IMPACT OF GENETIC POLYMORPHISMS IN MMPS ON THE RENAL ALLOGRAFT

Mansi Bhatt (M.Sc.), Dr. Rama Mittal and Aneesh Srivastava* (MS, M.Ch.)

ABSTRACT

Renal transplantation (RT) is currently the most effective replacement therapy and believed as a boon for patients with end-stage renal disease (ESRD). The short-term outcomes of transplant have improved significantly, whereas the long term outcomes are still fairly compromised. The role of early acute rejections with their impact on long term graft survival has been widely recognized as one of the most important factor. The Matrix metalloproteinases (MMPs) are traditionally evolved as antifibrotic players in the development and progression of chronic kidney diseases and ESRD in which RT is required. The goal of this review is to highlight the role of MMPs as biomarkers in RT; their impact on the rejection process and therefore longevity of the graft; on the therapeutic regimen and on the delayed graft function. We found that MMP-1, MMP-2, MMP-7, MMP-9 and MMP-20 have impact on renal transplant and allograft rejection. They represent as new mediators involved in acute kidney transplant rejection. MMP-1, MMP-7, MMP-9, and MMP-13 represent as potential molecular allograft rejection markers. MMP-9 was also found associated with delayed graft function. Complementary therapy of allograft rejection and pre-transplant allograft outcome can be predicted due to enhanced allograft survival in mutant allele carriers for MMP-2.

Keywords: Renal transplantation; Allograft rejection; Biomarkers; Delayed Graft Function; Matrix metalloproteinases (MMPs).