摘要
背景:IFN-λ4基因多态性与循环型IFN-λ3相关,血浆IFN-λ3水平升高与抗HBs抗体的产生密切相关。IFNL 4 rs 8099在血液透析(HD)患者中,917 T等位基因和乙肝疫苗的抗-HBs开发与更好的生存有关。 目的:探讨血浆干扰素-λ3是否也是HD患者生存的预测指标. 方法:对随访2.6年的135例HD患者进行血浆干扰素-λ3的测定.生存概率用Kaplan-Meier方法和Cox比例风险模型进行检验. 结果:HD患者血浆IFN-λ3(ng/L)为116.8(20.4~227.5)(n=89,65.9%),死亡患者(n=37,27.4%)为75.1(36.0~228.8),肾转移患者为109.0(40.0~232.7)。(n=9,6.7%)。死亡患者的IFN-λ3水平低于其余患者(P=0.039)和未进行移植的HD患者(P=0.028)。干扰素-λ3与抗-HBs效价相关分析(r=0.587,P<0.000001)。第1位(<73.8ng/L,P=0.005)和第2位(λ73.8-)患者显示IFN-λ3>126.1 ng/L(第3层)患者的生存率优于IFN-λ3型患者。<126.1 ng/L,P=0.013)。干扰素-λ3/10 ng/L每下降一次,危害比为1.076(95%CI 1.015~1.140,P=0.013)。在多变量分析中,独立预测器存活时间分别为年龄(P=0.008)、透析方式(P=0.038)、循环干扰素-λ3(P=0.044)和糖尿病肾病(P=0.047),但不包括性别、透析时间、研究前平均动脉前。ssure,BMI,CRP,白蛋白,25(OH)D,或抗-HBs. 结论:循环IFN-λ3可作为HD患者生存的预测指标.
关键词: 抗-HBs,透析方式,终末期肾病,血液透析,干扰素λ3,生存预测因子.
Current Molecular Medicine
Title:Interferon-λ3 as a Predictor of Survival in Hemodialysis Patients.
Volume: 18 Issue: 4
关键词: 抗-HBs,透析方式,终末期肾病,血液透析,干扰素λ3,生存预测因子.
摘要: Background: IFNL4 polymorphisms are associated with circulating IFN-λ3, and higher plasma IFN-λ3 are associated with higher production of antibodies to HBV surface antigen (anti-HBs). The IFNL4 rs8099917 T allele and anti-HBs development in response to HBV vaccine are associated with better survival in hemodialysis (HD) patients.
Objective: To show whether plasma IFN-λ3 is also a predictor of survival in HD patients.
Methods: Plasma IFN-λ3 was measured in 135 HD patients who were followed-up for 2.6 years. Survival probability was tested using the Kaplan-Meier method and the Cox proportional hazard model.
Results: Plasma IFN-λ3 (ng/L) was 116.8 (20.4–227.5) in survivors on HD (n=89, 65.9%), 75.1 (36.0-228.8) in deceased patients (n=37, 27.4%), and 109.0 (40.0–232.7) in subjects submitted to kidney transplantation (n=9, 6.7%). IFN-λ3 was lower in deceased patients than that in all remaining patients (P=0.039) and patients who continued HD without transplantation (P=0.028). IFN-λ3 and anti-HBs titers were correlated (r=0.587, P<0.000001). Patients showing IFN-λ3 >126.1 ng/L (3rd tertile) presented better survival compared with patients with IFN-λ3 in the 1st (<73.8 ng/L, P=0.005) and 2nd (≥73.8 - <126.1 ng/L, P=0.013) tertiles. Each decrease in IFN-λ3 per 10 ng/L was associated with a hazard ratio equal to 1.076 (95%CI 1.015–1.140, P=0.013). In multivariate analysis, the independent predictors of survival were age (P=0.008), dialysis modality (P=0.038), circulating IFN-λ3 (P=0.044), and diabetic nephropathy (P=0.047), but not gender, dialysis duration prior to the study, mean arterial pressure, BMI, CRP, albumin, 25(OH)D, or anti-HBs.
Conclusion: Circulating IFN-λ3 is a promising predictor of HD patient survival.
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Cite this article as:
Interferon-λ3 as a Predictor of Survival in Hemodialysis Patients., Current Molecular Medicine 2018; 18 (4) . https://dx.doi.org/10.2174/1566524018666180926162324
DOI https://dx.doi.org/10.2174/1566524018666180926162324 |
Print ISSN 1566-5240 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5666 |
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