Impact of selectin gene polymorphisms on rapid progression to end-stage renal disease in patients with IgA nephropathy

Objective It is evident that leukocyte infiltration plays an important role in the pathogenesis of IgA nephropathy (IgAN). Selectin is one of the key adhesion molecules involved in leukocyte infiltration. Recent studies demonstrated a significant association between the selectin gene polymorphisms and susceptibility to IgAN. However, the impact of selectin gene polymorphisms on the progression to end-stage renal disease (ESRD) has not been studied. Patients and Methods To evaluate the influence of the selectin gene polymorphisms on the progression of IgAN, we designed specific primers for PCR genotyping and analyzed the association of selectin gene polymorphisms with the declining rate in renal function to its ESRD. Results A total of 61 hemodialysis patients were enrolled in the study. The mean age at renal biopsy was 33.0 +/- 13.3 years old, and the mean age at the start of hemodialysis was 41.2 +/- 13.8 years old. The mean interval between the time points of renal biopsy and the start of hemodialysis was 8.2 +/- 6.5 years (ranging from 0 to 33 years). The interval was significantly longer in IgAN patients with a homoallele of C in C1402T, C 1402/C1402, of the E-selectin gene, or a homoallele of C in C712T, C712/C712, of the L-selectin gene compared to others. The haplotype, which is a combination of C1402/C1402 and C712/C712, is able to distinguish the group that is at least a better prognosis than the severest prognostic one. Conclusion This study provides a possible association between the selectin gene polymorphisms and the rapid progression to ESRD in IgAN patients.