Abstract
Purpose: :
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.
Methods: :
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.
Results: :
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.
Conclusions: :
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.
Keywords: transplantation • cytokines/chemokines • keratoconus