Drysdale Simon B, Prendergast Michael, Alcazar Mireia, Wilson Theresa, Smith Melvyn, Zuckerman Mark, Broughton Simon, Rafferty Gerrard F, Johnston Sebastian L, Hodemaekers Hennie M, Janssen Riny, Bont Louis, Greenough Anne
Division of Asthma, Allergy and Lung Biology, MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK.
Eur J Pediatr. 2014 Jul;173(7):905-12. doi: 10.1007/s00431-014-2263-0. Epub 2014 Feb 2.
The aim of this study was to assess whether prematurely born infants have a genetic predisposition to respiratory syncytial virus (RSV) infection-related respiratory morbidity. One hundred and forty-six infants born at less than 36 weeks of gestation were prospectively followed. Nasopharygeal aspirates were obtained on every occasion the infants had a lower respiratory tract infection (LRTI) regardless of need for admission. DNA was tested for 11 single-nucleotide polymorphisms (SNPs). Chronic respiratory morbidity was assessed using respiratory health-related questionnaires, parent-completed diary cards at a corrected age of 1 year and review of hospital notes. Lung function was measured at a post menstrual age (PMA) of 36 weeks and corrected age of 1 year. A SNP in ADAM33 was associated with an increased risk of developing RSV LRTIs, but not with significant differences in 36-week PMA lung function results. SNPs in several genes were associated with increased chronic respiratory morbidity (interleukin 10 (IL10), nitric oxide synthase 2A (NOS2A), surfactant protein C (SFTPC), matrix metalloproteinase 16 (MMP16) and vitamin D receptor (VDR)) and reduced lung function at 1 year (MMP16, NOS2A, SFTPC and VDR) in infants who had had RSV LRTIs.
Our results suggest that prematurely born infants may have a genetic predisposition to RSV LRTIs and subsequent respiratory morbidity which is independent of premorbid lung function.
本研究的目的是评估早产婴儿是否具有呼吸道合胞病毒（RSV）感染相关呼吸道疾病的遗传易感性。对146例孕周小于36周出生的婴儿进行前瞻性随访。无论是否需要住院，每当婴儿发生下呼吸道感染（LRTI）时均采集鼻咽抽吸物。检测11个单核苷酸多态性（SNP）的DNA。使用与呼吸健康相关的问卷、1岁矫正年龄时家长填写的日记卡以及查阅医院病历评估慢性呼吸道疾病。在月经后年龄（PMA）36周和矫正年龄1岁时测量肺功能。ADAM33基因中的一个SNP与发生RSV-LRTI的风险增加相关，但与36周PMA时的肺功能结果无显著差异。在发生过RSV-LRTI的婴儿中，几个基因中的SNP与慢性呼吸道疾病增加（白细胞介素10（IL10）、一氧化氮合酶2A（NOS2A）、表面活性蛋白C（SFTPC）、基质金属蛋白酶16（MMP16）和维生素D受体（VDR））以及1岁时肺功能降低（MMP16、NOS2A、SFTPC和VDR）相关。
我们的结果表明，早产婴儿可能具有RSV-LRTI及随后呼吸道疾病的遗传易感性，这与病前肺功能无关。
