Genetic variations including single nucleotide polymorphisms, dinucleotide repeats and microsatellites have been identified in a number of genes encoding cytokines, cytokine receptors, chemokines and their receptors, adhesion molecules. Several of the polymorphisms are located in the promoter region of the gene, affect transcription or translation, and not infrequently determine the level of expression of the protein product. An interesting and testable hypothesis for the clinical heterogeneity and differential responsiveness in allograft recipients is genetic variation. These nucleotide sequence variations, polymorphisms located in genes contributing to immune repertory and in genes responsible for drug metabolism, are excellent candidates for the differential clinical phenotype.
Division of Nephrology, Department of Transplantation Medicine, New York-Presbyterian Hospital, Weill Medical College of Cornell University, New York, USA
Correspondence to M. Suthanthiran MD, 525 East 68th Street, Box 3, New York, NY 10021, USA. Tel: +1 212 746 4498, fax: +1 212 746 8091; e-mail: firstname.lastname@example.org