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Steroid regulation: An overlooked aspect of tolerance and chronic rejection in kidney transplantation

  • Sofia Christakoudi*
  • , Manohursingh Runglall
  • , Paula Mobillo
  • , Irene Rebollo-Mesa
  • , Tjir Li Tsui
  • , Estefania Nova-Lamperti
  • , Sonia Norris
  • , Yogesh Kamra
  • , Rachel Hilton
  • , Sunil Bhandari
  • , Richard Baker
  • , David Berglund
  • , Sue Carr
  • , David Game
  • , Sian Griffin
  • , Philip A. Kalra
  • , Robert Lewis
  • , Patrick B. Mark
  • , Stephen D. Marks
  • , Iain Macphee
  • William McKane, Markus G. Mohaupt, Ravi Pararajasingam, Sui Phin Kon, Daniel Serón, Manish Sinha, Beatriz Tucker, Ondrej Viklický, Robert I. Lechler, Graham M. Lord, Daniel Stahl, Maria P. Hernandez-Fuentes
*Corresponding author for this work
  • King's College London
  • St Thomas' Hospital
  • UCB Pharma S A
  • University of Concepción
  • Mortimer Market Centre
  • Hull & East Yorkshire Hospitals NHS Trust
  • Genetics and Pathology
  • Leicester General Hospital
  • Cardiff and Vale University Local Health Board
  • Queen Alexandra Hospital
  • University of Glasgow
  • St George's University Hospitals NHS Foundation Trust
  • Northern General Hospital
  • Inselspital
  • King's College Hospital NHS Foundation Trust
  • Universitat Autonoma de Barcelona
  • Institut klinické a experimentální medicíny (IKEM)
  • King's Health Partners

Research output: Contribution to journalArticlepeer-review

Abstract

Steroid conversion (HSD11B1, HSD11B2, H6PD) and receptor genes (NR3C1, NR3C2) were examined in kidney-transplant recipients with “operational tolerance” and chronic rejection (CR), independently and within the context of 88 tolerance-associated genes. Associations with cellular types were explored. Peripheral whole-blood gene-expression levels (RT-qPCR-based) and cell counts were adjusted for immunosuppressant drug intake. Tolerant (n = 17), stable (n = 190) and CR patients (n = 37) were compared. Healthy controls (n = 14) were used as reference. The anti-inflammatory glucocorticoid receptor (NR3C1) and the cortisol-activating HSD11B1 and H6PD genes were up-regulated in CR and were lowest in tolerant patients. The pro-inflammatory mineralocorticoid gene (NR3C2) was downregulated in stable and CR patients. NR3C1 was associated with neutrophils and NR3C2 with T-cells. Steroid conversion and receptor genes, alone, enabled classification of tolerant patients and were major contributors to gene-expression signatures of both, tolerance and CR, alongside known tolerance-associated genes, revealing a key role of steroid regulation and response in kidney transplantation.

Original languageEnglish
Pages (from-to)205-216
Number of pages12
JournalMolecular and Cellular Endocrinology
Volume473
DOIs
Publication statusPublished - 15 Sept 2018

Keywords

  • Chronic rejection
  • Kidney
  • Steroid conversion
  • Steroid receptor genes
  • Tolerance
  • Transplantation

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