Laboratory Effect of HBV Infection in Kidney Transplant Recipients and Donors

Association of IL-17, IL-21, and IL-23R gene polymorphisms with HBV infection in kidney transplant patients

Inflammatory cytokine gene polymorphisms may influence the hepatic and extrahepatic HBV-related disease in transplant patients. In this study, the association between IL-17, IL-23R, and IL-21 gene polymorphisms with hepatitis B virus (HBV) infection was evaluated in kidney transplant patients. In total, 220 kidney transplant patients were enrolled in this cross-sectional study between years 2007 and 2011. The genomic HBV DNA was identified using an HBV PCR detection Kit according to the manufacturer's instruction. The cytokine gene polymorphisms, including IL-17 197 A/G (rs2275913), IL-21 +1472 G/T (rs2055979), IL-21 5250 C/T (rs4833837), and IL-23R C/A (rs10889677) were evaluated by PCR-RFLP and ARMS-PCR protocols. The serum levels of IL-17 and IL-21 were analyzed in HBV infected and noninfected transplant patients by ELISA methods according to manufacturer's instructions. 70 of 220 (35%) transplant patients experienced acute rejection. HBV DNA was detected in 52 of 220 (23.64%) transplant patients. 16 of 52 (30.8%) HBV-infected kidney transplant patients experienced acute rejection. A significant higher frequency of C allele of IL-23R (rs10889677) polymorphism, a higher frequency of AG heterozygote genotype and A allele of IL-17-G197A (rs2275913) polymorphism, a higher frequency of TT homozygote genotype and T allele of IL-21-G1472T (rs2055979) polymorphism, and a higher frequency of CC homozygote genotype and C allele of IL-21-C5250T (rs4833837) polymorphism were found in HBV-infected kidney transplant patients with acute rejection. Diagnosis of the higher frequency of the IL-17, IL-21, and IL-23R cytokine genotypes and allele polymorphisms in HBV-infected kidney transplant patients who experienced acute rejection, illustrates the importance of Th17-related cytokine genetic patterns. A better evaluation of HBV infection in kidney transplant patients is needed.

Isoformononetin, a methoxydaidzein present in medicinal plants, reverses bone loss in osteopenic rats and exerts bone anabolic action by preventing osteoblast apoptosis

PURPOSE

Daidzein (Daid) has been implicated in bone health for its estrogen-'like' effects but low bioavailability, unfavorable metabolism and uterine estrogenicity impede its clinical potential. This study was aimed at assessing isoformononetin (Isoformo), a naturally occurring methoxydaidzein, for bone anabolic effect by overcoming the pitfalls associated with Daid.

METHODS

Sprague-Dawley ovariectomized (OVx) rats with established osteopenia were administered Isoformo, 17β-oestradiol (E2) or human parathyroid hormone. Efficacy was evaluated by bone microarchitecture using microcomputed tomography and determination of new bone formation by fluorescent labeling of bone. Osteoblast apoptosis was measured by co-labeling of bone sections with Runx-2 and TUNEL. Biochemical markers of bone metabolism were measured by ELISA. Plasma and bone marrow levels of Isoformo and Daid were determined by LC-MS-MS. Rat bone marrow stromal cells were harvested to study osteoblastic differentiation by Isoformo and Daid. New born rat pups were injected with Isoformo and Daid to study the effect of the compounds on the expression of osteogenic genes in the calvaria by real time PCR.

RESULTS

In osteopenic rats, Isoformo treatment restored trabecular microarchitecture, increased new bone formation, increased the serum osteogenic marker (procollagen N-terminal propeptide), decreased resorptive marker (urinary C-terminal teleopeptide of type I collagen) and diminished osteoblast apoptosis in bone. At the most effective osteogenic dose of Isoformo, plasma and bone marrow levels were comprised of ~90% Isoformo and the rest, Daid. Isoformo at the concentration reaching the bone marrow achieved out of its most effective oral dosing induced stromal cell mineralization and osteogenic gene expression in the calvaria of neonatal rats. Isoformo exhibited uterine safety.

CONCLUSIONS

Our study demonstrates that Isoformo reverses established osteopenia in adult OVx rats likely via its pro-survival effect on osteoblasts. Given its bone anabolic and anti-catabolic effects accompanied with safety at uterine level we propose its potential in the management of postmenopausal osteoporosis.