Endeman Henrik, Cornips Marie Claire A, Grutters Jan C, van den Bosch Jules M, Ruven Hendrik J T, van Velzen-Blad Heleen, Rijkers Ger T, Biesma Douwe H
Department of Internal Medicine, St Antonius Hospital, Nieuwegein, The Netherlands.
Clin Vaccine Immunol. 2009 Jul;16(7):1087-90. doi: 10.1128/CVI.00037-09. Epub 2009 Jun 3.
Community-acquired pneumonia (CAP) can be caused by a variety of microorganisms but is most frequently associated with Streptococcus pneumoniae and gram-negative bacteria like Haemophilus influenzae. Encapsulated bacteria are able to escape phagocytosis, unless they are bound by immunoglobulin G2 subclass antibodies. These antibodies interact with Fcgamma receptor IIa (Fcgamma-RIIa), thereby facilitating opsonophagocytosis of the encapsulated bacteria. We studied the relationship between the Fcgamma-RIIa-R/H131 polymorphism and the clinical course of CAP and pathogen-specific susceptibility. Regarding methodology, the Fcgamma-RIIa genotype R/H131 was determined in 200 patients with CAP and in 313 healthy controls and was correlated with the clinical course, laboratory parameters, and causative microorganism. The Fcgamma-RIIa-R/R131 genotype was found more frequently in patients with severe sepsis (odds ratio [OR], 2.55; 95% confidence interval [CI], 1.30 to 5.00; P < 0.01). The majority of patients in this group suffered from invasive pneumococcal disease. The duration of hospital stay was longer for patients with the Fcgamma-RIIa-R/R131 genotype. Fcgamma-RIIa genotypes were not associated with an increased risk of CAP in general; however, the Fcgamma-RIIa-R/R131 genotype was found more frequently in patients with CAP caused by H. influenzae than in controls (OR, 3.03; CI, 1.04 to 9.09; P < 0.05). In conclusion, the Fcgamma-RIIa-R/R131 genotype is associated with severity of CAP and is more frequent in CAP caused by H. influenzae.
社区获得性肺炎（CAP）可由多种微生物引起，但最常与肺炎链球菌以及流感嗜血杆菌等革兰氏阴性菌相关。有荚膜的细菌能够逃避吞噬作用，除非它们被免疫球蛋白G2亚类抗体所结合。这些抗体与Fcγ受体IIa（Fcγ-RIIa）相互作用，从而促进对有荚膜细菌的调理吞噬作用。我们研究了Fcγ-RIIa-R/H131多态性与CAP临床病程及病原体特异性易感性之间的关系。关于方法，在200例CAP患者和313名健康对照中确定了Fcγ-RIIa基因型R/H131，并将其与临床病程、实验室参数及致病微生物进行关联分析。发现Fcγ-RIIa-R/R131基因型在严重脓毒症患者中更为常见（优势比[OR]，2.55；95%置信区间[CI]，1.30至5.00；P<0.01）。该组中的大多数患者患有侵袭性肺炎球菌疾病。Fcγ-RIIa-R/R131基因型患者的住院时间更长。一般而言，Fcγ-RIIa基因型与CAP风险增加无关；然而，在由流感嗜血杆菌引起的CAP患者中，Fcγ-RIIa-R/R131基因型的出现频率高于对照组（OR，3.03；CI，1.04至9.09；P<0.05）。总之，Fcγ-RIIa-R/R131基因型与CAP的严重程度相关，且在由流感嗜血杆菌引起的CAP中更为常见。
