HLA - A*31作为脓毒症遗传易感性的标志物。
HLA-A*31 as a marker of genetic susceptibility to sepsis.
作者信息
da Silva Fabiano Pinheiro, Preuhs Filho Germano, Finger Eduardo, Barbeiro Hermes Vieira, Zampieri Fernando Godinho, Goulart Alessandra Carvalho, Torggler Filho Francisco, Panajotopoulos Nicolas, Velasco Irineu Tadeu, Kalil Jorge, de Souza Heraldo Possolo, da Cruz Neto Luiz Monteiro, Rodrigues Hélcio
机构信息
Universidade de São Paulo, Departamento de Emergências Clínicas, São PauloSP, Brasil, Departamento de Emergências Clínicas, Universidade de São Paulo - USP - São Paulo (SP), Brasil.
Universidade de São Paulo, Instituto do Coração, Departamento de Imunologia, São PauloSP, Brasil, Departamento de Imunologia, Instituto do Coração, Universidade de São Paulo - USP - São Paulo (SP), Brasil.
出版信息
Rev Bras Ter Intensiva. 2013 Oct-Dec;25(4):284-9. doi: 10.5935/0103-507X.20130049.
OBJECTIVE
The HLA haplotype has been associated with many autoimmune diseases, but no associations have been described in sepsis. This study aims to investigate the HLA system as a possible marker of genetic sepsis susceptibility.
METHODS
This is a prospective cohort study including patients admitted to an intensive care unit and healthy controls from a list of renal transplant donors. Patients with less 18 years of age; pregnant or HIV positive patients; those with metastatic malignancies or receiving chemotherapy; or with advanced liver disease; or with end-of-life conditions were excluded. The DNA was extracted from the whole blood and HLA haplotypes determined using MiliPlex® technology.
RESULTS
From October 2010 to October 2012, 1,121 patients were included (1,078 kidney donors, 20 patients admitted with severe sepsis and 23 with septic shock). HLA-A*31 positive subjects had increased risk of developing sepsis (OR 2.36, 95%CI 1.26-5.35). Considering a p value <0.01, no other significant association was identified.
CONCLUSION
HLA-A*31 expression is associated to risk of developing sepsis.
目的
人类白细胞抗原（HLA）单倍型已与多种自身免疫性疾病相关，但脓毒症方面尚无相关关联的描述。本研究旨在调查HLA系统作为脓毒症遗传易感性的一种可能标志物。
方法
这是一项前瞻性队列研究，纳入入住重症监护病房的患者以及来自肾移植供体名单中的健康对照。排除年龄小于18岁的患者；孕妇或HIV阳性患者；患有转移性恶性肿瘤或正在接受化疗的患者；患有晚期肝病的患者；或处于临终状态的患者。从全血中提取DNA，并使用MiliPlex®技术确定HLA单倍型。
结果
2010年10月至2012年10月，共纳入1121名患者（1078名肾供体、20名因严重脓毒症入院的患者和23名感染性休克患者）。HLA - A*31阳性受试者发生脓毒症的风险增加（比值比2.36，95%置信区间1.26 - 5.35）。考虑到p值<0.01，未发现其他显著关联。
结论
HLA - A*31表达与发生脓毒症的风险相关。
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