Investigation of the Suppressing Effect on Post-Kidney Transplantation Malignancy Due to KIR Ligand Mismatch

2022 Fiscal Year Final Research Report

• Project/Area Number: 17K16773
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Urology
• Research Institution: Akita University
• Principal Investigator: Fujiyama Nobuhiro 秋田大学, 医学部附属病院, 講師 (90603275)
• Project Period (FY): 2017-04-01 – 2023-03-31
• Keywords: 移植医療 / 腎移植 / 組織適合性 / HLA / KIR

Outline of Final Research Achievements

Histocompatibility assessment is essential for kidney transplantation between the recipient and the organ donor. This predicts the immunological alloreactivity between the recipient and the donor. There exists a diverse repertoire for the HLA receptor-KIR involved in innate immunity, but pre-transplant compatibility assessments are hardly ever conducted. Therefore, we retrospectively explored the impact on the prognosis of kidney transplantation by assessing the tissue compatibility between the recipient and donor in the innate immune system. As a result, we found a difference in the frequency of carcinogenesis depending on the presence or absence of KIR ligand mismatch, that innate immunity is maintained when there is a KIR ligand mismatch, and we propose that it is involved in suppressing the onset of viral infections.

Free Research Field

移植免疫

Academic Significance and Societal Importance of the Research Achievements

近年の腎移植医療は良好な治療成績を示し、長期QOLを得ることが大きな課題となっている。しかし、腎移植後の悪性腫瘍による死亡率は15%と高く（罹患率は健常人3 倍いじょうとされ）、増加傾向にある。本研究はレシピエントKIR遺伝子ハプロタイプが悪性腫瘍発症リスクを客観的に把握できる極めて重要な指標となりえることを示唆した。また、特定のウイルス感染リスクとも強く関連する可能性もある。現在の腎移植における免疫学的な適合性評価にKIR遺伝子は含まれていない。移植後重大合併症を回避するための治療戦略としてKIR-HLA適合性の重要性を提唱する。