Barletta-Naveca Raphaela Honorato, Naveca Felipe Gomes, de Almeida Vanessa Alves, Porto Jorge Ivan Rebelo, da Silva George Allan Villarouco, Ogusku Mauricio Morishi, Sadahiro Aya, Ramasawmy Rajendranath, Boechat Antonio Luiz
Laboratório de Micobacteriologia, Instituto Nacional de Pesquisas da Amazônia (INPA), Manaus, Brazil.
Programa de Pós-graduação em Genética, Conservação e Biologia Evolutiva (PPG-GCBEv), Instituto Nacional de Pesquisas da Amazônia (INPA), Manaus, Brazil.
Front Immunol. 2018 Jun 25;9:1455. doi: 10.3389/fimmu.2018.01455. eCollection 2018.
Tuberculosis (TB), caused by mycobacterial species of the complex, is a serious global health issue. Brazil is among the 22 countries with the highest number of TB cases, and the state of Amazonas has the highest incidence of TB cases in the country. Toll-like receptors (TLRs) are important pattern recognition receptors of the innate immunity and play a key role in orchestrating an effective immune response. We investigated whether the single-nucleotide polymorphisms (SNPs) 1805T/G , 2258G/A , 896A/G and 1196C/T of , 745T/C , and -1237A/G and -1486A/G of are associated with the predisposition to TB and/or bacillary load. The SNPs genotyping was performed by nucleotide sequencing in 263 TB patients and 232 healthy controls residing in the state of Amazonas. Alleles and genotypes frequencies were similar between patients and healthy individuals for most of the investigated SNPs. Stratification of the TB patients according to their bacillary load showed that the genotype 1805TT (rs5743618) was prevalent among paucibacillary patients [odds ratio (OR) = 0.38; 95% confidence interval (CI) = 0.19-0.76; = 0.009] while the genotype 1805TG was common among multibacillary patients (OR = 3.72; CI = 1.65-8.4; = 0.004). Comparison of demographic characteristics of patients to controls showed that TB is strongly associated with smoking (OR = 6.55; 95% CI = 3.2-13.6; < 0.0001); alcohol use disorder (OR = 7.14; 95% CI = 3.7-13.9; < 0.0001); and male gender (OR = 3.66; 95% CI = 2.52-5.3; < 0.0001). Multivariate logistic regression demonstrated that alcoholism (OR = 2.93; 95% CI = 1.05-8.16; = 0.03) and the 1805G allele (OR = 2.75; 95% CI = 1.33-5.7; = 0.006) are predictive variables for multibacillary TB. Altogether, we suggest that the 1805G allele may be a relevant immunogenetic factor for the epidemiology of TB together with environmental, sociodemographic, and behavioral factors.
由结核分枝杆菌复合群引起的结核病是一个严重的全球健康问题。巴西是结核病病例数最多的22个国家之一,而亚马孙州的结核病发病率在该国最高。Toll样受体(TLRs)是天然免疫中重要的模式识别受体,在协调有效的免疫反应中起关键作用。我们调查了TLR2基因的单核苷酸多态性(SNP)1805T/G、2258G/A、896A/G和1196C/T以及TLR4基因的745T/C、-1237A/G和-1486A/G是否与结核病易感性和/或细菌载量相关。对居住在亚马孙州的263例结核病患者和232例健康对照进行核苷酸测序,以进行SNP基因分型。在大多数研究的SNP中,患者和健康个体的等位基因和基因型频率相似。根据细菌载量对结核病患者进行分层显示,基因型1805TT(rs5743618)在痰菌阴性患者中普遍存在[比值比(OR)=0.38;95%置信区间(CI)=0.19-0.76;P=0.009],而基因型1805TG在痰菌阳性患者中常见(OR=3.72;CI=1.65-8.4;P=0.004)。患者与对照的人口统计学特征比较显示,结核病与吸烟密切相关(OR=6.55;95%CI=3.2-13.6;P<0.0001);酒精使用障碍(OR=7.14;95%CI=3.7-13.9;P<0.0001);以及男性(OR=3.66;95%CI=2.52-5.3;P<0.0001)。多因素logistic回归表明,酗酒(OR=2.93;95%CI=1.05-8.16;P=0.03)和1805G等位基因(OR=2.75;95%CI=1.33-5.7;P=0.006)是痰菌阳性结核病的预测变量。总之,我们认为1805G等位基因可能是与环境、社会人口学和行为因素一起影响结核病流行病学的一个相关免疫遗传因素。