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D. Dobrowolski, E. Wylegala, D. Tarnawska, U. Siekiera; Influence of IL-6, IL-10 Genes Polymorphisms and HLA Antigenes Matching on Incidence of Corneal Graft Rejection in Keratoconus Patients. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5763.
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The study was designed to evaluate the influence of IL-6, IL-10 cytokines gene polymorphisms and HLA class I and II antigens matching on outcomes of the penetrating keratoplasty (PK) and graft rejection risk in keratoconus patients.
For this retrospective study, patients after PK for keratoconus were qualified. 148 PK were performed between 2000 and 2006, minimum follow-up was 12 months. There were 82 men and 66 women in mean age 33,0±10,1 ranged from 17 to 59. 27,7% (41) of grafts were rejected. Polymorphisms of IL-6, IL-10 was genotyped. According to the genetic profile patients were classified as low (LP), intermediate (IP-only IL-10) and high producers (HP). Cytokines single nucleotide polymorphisms identification (SNP) was performed using PCR-SSP. Result of HLA -A, -B, -DR matching was described as number of mismatches (0, 1, 2 mismatches). Profile of HLA compatibility was compared between rejection positive and negative subgroups. Local rejection risk factors were included in evaluation of rejection risk.
Distribution of IL-6 secretion level was: in rejection group 36 HP and 5 LP and in non rejection group 82 HP and 25 LP. Distribution of IL-10 secretion level was: 7 HP, 22 IP, 12 LP and 23 HP, 66 IP, 18 LP respectively. Genotyping of cytokines do not revealed significant differences between groups in secretion profiles. Number of mismatches in HLA-A and -B antigens was higher in rejection group, if compared to successful grafts. 41,6% 2 mismatches in HLA -A in rejection group vs 30,8 % non rejection group were noted. For HLA-B antigens 2 mismatches were present in 48,7% and 36,4% of patients respectively. Presence of suture loosening and vessels in graft-host interface was significantly higher in rejected corneas.
There is no evidence of influence of cytokine genetic profile for rejection risk in keratoconus patients. Beneficial effect of HLA -A and -B antigens matching was observed.
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