Protective effects of FCGR2A polymorphism in invasive pneumococcal diseases
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KeywordsMeningitis Hospital Mortality Amino Acid Change Streptococcus Pneumoniae Genetic Association Study
Streptococcus pneumoniae is a major cause of pneumonia and meningitis. Several genetic polymorphisms have been described to explain differences in susceptibility and severity of encapsulated pathogen-related diseases. Among them, a functional FCGR2A polymorphism leading to amino acid change of histidine (H) to arginine (R) at position 131 appears to be a major candidate in adult invasive pneumococcal diseases (IPD). However, previous reports needed confirmation in a large well-defined population.
A prospective genetic association study in a 24-bed medical ICU of a tertiary teaching hospital over 7 years. Patients were retrospectively selected from two prospective cohorts generated between January 2001 and December 2008. All Caucasian subjects with proven IPD and hospitalized in the ICU were included. Cases of IPD were defined by the isolation of S. pneumoniae from a normally sterile site (blood, bronchoalveolar lavage, quantitative tracheal aspiration, cerebrospinal fluid (CSF)). DNA from all Caucasian patients with IPD (pneumonia and/or meningitis) was genotyped for the FcγRIIa-R/H131polymorphism.
In a well-defined population of IPD patients, the frequency of the variant FcγRIIa-R131 does not differ from other critically ill patients. However, the FcγRIIa-R/R131 genotype was independently associated with increased survival regardless of the site of infection.
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