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重症白种人患者中功能多态性TREM-1 rs2234237与脓毒症临床病程之间缺乏相关性——一项单中心前瞻性基因关联研究

Lack of an Association between the Functional Polymorphism TREM-1 rs2234237 and the Clinical Course of Sepsis among Critically Ill Caucasian Patients-A Monocentric Prospective Genetic Association Study.

作者信息

Runzheimer Julius, Mewes Caspar, Büttner Benedikt, Hinz José, Popov Aron-Frederik, Ghadimi Michael, Kristof Katalin, Beissbarth Tim, Schamroth Joel, Tzvetkov Mladen, Schmack Bastian, Quintel Michael, Bergmann Ingo, Mansur Ashham

机构信息

Department of Anesthesiology, University Medical Center, Georg August University, D-37075 Goettingen, Germany.

Department of Anesthesiology and Intensive Care Medicine, Klinikum Region Hannover, D-30459 Hannover, Germany.

出版信息

J Clin Med. 2019 Mar 3;8(3):301. doi: 10.3390/jcm8030301.

Abstract

Sepsis is a life-threatening condition and a significant challenge for those working in intensive care, where it remains one of the leading causes of mortality. According to the sepsis-3 definition, sepsis is characterized by dysregulation of the host response to infection. The TREM-1 gene codes for the triggering receptor expressed on myeloid cells 1, which is part of the pro-inflammatory response of the immune system. This study aimed to determine whether the functional TREM-1 rs2234237 single nucleotide polymorphism was associated with mortality in a cohort of 649 Caucasian patients with sepsis. The 90-day mortality rate was the primary outcome, and disease severity and microbiological findings were analyzed as secondary endpoints. TREM-1 rs2234237 TT homozygous patients were compared to A-allele carriers for this purpose. Kaplan⁻Meier survival analysis revealed no association between the clinically relevant TREM-1 rs2234237 single nucleotide polymorphism and the 90-day or 28-day survival rate in this group of septic patients. In addition, the performed analyses of disease severity and the microbiological findings did not show significant differences between the TREM-1 rs2234237 genotypes. The TREM-1 rs2234237 genotype was not significantly associated with sepsis mortality and sepsis disease severity. Therefore, it was not a valuable prognostic marker for the survival of septic patients in the studied cohort.

摘要

脓毒症是一种危及生命的病症,对于重症监护领域的工作人员而言是一项重大挑战,脓毒症仍是主要死因之一。根据脓毒症-3的定义,脓毒症的特征是宿主对感染的反应失调。触发受体表达于髓样细胞1(TREM-1)基因编码髓样细胞触发受体1,它是免疫系统促炎反应的一部分。本研究旨在确定功能性TREM-1 rs2234237单核苷酸多态性是否与649名患有脓毒症的白种人患者队列中的死亡率相关。90天死亡率是主要结局指标,疾病严重程度和微生物学检查结果作为次要终点进行分析。为此,将TREM-1 rs2234237 TT纯合子患者与A等位基因携带者进行比较。Kaplan-Meier生存分析显示,在这组脓毒症患者中,临床相关的TREM-1 rs2234237单核苷酸多态性与90天或28天生存率之间无关联。此外,对疾病严重程度和微生物学检查结果的分析显示,TREM-1 rs2234237基因型之间无显著差异。TREM-1 rs2234237基因型与脓毒症死亡率和脓毒症疾病严重程度无显著关联。因此,在研究队列中,它不是脓毒症患者生存的有价值的预后标志物。

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