Department of Allergy, University Hospital of Salamanca, Salamanca, Spain.
J Investig Allergol Clin Immunol. 2012;22(5):331-40.
Nasal polyposis (NP) is a chronic inflammatory disease of the upper airways with a variable clinical course and unknown pathogenesis that often coexists with other conditions. Considering the possibility of genetic predisposition, we decided to analyze whether polymorphisms in LTC4S, CYSLTR1, PTGDR, and NOS2A were associated with NP.
The study population comprised 486 Caucasian individuals. Polyposis and aspirin intolerance were diagnosed following the recommendations of the European Position Paper on Rhinosinusitis and Nasal Polyps. Genotypes were determined using polymerase chain reaction amplification and direct sequencing.
The -444A > C LTC4S polymorphism was significantly associated with NP and atopy (P = .033) and with NP and atopic asthma, (P =.012). In addition, a significant association was found when the (CCTTT) repetition of the NOS2A gene was present more than 14 times in patients with NP and asthma (P = .034), in patients with polyposis and intolerance to nonsteroidal anti-inflammatory drugs (P = .009), and in patients with the aspirin triad (P = .005). The PTGDR diplotype CCCT/CCCC (-613CC, -549CC, -441CC and -197TC) was more frequent in patients with NP (P = .043), NP with asthma (P = .013), and the aspirin triad (P = .041).
NP was associated with specific polymorphisms only when it occurred with related phenotypes. Our results suggest that this genetic background plays a more relevant role in the development of the associated clinical features of nasal polyposis than in simple polyposis.
鼻息肉(NP)是一种上呼吸道的慢性炎症性疾病,其临床表现具有变异性,发病机制不明,且常与其他疾病共存。鉴于存在遗传易感性的可能,我们决定分析 LTC4S、CYSLTR1、PTGDR 和 NOS2A 中的多态性是否与 NP 相关。
研究人群包括 486 名高加索人。鼻息肉和阿司匹林不耐受根据欧洲鼻窦炎和鼻息肉诊治指南进行诊断。采用聚合酶链反应扩增和直接测序法检测基因型。
LTC4S-444A > C 多态性与 NP 和特应性(P =.033)以及 NP 和特应性哮喘(P =.012)显著相关。此外,当 NOS2A 基因的(CCTTT)重复出现 14 次以上时,NP 合并哮喘的患者(P =.034)、NP 合并非甾体抗炎药不耐受的患者(P =.009)和阿司匹林三联征患者(P =.005)的多态性也具有显著相关性。PTGDR 二倍型 CCCT/CCCC(-613CC、-549CC、-441CC 和-197TC)在 NP 患者(P =.043)、NP 合并哮喘患者(P =.013)和阿司匹林三联征患者(P =.041)中更为常见。
只有当 NP 与相关表型同时存在时,才与特定的多态性相关。我们的研究结果表明,这种遗传背景在 NP 相关临床表现的发展中发挥着更为重要的作用,而不是在单纯的鼻息肉中。