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Background Persistent inflammation and fibrosis have been related to active progression of renal deterioration and reduced survival of kidney transplant. The aim of this study was to determine the impact of single-nucleotide polymorphisms (SNPs) located in regions related to inflammatory and immune processes on the development of chronic renal allograft dysfunction (CRAD). Methods A retrospective study was carried out on 276 patients who received kidney transplant (KT). SNPs were genotyped via the SNPlex platform. Statistical analysis was performed with SNPstat and regression logistic analyses were adjusted by age and gender of recipients and donors, cold ischemia time and the number of human leukocyte antigen (HLA) mismatches. Results From 276 patients with KT, 118 were non-CRAD and 158 were CRAD. Three SNPs showed significant associations with CRAD development: rs1800471 in transforming growth factor beta 1 (TGFB1), rs5186 in angiotensin II receptor type 1 (AGTR1), and rs699947 in vascular endothelial growth factor A (VEGFA). GC genotype of rs1800471 was associated with increased odds of CRAD compared to GG genotype (OR = 2.65 (95% confidence interval (CI) = 1.09; 6.47), p = 0.025), as well as AC and AA genotype of rs699947 assuming a dominant model (OR = 1.80 (95% CI = 1.02; 3.20), p = 0.044). Besides, AC and CC genotypes of rs5186 were associated with reduced odds of CRAD assuming a dominant model (OR = 0.56 (95% CI = 0.33; 0.96), p = 0.033). Conclusion Our findings suggest that three genes related to immunity and inflammation (rs1800471, rs5186 and rs699947) are associated to susceptibility or protection to CRAD, and might have diagnostic utility in predicting the likelihood of developing CRAD.

Objective The diagnostic work-up of a drug hypersensitivity reaction is indeed difficult. In general, medical documentation of allergic reactions in medical reports is usually highly deficient or non-existent. The aim of this study was to analyse the prevalence of self-reported drug allergies in the surgical population as well as the criteria used in the diagnosis of drug hypersensitivity reactions. Methods A prospective study with the consecutive participation of 1439 patients, following surgical intervention, attended the Post-Operative Care Unit. Previously, as a routine process during the pre-anesthesia consultation, all patients were questioned about whether they had any drug allergies to report and diagnostic work-up. Results The prevalence of self-reported drug allergies was 8.3% (119/1439): 3.6% considered themselves allergic to β-lactams and 2.4% to non-steroidal anti-inflammatory drugs. Approximately one-third of the subjects (40 out of the 119) had not been subjected to any allergy diagnostic procedure and with 79 (66.4%), the only diagnostic test used by the Allergy Unit had been the skin prick-test. None of those participating in the study had tryptase, methylhistamine, specific IgE or intradermal tests carried out to characterize the diagnosis of the allergic reaction. Conclusions These results show that self-reported drug allergies are highly prevalent and as yet little explored. It is an important prevalence which should bring about modifications to the prescription of certain medicaments. The medical personnel must be made aware of the need to make an accurate diagnosis of allergies to medicaments.

The relationships between cytokine responses in septic shock are currently poorly understood. Some studies have pointed to a biphasic model, with an initial proinflammatory phase, followed by a reactive, anti-inflammatory response to explain the pathogenesis of the most severe form of sepsis. However, evidence for the coexistence of both responses has been found. In this study, the plasma levels of 17 cytokines and chemokines, in 20 patients with septic shock, 11 patients with systemic inflammatory response syndrome (SIRS), during the first 24 hours following diagnosis, and 10 healthy controls, were analyzed and compared. Patients with septic shock showed increased levels of IL-6, IL-8, MCP-1, MIP-1β, IFN-γ, GM-CSF and IL-10 compared to healthy controls. Patients with SIRS showed higher levels of IL-6, IL-8, MCP-1, MIP-1β, G-CSF and IL-10 than controls. Patients with septic shock showed higher levels of IL-8, GM-CSF, MIP-1β than those with SIRS. The Spearman test demonstrated a positive association between the pro-inflammatory mediators IL-6, IL-8, MCP-1, MIP-1β, IFN-γ, GM-CSF and the immunomodulatory cytokine IL-10 in septic shock. Consequently, correlation studies supported the notion that secretion of pro- and anti-inflammatory mediators in septic shock occurs as a simultaneous immune response program initiated early in the course of the disease, revealing that both types of cytokine play a role from the very beginning of this life-threatening condition.