Genetic variation in the prostaglandin E2 pathway is associated with primary graft dysfunction.

Journal Article (Clinical Trial;Journal Article;Multicenter Study)

RATIONALE: Biologic pathways with significant genetic conservation across human populations have been implicated in the pathogenesis of primary graft dysfunction (PGD). The evaluation of the role of recipient genetic variation in PGD has thus far been limited to single, candidate gene analyses. OBJECTIVES: We sought to identify genetic variants in lung transplant recipients that are responsible for increased risk of PGD using a two-phase large-scale genotyping approach. METHODS: Phase 1 was a large-scale candidate gene association study of the multicenter, prospective Lung Transplant Outcomes Group cohort. Phase 2 included functional evaluation of selected variants and a bioinformatics screening of variants identified in phase 1. MEASUREMENTS AND MAIN RESULTS: After genetic data quality control, 680 lung transplant recipients were included in the analysis. In phase 1, a total of 17 variants were significantly associated with PGD, four of which were in the prostaglandin E2 family of genes. Among these were a coding variant in the gene encoding prostaglandin E2 synthase (PTGES2; P = 9.3 × 10(-5)) resulting in an arginine to histidine substitution at amino acid position 298, and three variants in a block containing the 5' promoter and first intron of the PTGER4 gene (encoding prostaglandin E2 receptor subtype 4; all P < 5 × 10(-5)). Functional evaluation in regulatory T cells identified that rs4434423A in the PTGER4 gene was associated with differential suppressive function of regulatory T cells. CONCLUSIONS: Further research aimed at replication and additional functional insight into the role played by genetic variation in prostaglandin E2 synthetic and signaling pathways in PGD is warranted.

Full Text

Duke Authors

Cited Authors

  • Diamond, JM; Akimova, T; Kazi, A; Shah, RJ; Cantu, E; Feng, R; Levine, MH; Kawut, SM; Meyer, NJ; Lee, JC; Hancock, WW; Aplenc, R; Ware, LB; Palmer, SM; Bhorade, S; Lama, VN; Weinacker, A; Orens, J; Wille, K; Crespo, M; Lederer, DJ; Arcasoy, S; Demissie, E; Christie, JD; Lung Transplant Outcomes Group,

Published Date

  • March 1, 2014

Published In

Volume / Issue

  • 189 / 5

Start / End Page

  • 567 - 575

PubMed ID

  • 24467603

Pubmed Central ID

  • PMC3977709

Electronic International Standard Serial Number (EISSN)

  • 1535-4970

Digital Object Identifier (DOI)

  • 10.1164/rccm.201307-1283OC


  • eng

Conference Location

  • United States