Intensive Care Unit, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain.
Crit Care Med. 2011 Jun;39(6):1388-93. doi: 10.1097/CCM.0b013e31820eda74.
To assess the potential association of the functional polymorphism rs1801274 in the receptor IIa for the Fc portion of immunoglobin G (FcγRIIa) gene (FCGR2A-H131R) with the susceptibility to and the severity of community-acquired pneumonia (CAP).
Multicenter prospective and observational study.
Four university hospitals in Spain.
FCGR2A-H131R polymorphism was determined in 1,262 patients with CAP and in 1,224 in the subject control group.
Severe sepsis was recorded in 366 patients. No significant differences in genotype or allele frequencies were seen among patients with CAP or pneumococcal CAP (PCAP) and controls. Patients with bacteremic PCAP (B-PCAP) had significantly higher frequencies of FCGR2A-H/H131 genotypes than those with nonbacteremic PCAP (p = .00016, odds ratio = 2.9, 95% confidence interval 1.58-5.3). The differences remained significant when adjusting for pneumonia severity index, hospital of origin, and intensive care unit admission (p = .0012, odds ratio = 2.83, 95% confidence interval 1.51-5.32). B-PCAP was associated with a significantly higher severity of the disease, evaluated as sepsis severity (p = .000007, odds ratio = 4.40, 95% confidence interval 2.31-8.39), multiorgan dysfunction syndrome (0.00048, odds ratio = 3.29, 95% confidence interval 1.69-6.41), intensive care unit admission, acute renal failure, and acute respiratory distress syndrome.
Our results do not support a role of FCGR2A-H131R polymorphism in susceptibility to CAP or PCAP. However, we provide the insight that homozygosity for FCGR2A-H131 predisposes B-PCAP, which was associated with higher severity in our study.
评估免疫球蛋白 G（IgG）Fc 段受体 IIa 上的功能多态性 rs1801274（FcγRIIa-H131R）与社区获得性肺炎（CAP）易感性和严重程度的潜在关联。
多中心前瞻性和观察性研究。
西班牙的四所大学医院。
在 1262 例 CAP 患者和 1224 例对照患者中确定了 FCGR2A-H131R 多态性。
366 例患者记录为严重脓毒症。CAP 或肺炎球菌性 CAP（PCAP）患者与对照组之间在基因型或等位基因频率上无显著差异。菌血症性 PCAP（B-PCAP）患者的 FCGR2A-H/H131 基因型频率明显高于非菌血症性 PCAP（p=0.00016，优势比=2.9，95%置信区间 1.58-5.3）。调整肺炎严重指数、来源医院和重症监护病房入院后，差异仍有统计学意义（p=0.0012，优势比=2.83，95%置信区间 1.51-5.32）。B-PCAP 与疾病严重程度显著相关，表现为脓毒症严重程度（p=0.000007，优势比=4.40，95%置信区间 2.31-8.39）、多器官功能障碍综合征（0.00048，优势比=3.29，95%置信区间 1.69-6.41）、重症监护病房入院、急性肾衰竭和急性呼吸窘迫综合征。
我们的结果不支持 FCGR2A-H131R 多态性在 CAP 或 PCAP 易感性中的作用。然而，我们提供了一个见解，即 FCGR2A-H131 的纯合性使 B-PCAP 易感性增加，在我们的研究中，B-PCAP 与更高的严重程度相关。
