IFNL4多态性与循环IFN-λ3相关,较高的血浆IFN-λ3与HBV表面抗原(抗HBs)抗体的较高产量相关。响应HBV疫苗的IFNL4rs8099917T等位基因和抗HBs开发与血液透析(HD)患者的更好生存率相关。
显示血浆IFN-λ3是否也是HD患者存活的预测因子。
在135例HD患者中测量血浆IFN-λ3,随访2.6年。使用Kaplan-Meier方法和Cox比例风险模型测试生存概率。
HD幸存者的血浆IFN-λ3(ng/L)为116.8(20.4-227.5)(n=89,65.9%),死亡患者75.1(36.0-228.8)(n=37,27.4%),接受肾脏移植的受试者(n=9,6.7%)和109.0(40.0-232.7)。死亡患者的IFN-λ3低于所有其余患者(P=0.039)和未进行移植的HD患者(P=0.028)。IFN-λ3和抗-HBs滴度相关(r=0.587,P<0.000001)。显示IFN-λ3>126.1ng/L(第三三分)的患者与第1位的IFN-λ3患者相比,生存率更高(<73.8ng/L,P=0.005)和第二(≥73.8-<126.1ng/L,P=0.013)三元率。每10ng/LIFN-λ3的减少与等于1.076的风险比相关(95CI1.015-1.140,P=0.013)。在多变量分析中,生存的独立预测因素是年龄(P=0.008),透析方式(P=0.038),循环IFN-λ3(P=0.044),糖尿病肾病(P=0.047),但不是性别,研究前的透析持续时间,平均动脉压,BMI,CRP,白蛋白,25(OH)D,或抗HBs。
循环IFN-λ3是HD患者生存的有希望的预测因子。
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.
To show whether plasma IFN-λ3 is also a predictor of survival in HD patients.
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.
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.
Circulating IFN-λ3 is a promising predictor of HD patient survival.