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NFKB1 promoter polymorphism: A new predictive marker of cytomegalovirus infection after kidney transplantation
Author(s) -
Leone Francesca,
Gigliotti Paolo,
La Russa Antonella,
Lofaro Danilo,
Perri Anna,
Vizza Donatella,
Lupinacci Simona,
Toteda Giuseppina,
Bonofiglio Martina,
Presta Pierangela,
Talarico Roberta,
Aquino Benedetta,
Bonofiglio Renzo
Publication year - 2019
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13027
Subject(s) - medicine , cytomegalovirus , immunology , transplantation , cytomegalovirus infection , kidney transplantation , pathogenesis , virus , proportional hazards model , human cytomegalovirus , herpesviridae , viral disease
Cytomegalovirus (CMV) infection represents a common cause of morbidity and mortality in kidney transplant recipients (KTR). The NF‐kB signaling pathway is highly involved in the pathogenesis of CMV infection. The ‐94ins/delATTG functional polymorphism in the promoter of NFKB1 has been associated with low intracellular levels of the protein and high incidence of inflammatory and autoimmune disease. In this study, we evaluated the association of this NFKB1 polymorphism with the risk of CMV infection. Methods CMV infection was defined as virus isolation or detection of viral antigens or nucleic acid in any body fluid or tissue specimen. Using Cox regression and survival analysis, we analyzed the association between the polymorphism and CMV infection as well as recurrence in the first 12 months after transplantation. Results We analyzed the ‐94ins/delATTG NFKB1 polymorphism of 189 KTRs. The 65% of CMV infections occurred in ins/ins group. Survival free from CMV infection was 54.7% for ins/ins group and 79.4% for deletion carriers one year after transplantation ( P < 0.0001). At multivariate regression, deletion carriers showed a lower risk of CMV infection and recurrence with respect to ins/ins KTRs (HR = 0.224 P = 0.0002; HR = 0.307, P = 0.012, respectively). Conclusions In conclusion, pretransplantation screening for NFKB1 ‐94ins/delATTG polymorphism may predict CMV infection and improve the management of patients at higher risk of infection in the post‐transplant period.