dialysis period were, respectively, male (62%), white (62%) and 1–3 years (40%). The highest and lowest frequencies of Duffy phenotypes were Fy(a+b+) and Fy(a−b−), respectively. Nineteen HLA-A, 30 HLA-B and 13 HLA-DRB1 allele groups were identified. The most frequent HLA allele groups were HLA-A*01, -A*02, -A*03, -A*11, -A*24; HLA-B*07, -B*15, -B*35, -B*44, -B*51; HLA-DRB1*03, -DRB1*04, -DRB1*07, -DRB1*11 and -DRB1*13. Statistically significant differences were observed in the Duffy and HLA polymorphisms compared between CKD patients and healthy subjects. The Fy(a+b−) phenotype (p<0.0001, OR = 2.56, 95% CI = 1.60–4.07) was the most frequent in the patients (p<0.05), and the Fy(a+b+) phenotype (p = 0.0039, OR = 1.71, 95% CI = 1.18–2.51) was the most frequent in the healthy subjects in the same region of Paraná state (p<0.05). Regarding HLA, the HLA-B*42, -B*45, -B*51 and -DRB1*03 allele groups were the most frequent in the patients (p<0.05), and the HLA-B*44 allele group was the most frequent in the healthy subjects in the same region of Brazil (p<0.05). The polymorphism of these two markers among CKD patients in southern Brazil and healthy subjects of other studies, suggests that these markers might be involved with CKD development. Further studies should be undertaken to analyze the markers' influence on CKD and the long-term results from kidney transplantation.
Highlights
The human leukocyte antigen (HLA) system is composed of molecules found on the surface of leukocytes and in almost all tissue cells
The frequencies of the Duffy blood group system phenotypes reported in this study were mainly compared with those published by Guelsin et al [10], since we adopted the same criteria used in that study
In comparison with the study of Novaretti et al [8], which included 2,462 voluntary blood donors, both genders, Caucasians (n = 834), mulattos (n = 827), and blacks (n = 801), the results of the current study showed statistically significant differences in almost all Duffy phenotypes, underscoring the difference reported when frequencies of the Fy(a2b2) phenotype were compared between healthy subjects and chronic kidney disease (CKD) patients (p,0.0001; odds ratio (OR) = 8.53, 95% confidence interval (CI) = 4.49–18.20) (Table 2)
Summary
The human leukocyte antigen (HLA) system is composed of molecules found on the surface of leukocytes and in almost all tissue cells. Several studies have reported the involvement of HLA alleles in many diseases [2,3]. The HLA system has an important role in kidney transplants, since HLA compatibility between donor and recipient is extremely important to prevent organ rejection [4]. Besides the HLA system, other human systems are involved in the analysis of compatibility between donor and recipient. The erythrocyte systems (ABO and Rh are the best known and the most important) are important parameters in transfusion and transplants, the role of the Duffy erythrocyte system is widely discussed because of its association with immediate and late hemolytic transfusion reactions, hemolytic disease of newborn children [5] and organ rejection processes [6,7]
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