Polimorfismo inserção/deleção no gene da enzima conversora de angiotensina associado à interleucina 1 beta, à capacidade antioxidante do plasma e à função renal.

Abstract

Renal transplantation presents as the best therapeutic choice for the patient with terminal chronic renal disease, bringing improvement in the quality of life of these patients. Angiotensin converting enzyme (ACE) plays a crucial role in renal physiology. The insertion / deletion (I / D) polymorphism in the ACE gene determines the plasma variation of ACE and, consequently, affects the kidneys and renal transplantation. This study evaluated the association of inflammatory markers, interleukin 1 beta (IL-1β) and antioxidant capacity with the I / D polymorphism in the ACE gene against renal transplant function and the presence of rejection. A total of 173 kidney transplant recipients were selected and were divided into groups according to the creatinine level (C1: creatinine ≤1.4 mg / dL and C2: creatinine> 1.4 mg / dL); according to the estimated glomerular filtration rate (eRFG) (R1: eRFG ≥60 mL / min / 1.73m2 and R2: eRFG <60 mL / min / 1.73m2); the presence of a previous history of graft rejection (no REJ: no rejection episode, REJ: prior rejection, INDET: undetermined rejection), and the time after transplantation, ie the time between surgery and the date of blood collection. (T1: 01 to 24 months, T2: 25 to 60 months, T3: 61 to 120 months, T4:> 120 months after transplantation). Polymerase chain reaction was used for the detection of polymorphisms, the Multiplex immunoenzymatic assay was used for IL-1β and for oxidation profile determination the colorimetric method of reducing MTT [(3- (4,5- dimethylthiazol-2yl ) -2,5-diphenyl tetrazoline bromide)]. The study demonstrated a positive correlation between creatinine levels and oxidative stress profile, eRFG and post-transplant time, as well as a negative correlation between the MTT eRFG assay. Lower IL-1 levels were related to the longer post-transplant group. Patients who did not use angiotensin converting enzyme inhibitors (ACEI) demonstrated a higher index of antioxidant capacity profile. It should be noted that this study is part of a project that listed other biomarkers related to kidney transplantation and all of them will be correlated later. In view of these results and the limitations of the study, further research needs to be done to demonstrate whether the biomarkers evaluated could be used to monitor renal and graft function after renal transplantation.