HLA evolutionary divergence effect on bacterial infection risk in cirrhotic liver transplant candidates.

Autor: Mazzola A; Sorbonne Université, Unité médicale de transplantation hépatique, hépato-gastroentérologie, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France; MICS-Research laboratory in Mathematics and Computer Science at CentraleSupélec, Gif-Sur-Yvette, France. Electronic address: alessandra.mazzola2@aphp.fr., Roger C; Sorbonne Université, Unité médicale de transplantation hépatique, hépato-gastroentérologie, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France. Electronic address: clementine.roger@aphp.fr., Lhotte R; CHU Paris-GH St-Louis Lariboisière F. Widal, Laboratoire d'immunologie-Histocomptabilité, Hôpital Saint-Louis, 75010 Paris, France; MICS-Research laboratory in Mathematics and Computer Science at CentraleSupélec, Gif-Sur-Yvette, France. Electronic address: romain.lhotte@centralesupelec.fr., Mallet M; Sorbonne Université, Unité médicale de transplantation hépatique, hépato-gastroentérologie, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France. Electronic address: maxime.mallet@aphp.fr., Thabut D; Sorbonne Université, Unité médicale de transplantation hépatique, hépato-gastroentérologie, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France. Electronic address: dominique.thabut@aphp.fr., Taupin JL; CHU Paris-GH St-Louis Lariboisière F. Widal, Laboratoire d'immunologie-Histocomptabilité, Hôpital Saint-Louis, 75010 Paris, France. Electronic address: jean-luc.taupin@aphp.fr., Conti F; Sorbonne Université, Unité médicale de transplantation hépatique, hépato-gastroentérologie, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France. Electronic address: filomena.conti@aphp.fr.
Jazyk: angličtina
Zdroj: Clinical immunology (Orlando, Fla.) [Clin Immunol] 2025 Jan; Vol. 270, pp. 110399. Date of Electronic Publication: 2024 Nov 17.
DOI: 10.1016/j.clim.2024.110399
Abstrakt: Bacterial infections are common in cirrhosis patients, increasing the risk of decompensation and death. The impact of HLA evolutionary divergence (HED) on infection risk hasn't been studied in humans before. We conducted a retrospective study on cirrhosis patients awaiting liver transplantation (LT) from January 2019 to February 2022, examining class I and II-HED effects on bacterial infections and cirrhosis decompensation. We included 269 cirrhosis patients. Among them, 98 experienced 153 bacterial infections. Multivariable analysis after variable selection revealed that higher class II-HED was linked to fewer bacterial infections (p = 0.034), while class I-HED showed no effect (p = 0.074). Independent risk factors for bacterial infections included invasive procedures (p < 0.001), ICU hospitalization (p < 0.001), recent antibiotic treatment (p = 0.046), rifaximin use (p = 0.043), and cirrhosis decompensation (p = 0.002). Neither class I nor II-HED affected decompensation risk. This pioneering study shows that high class II-HED levels may protect against bacterial infections in cirrhosis patients awaiting LT, suggesting an immunological mechanism at play.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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