Taha Sara I, Shata Aalaa K, El-Sehsah Eman M, Mohamed Manar F, Moustafa Nouran M, Youssef Mariam K
Department of Clinical Pathology/Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Pulmonary Medicine, Faculty of Medicine, Ain Shams university, Cairo, Egypt.
Infez Med. 2022 Mar 1;30(1):96-103. doi: 10.53854/liim-3001-11. eCollection 2022.
Toll-like receptor (TLR)-4 plays a vital role in recognizing viral particles, activating the innate immune system, and producing pro-inflammatory cytokines.
This cross-sectional study aimed to compare COVID-19 severity, progression, and fate according to TLR-4 (Asp299Gly) polymorphism in Egyptian patients.
A total of 145 COVID-19 patients were included in this study. TLR-4 (Asp299Gly) genotyping was done using the PCR restriction fragment length polymorphism (PCR-RFLP) approach.
The most commonly encountered TLR-4 genotype in relation to the amino acid at position 299 was the wild-type AA (73.1%); meanwhile, the homozygous mutant GG genotype (8.3%) was the least encountered. At hospital admission, 85.8% of the AA group had free (with no ground glass opacities) chest computed tomography (CT) examination, and 16.0% were asymptomatic. On the other hand, of the AG and GG groups, 81.5% and 83.3%, respectively showed bilateral ground-glass opacities in chest CT, as well as 25.9% and 75.0%, respectively were dyspneic. Values of the total leucocytic count, C-reactive protein (CRP), ferritin, and D dimer increased in the AA<AG<GG sequence. In contrast, hemoglobin values and the absolute lymphocyte counts decreased in the AA>AG>GG sequence. ICU admission (83.3%) and in-hospital death (33.3%) rates were significantly higher in the GG group.
In COVID-19 patients, the TLR-4 mutant G allele may be associated with a more aggressive disease course and in-hospital death. New therapeutic alternatives could be aimed at this area.
Toll样受体（TLR）-4在识别病毒颗粒、激活先天性免疫系统和产生促炎细胞因子方面发挥着至关重要的作用。
本横断面研究旨在根据埃及患者的TLR-4（Asp299Gly）多态性比较新型冠状病毒肺炎（COVID-19）的严重程度、进展情况和转归。
本研究共纳入145例COVID-19患者。采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法进行TLR-4（Asp299Gly）基因分型。
与第299位氨基酸相关的最常见TLR-4基因型是野生型AA（73.1%）；同时，纯合突变GG基因型（8.3%）是最不常见的。入院时，AA组85.8%的患者胸部计算机断层扫描（CT）检查结果正常（无磨玻璃影），16.0%无症状。另一方面，AG组和GG组分别有81.5%和83.3%的患者胸部CT显示双侧磨玻璃影，分别有25.9%和75.0%的患者出现呼吸困难。总白细胞计数、C反应蛋白（CRP）、铁蛋白和D-二聚体的值在AA<AG<GG序列中升高。相反，血红蛋白值和绝对淋巴细胞计数在AA>AG>GG序列中降低。GG组的重症监护病房（ICU）入住率（83.3%）和院内死亡率（33.3%）显著更高。
在COVID-19患者中，TLR-4突变G等位基因可能与更严重的病程和院内死亡相关。新的治疗方案可针对这一领域。
