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Cytokine gene polymorphisms in children successfully withdrawn from immunosuppression after liver transplantation1

Background. Cytokine genetic polymorphisms have been associated with transplant outcome in some experimental and clinical studies, but the cytokine profile of patients who are clinically tolerant has not been investigated. Aim. Allelic variations in tumor necrosis factor (TNF)-&agr;, interferon (INF)-&ggr;, transforming growth factor (TGF)-&bgr;1, interleukin (IL)-6, and IL-10 were evaluated in patients successfully withdrawn from immunosuppression. Methods. Pediatric liver transplant recipients who were successfully withdrawn from immunosuppression (n=12) or who are on minimal immunosuppression (n=7) were genotyped. A control group of liver recipients who required maintenance immunosuppression served as a control group (n=37). Results. Compared to the control group, low TNF- &agr; and high/intermediate IL-10 profiles were seen in all 12 children maintained off immunosuppression and in 6 of 7 children requiring minimal immunosuppression. Conclusion. Children successfully maintained off immunosuppression are more likely to have a genetic predisposition toward low TNF-&agr; and high/intermediate IL-10 production. Children maintained on minimal immunosuppression exhibit a similar cytokine profile to those successfully weaned.