ITPKC 基因 SNP rs28493229 的 C 等位基因在川崎病中的临床意义:与疾病易感性和卡介苗瘢痕再激活的关联。

Clinical Implication of the C Allele of the ITPKC Gene SNP rs28493229 in Kawasaki Disease: Association With Disease Susceptibility and BCG Scar Reactivation.

机构信息

Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.

出版信息

Pediatr Infect Dis J. 2011 Feb;30(2):148-52. doi: 10.1097/INF.0b013e3181f43a4e.

Abstract

BACKGROUND

a functional single nucleotide polymorphism (SNP) (rs28493229) in the inositol 1,4,5-trisphosphate 3-kinase C (ITPKC) gene has been linked to the susceptibility to Kawasaki disease (KD). The implication remains unclear.

SUBJECTS AND METHODS

genotyping for the ITPKC polymorphism was conducted on 280 unrelated Taiwanese children with KD and 492 healthy ethnically and gender-matched controls. The clinical manifestations and laboratory data were systemically collected.

RESULTS

the GC and CC genotypes of ITPKC gene SNP rs28493229 were overrepresented in KD patients (GG:GC:CC was 236:43:1, C allele frequency: 8.04%) than those in the controls (GG:GC:CC was 454:37:1, C allele frequency: 3.96%; OR: 2.23, P = 0.001). In KD patients, those with GC or CC genotypes of SNP rs28493229 (19/44) were more likely to have reactivation at the Bacille Calmette-Guérin (BCG) inoculation site than those with GG genotypes (66/236; OR: 1.96, P = 0.044). Such association was particularly strong in patients aged <20 months (OR: 3.26, P = 0.017). The other clinical manifestations were not related to this SNP. There were 160 (57.1%) patients with coronary arterial lesions. The development and the severity of coronary arterial lesion were also not associated with this SNP. Comparison between patients with and without BCG reactivation revealed only one difference: patients with reactivation were younger.

CONCLUSION

in a cohort from a population with the world's third highest incidence of KD, we demonstrated that the C-allele of ITPKC SNP rs28493229 is associated with KD susceptibility and BCG scar reactivation during the acute phase, although its frequency is lower than that in the Japanese cohort (22.6%), suggesting this SNP contributes to KD susceptibility through induced hyperimmune function reflected in the BCG reactivation.

摘要

背景

肌醇 1,4,5-三磷酸 3-激酶 C(ITPKC)基因中的一个功能单核苷酸多态性(SNP)(rs28493229)与川崎病(KD)的易感性有关。其意义尚不清楚。

受试者和方法

在 280 名无关的台湾 KD 患儿和 492 名种族和性别匹配的健康对照中进行 ITPKC 多态性基因分型。系统收集临床症状和实验室数据。

结果

KD 患者中 ITPKC 基因 SNP rs28493229 的 GC 和 CC 基因型(GG:GC:CC 为 236:43:1,C 等位基因频率:8.04%)高于对照组(GG:GC:CC 为 454:37:1,C 等位基因频率:3.96%;OR:2.23,P = 0.001)。在 KD 患者中,SNP rs28493229 的 GC 或 CC 基因型(19/44)的患者比 GG 基因型(66/236;OR:1.96,P = 0.044)的卡介苗(BCG)接种部位更易出现再激活。这种关联在年龄<20 个月的患者中尤为强烈(OR:3.26,P = 0.017)。其他临床表现与该 SNP 无关。有 160 例(57.1%)患者存在冠状动脉病变。冠状动脉病变的发生和严重程度也与该 SNP 无关。有和无 BCG 再激活的患者比较仅发现一个差异:再激活的患者更年轻。

结论

在来自 KD 发病率居世界第三的人群的队列中,我们证明 ITPKC SNP rs28493229 的 C 等位基因与 KD 易感性以及急性期中的 BCG 瘢痕再激活有关,尽管其频率低于日本队列(22.6%),这表明该 SNP 通过诱导 BCG 再激活反映的过强免疫功能导致 KD 易感性。

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