5df219a7-e20c-4f53-9ac7-0080841e5a3e
title
Relationship between postrenal transplant osteonecrosis of the femoral head and gene polymorphisms related to the coagulation and fibrinolytic systems in Japanese subjects.
2e514b49-6702-49d2-9f76-58995483ae75
abstract
BACKGROUND: Nontraumatic osteonecrosis of the femoral head (ONFH) is one of the complications that may occur after renal transplantation. We investigated the relationship between the incidence of ONFH and polymorphisms in the genes for  plasminogen activator inhibitor (PAI)-1 , which is one of the major regulatory proteins of the fibrinolytic system, and  5,10-methylenetetrahydrofolate reductase  ( MTHFR ), which is associated with the plasma levels of homocysteine in Japanese subjects. METHODS: Thirty-one patients with postrenal transplant ONFH and 106 patients without ONFH were selected. Genotypes of  PAI-1   4G/5G  and  MTHFR   C677T  were determined by direct sequencing of genomic DNA. In addition, plasma  PAI-1  antigen (Ag) levels and plasma total homocysteine (tHcy) levels at the steady state were measured. The relationships between the incidence of ONFH and these genotypes, as well as plasma levels of the gene products, were investigated. RESULTS: Plasma  PAI-1  Ag levels were the highest in patients with the 4G/4G genotype, and plasma tHcy levels were the highest in patients with TT genotypes of  MTHFR   C677T . However, the relationship between the incidence of ONFHH and  PAI-1   4G/5G  or  MTHFR   C677T  was not observed. The relationship between the incidence of ONFH and plasma levels of  PAI-1  Ag or tHcy was not observed. CONCLUSIONS: Genotypes of  PAI-1   4G/5G  and  MTHFR   C677T  or plasma concentrations of  PAI-1  Ag and tHcy had no effect on the incidence of ONFH in Japanese subjects, unlike the results of studies performed in white subjects. The effect of genetic background on the pathologic conditions that developed in patients with postrenal transplant ONFH may differ according to race.