巨细胞病毒持续感染的年轻患者中，Toll样受体4基因多态性对社区获得性肺炎病程的预后影响

Prognostic influence of toll-like receptor 4 gene polymorphism into community-acquired pneumonia course among young patients with cytomegalovirus persistence.

作者信息

Moroz Larysa V, Chichirelo-Konstantynovych Kiarina D, Konstantynovych Tetyana V, Dudnyk Veronika M

机构信息

Department of Infectious Diseases, National Pirogov Memorial Medical University, Vinnytsia, Ukraine.

Department of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsia, Ukraine.

出版信息

Lung India. 2019 Jul-Aug;36(4):319-323. doi: 10.4103/lungindia.lungindia_355_18.

DOI:10.4103/lungindia.lungindia_355_18

PMID:31290417

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6625249/

Abstract

OBJECTIVES

The aim of this study was to determine the predictive role of TLR4 polymorphism in CAP course among young cytomegalovirus-positive patients.

SUBJECTS AND METHODS

One hundred and five patients with pneumonia (age range: 18-44 years) and 61 healthy respondents were observed clinically and specifically (by cytomegalovirus markers and TLR4 + 3725 G/C polymorphism).

RESULTS

Among CAP patients, there were 51 male (48.6%) and 54 female (51.4%), with average age 34.1 ± 0.8 years, and there were 19 (18.1%) patients with Pneumonia Patient Outcomes Research Team (PORT) I, 46 (43.8%) patients with PORT II, 31 (29.5%) patients with PORT III, and 9 (8.6%) patients with PORT IV. Cytomegalovirus persistence was detected in 80 (48.2%) patients and 34 (20.5%) healthy respondents (P = 0.003). G/G genotype of TLR4 signaling was found in 78 (74%) patients with pneumonia, G/C in 24 (23%) patients, and C/C in 3 (3%) patients. Among G/C patients, there were 16.2% cytomegalovirus-positive patients versus 6.7% negative patients (P < 0.05), as well as among G/G patients, and there were 59% versus 15,2%, accordingly (P < 0.01). The patients of the main group with G/G genotype were characterized by mostly mild (PORT I - 15 [14.3%]) and moderate pneumonia severity (PORT II - 32 [30.5%] and PORT III - 26 [24.8%] patients). The patients with G/C genotype were characterized by mostly PORT II (11 [10.5%] patients). All C/C genotype patients have PORT II (P < 0.05).

CONCLUSIONS

Cytomegalovirus persistence worsens the pneumonia course. G/G and G/C TLR4 genotypes are associated with mild pneumonia severity.

摘要

目的

本研究旨在确定TLR4基因多态性在年轻巨细胞病毒阳性患者社区获得性肺炎（CAP）病程中的预测作用。

对象与方法

对105例肺炎患者（年龄范围：18 - 44岁）和61名健康对照者进行临床观察及特异性检测（通过巨细胞病毒标志物和TLR4 + 3725 G/C基因多态性）。

结果

在CAP患者中，男性51例（48.6%），女性54例（51.4%），平均年龄34.1±0.8岁。肺炎患者预后研究团队（PORT）I级患者19例（18.1%），PORT II级患者46例（43.8%），PORT III级患者31例（29.5%），PORT IV级患者9例（8.6%）。80例（48.2%）患者和34名（20.5%）健康对照者检测到巨细胞病毒持续感染（P = 0.003）。肺炎患者中，TLR4信号通路的G/G基因型78例（74%），G/C基因型24例（23%），C/C基因型3例（3%）。在G/C基因型患者中，巨细胞病毒阳性患者占16.2%，阴性患者占6.7%（P < 0.05）；在G/G基因型患者中相应比例分别为59%和15.2%（P < 0.01）。主要组中G/G基因型患者大多表现为轻度（PORT I - 15例[14.3%]）和中度肺炎严重程度（PORT II - 32例[30.5%]和PORT III - 26例[24.8%]）。G/C基因型患者大多为PORT II级（11例[10.5%]）。所有C/C基因型患者均为PORT II级（P < 0.05）。