Michalek Jaroslav, Svetlikova Petra, Fedora Michal, Klimovic Michal, Klapacova Lenka, Bartosova Drahomira, Elbl Lubomir, Hrstkova Hana, Hubacek Jaroslav A
University Hospital Brno, First Department of Pediatrics, Cernopolni 9, 61300 Brno, Czech Republic.
Intensive Care Med. 2007 Dec;33(12):2158-64. doi: 10.1007/s00134-007-0860-3. Epub 2007 Sep 27.
To evaluate the role of genetic polymorphisms of the bactericidal permeability increasing protein (BPI) in pediatric patients with sepsis.
Prospective, single-center, case-control study at the pediatric intensive care unit (PICU) of a university hospital.
345 consecutive pediatric patients admitted to the PICU with fever, systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, septic shock, or multiple organ distress syndrome (MODS).
DNA was isolated and two BPI gene polymorphisms BPI (G545 > C) Taq and BPI (A645[ > G) 216 were studied in patients and compared with healthy controls.
Genetic analysis of the BPI Taq gene revealed significant differences between healthy controls and the subgroup of febrile patients (p = 0.0243), the subgroup of SIRS and sepsis (p = 0.0101), and the subgroup of severe sepsis, septic shock, and MODS (p = 0.0027), respectively. No statistically significant differences for the BPI 216 gene polymorphism were found between patient and healthy control groups. A statistically significant predisposition to Gram-negative sepsis in patients carrying the BPI Taq GG variant together with the BPI 216 AG or GG variant was revealed (p = 0.0081), and these haplotypes were also associated with death due to sepsis-related complications.
BPI Taq gene polymorphism is the accurate predictor of the severity of sepsis in children admitted to the PICU.
评估杀菌通透性增加蛋白（BPI）基因多态性在儿童脓毒症患者中的作用。
在一所大学医院的儿科重症监护病房（PICU）进行的前瞻性、单中心病例对照研究。
345例连续入住PICU的儿童患者，伴有发热、全身炎症反应综合征（SIRS）、脓毒症、严重脓毒症、感染性休克或多器官功能障碍综合征（MODS）。
提取DNA，研究患者的两个BPI基因多态性BPI（G545>C）Taq和BPI（A645[>G）216，并与健康对照进行比较。
BPI Taq基因的遗传分析显示，健康对照与发热患者亚组（p=0.0243）、SIRS和脓毒症亚组（p=0.0101）以及严重脓毒症、感染性休克和MODS亚组（p=0.0027）之间存在显著差异。患者组和健康对照组之间未发现BPI 216基因多态性有统计学显著差异。携带BPI Taq GG变异体以及BPI 216 AG或GG变异体的患者发生革兰氏阴性脓毒症的倾向具有统计学显著性（p=0.0081），并且这些单倍型也与脓毒症相关并发症导致的死亡有关。
BPI Taq基因多态性是入住PICU儿童脓毒症严重程度的准确预测指标。
