Pulmonary and Critical Care Division, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, USA.
N Engl J Med. 2013 Jun 6;368(23):2192-200. doi: 10.1056/NEJMoa1216076. Epub 2013 May 21.
A common promoter polymorphism (rs35705950) in MUC5B, the gene encoding mucin 5B, is associated with idiopathic pulmonary fibrosis. It is not known whether this polymorphism is associated with interstitial lung disease in the general population.
We performed a blinded assessment of interstitial lung abnormalities detected in 2633 participants in the Framingham Heart Study by means of volumetric chest computed tomography (CT). We evaluated the relationship between the abnormalities and the genotype at the rs35705950 locus.
Of the 2633 chest CT scans that were evaluated, interstitial lung abnormalities were present in 177 (7%). Participants with such abnormalities were more likely to have shortness of breath and chronic cough and reduced measures of total lung and diffusion capacity, as compared with participants without such abnormalities. After adjustment for covariates, for each copy of the minor rs35705950 allele, the odds of interstitial lung abnormalities were 2.8 times greater (95% confidence interval [CI], 2.0 to 3.9; P<0.001), and the odds of definite CT evidence of pulmonary fibrosis were 6.3 times greater (95% CI, 3.1 to 12.7; P<0.001). Although the evidence of an association between the MUC5B genotype and interstitial lung abnormalities was greater among participants who were older than 50 years of age, a history of cigarette smoking did not appear to influence the association.
The MUC5B promoter polymorphism was found to be associated with interstitial lung disease in the general population. Although this association was more apparent in older persons, it did not appear to be influenced by cigarette smoking. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT00005121.).
黏蛋白 5B(MUC5B)基因的一个常见启动子多态性(rs35705950)与特发性肺纤维化有关。目前尚不清楚该多态性是否与普通人群中的间质性肺病有关。
我们通过容积式胸部 CT 对弗雷明汉心脏研究中的 2633 名参与者的肺部间质异常进行了盲法评估。我们评估了 rs35705950 基因座的异常与基因型之间的关系。
在评估的 2633 例胸部 CT 扫描中,有 177 例(7%)存在肺部间质异常。与无此类异常的参与者相比,存在此类异常的参与者更容易出现呼吸急促、慢性咳嗽以及肺活量和弥散能力下降。在调整了协变量后,与不携带 minor rs35705950 等位基因的参与者相比,每携带一个 minor rs35705950 等位基因,出现肺部间质异常的几率增加 2.8 倍(95%置信区间,2.0 至 3.9;P<0.001),而 CT 证据确凿的肺纤维化的几率增加 6.3 倍(95%置信区间,3.1 至 12.7;P<0.001)。尽管在年龄大于 50 岁的参与者中,MUC5B 基因型与肺部间质异常之间的关联更明显,但吸烟史似乎并未影响这种关联。
MUC5B 启动子多态性与普通人群中的间质性肺病有关。尽管这种关联在老年人中更为明显,但似乎不受吸烟的影响。(由美国国立卫生研究院等资助;ClinicalTrials.gov 编号,NCT00005121。)