Publication: Impacto de los polimorfismos genéticos de las citoquinas en los resultados del trasplante renal
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2016-08-26
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Universidad Complutense de Madrid
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Abstract
En el trasplante de órganos sólidos los factores que conducen a la pérdida del injerto son muy diversos. A pesar del avance en el diagnóstico y tratamiento de los pacientes trasplantados renales, el rechazo agudo sigue siendo una de las principales causas de deterioro progresivo de la función renal. La presencia de episodios de rechazo acorta la supervivencia del injerto e, incluso, la del paciente, dado que implica la activación de un proceso inflamatorio no sólo local, sino también sistémico y obliga al incremento de la carga de inmunosupresión a administrar. La detección de los pacientes con mayor grado de susceptibilidad al desarrollo de rechazo, puede ayudarnos a prevenirlo. No existe consenso sobre la definición de "riesgo inmunológico elevado" y que características tiene que cumplir un paciente para poder ser incluido dentro de este grupo de riesgo. Las citoquinas, moléculas inmunomoduladoras que actúan como mediadores de la inflamación y la respuesta inmune, son secretadas por células T y macrófagos. Participan activamente en todos los procesos de la respuesta inmune, desde la activación a la diferenciación y proliferación celular. La producción de estas citoquinas se encuentra, en muchas ocasiones, sometida a una regulación genética, de tal forma que polimorfismos a nivel de las regiones promotoras o codificadoras pueden alterar los niveles de las mismas y por tanto modificar la respuesta inflamatoria y/o inmunológica ante cualquier estímulo...
In solid organ transplantation, the factors leading to graft loss are diverse. Despite progress in diagnosis and treatment of kidney transplant patients, acute rejection remains a major cause of progressive deterioration of renal function. The presence of rejection episodes reduce graft survival, and even the patient survival, since it involves activation of not only local but also systemic inflammatory process, and forces to increase immunosuppressive treatment administered. Early detection of patients with a greater susceptibility to develop a rejection is one of the objectives pursued since it can help to prevent it. At present, there is no consensus on the definition of "high immunological risk" and which features a patient must present to be included in this risk group. Cytokines, immunomodulatory molecules that act as mediators of inflammation and immune response, are secreted by many cells, T lymphocytes and macrophages among them. They actively participate in all processes of the immune response from activation to differentiation and cell proliferation. The production of these cytokines is, in many cases, under to genetic regulation, so polymorphisms located on promoter regions or coding region can alter their levels and thereby modify the inflammatory and/or immune response against any stimulus...
In solid organ transplantation, the factors leading to graft loss are diverse. Despite progress in diagnosis and treatment of kidney transplant patients, acute rejection remains a major cause of progressive deterioration of renal function. The presence of rejection episodes reduce graft survival, and even the patient survival, since it involves activation of not only local but also systemic inflammatory process, and forces to increase immunosuppressive treatment administered. Early detection of patients with a greater susceptibility to develop a rejection is one of the objectives pursued since it can help to prevent it. At present, there is no consensus on the definition of "high immunological risk" and which features a patient must present to be included in this risk group. Cytokines, immunomodulatory molecules that act as mediators of inflammation and immune response, are secreted by many cells, T lymphocytes and macrophages among them. They actively participate in all processes of the immune response from activation to differentiation and cell proliferation. The production of these cytokines is, in many cases, under to genetic regulation, so polymorphisms located on promoter regions or coding region can alter their levels and thereby modify the inflammatory and/or immune response against any stimulus...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 01/02/2016