Family Medicine Department, Poznan University of Medical Sciences, Przybyszewskiego 39, 60-355, Poznan, Poland.
Department of Oncology, Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland.
Inflamm Res. 2018 Aug;67(8):655-661. doi: 10.1007/s00011-018-1158-3. Epub 2018 May 12.
There are many studies analysing the effect of SNPs in genes coding proteins which are involved in innate immune response on susceptibility to invasive bacterial disease. Many of them gave inconclusive results. Regarding the complexity of immune response and cooperation between particular elements, number of SNPs may have a cumulative effect on the susceptibility to bacterial meningitis.
In most studies cooccurrence of several SNPs was not analysed. These studies were performed on small groups of patients and usually only few SNPs were checked simultaneously. Additionally, comparison of the results across the studies is hard to conduct. We hypothesise that the number of variants of genes involved in innate immune response plays a role in susceptibility to bacterial meningitis. However, the role of toll-like receptors and other part of innate immune response in the eradication of bacteria, and initiation of the inflammatory response in CNS need further studies.
Large multicentre studies assessing multiple SNPs in patients with microbiologically proven pneumococcal or meningococcal meningitis are needed to find real genetic risk factors for developing bacterial meningitis. This is necessary to design more effective treatment and prevention strategies for severe infections.
有许多研究分析了编码参与固有免疫反应的蛋白质的基因中的 SNPs 对侵袭性细菌性疾病易感性的影响。其中许多研究结果不一致。鉴于免疫反应的复杂性和特定元素之间的合作，SNP 的数量可能对细菌性脑膜炎的易感性有累积效应。
在大多数研究中，并未分析几种 SNPs 的共同发生情况。这些研究是在小患者组中进行的，通常同时检查的 SNPs 很少。此外，很难对研究结果进行比较。我们假设参与固有免疫反应的基因的变异数量在细菌性脑膜炎的易感性中起作用。然而，TLR 及固有免疫反应的其他部分在细菌清除和中枢神经系统炎症反应中的作用需要进一步研究。
需要进行大型多中心研究，评估微生物学证实的肺炎球菌或脑膜炎球菌性脑膜炎患者的多个 SNPs，以发现细菌性脑膜炎发生的真正遗传风险因素。这对于设计更有效的严重感染治疗和预防策略是必要的。
