Chen Jiwang, Wilson Esther S, Dahmer Mary K, Quasney Michael W, Waterer Grant W, Feldman Charles, Wunderink Richard G
Department of Medicine, Northwestern University, Chicago, Illinois, United States of America ; Section of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, Illinois, United States of America.
Oakbrook Pediatrics, Summerville, South Carolina, United States of America.
PLoS One. 2014 Feb 26;9(2):e89194. doi: 10.1371/journal.pone.0089194. eCollection 2014.
Community-acquired pneumonia (CAP) is a common cause of sepsis. Active full-length caspase-12 (CASP12L), confined to the people of African descent, has been associated with increased susceptibility to and mortality from severe sepsis. The objective of this study was to determine whether CASP12L was a marker for susceptibility and/or severity of CAP. We examined three CAP cohorts and two control populations: 241 adult Memphis African American CAP patients, 443 pediatric African American CAP patients, 90 adult South African CAP patients, 120 Memphis healthy adult African American controls and 405 adult Chicago African American controls. Clinical outcomes including mortality, acute respiratory distress syndrome (ARDS), septic shock or severe sepsis, need for mechanical ventilation, and S. pneumoniae bacteremia. Neither in the three individual CAP cohorts nor in the combined CAP cohorts, was mortality in CASP12L carriers significantly different from that in non-CASP12L carriers. No statistically significant association between genotype and any measures of CAP severity was found in any cohort. We conclude that the functional CASP12L allele is not a marker for susceptibility and/or severity of CAP.
社区获得性肺炎(CAP)是脓毒症的常见病因。活性全长半胱天冬酶-12(CASP12L)仅见于非洲裔人群,与严重脓毒症的易感性增加及死亡率升高有关。本研究的目的是确定CASP12L是否为CAP易感性和/或严重程度的标志物。我们研究了三个CAP队列和两个对照人群:241名孟菲斯成年非洲裔CAP患者、443名儿科非洲裔CAP患者、90名南非成年CAP患者、120名孟菲斯健康成年非洲裔对照者以及405名芝加哥成年非洲裔对照者。临床结局包括死亡率、急性呼吸窘迫综合征(ARDS)、感染性休克或严重脓毒症、机械通气需求以及肺炎链球菌菌血症。在三个单独的CAP队列以及合并的CAP队列中,CASP12L携带者的死亡率与非CASP12L携带者相比均无显著差异。在任何队列中均未发现基因型与CAP严重程度的任何指标之间存在统计学显著关联。我们得出结论,功能性CASP12L等位基因不是CAP易感性和/或严重程度的标志物。