Tsai Bo-Yang, Tsai Pei-Jane, Lee Ching-Chi, Chiu Chun-Wei, Lai Yi-Hsin, Lee Jen-Chieh, Ko Wen-Chien, Hung Yuan-Pin
Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Infect Drug Resist. 2023 Jan 24;16:413-421. doi: 10.2147/IDR.S392510. eCollection 2023.
Nucleotide-binding domain leucine-rich repeat protein (NLRP) is critical in the inflammasome-activation pathway, which is important for host survival and the clearance of . Therefore, the influence of NLRP1 polymorphisms on colonization (CdC) or infection (CDI) was analyzed.
A prospective cohort study consisted of hospitalized adults was conducted from January 2011 to January 2013. Single nucleotide polymorphisms (SNPs) of NLRP1, including rs12150220, rs2670660, rs6502867, rs878329, rs8182352, rs3744717, and rs11078571, were incorporating in analyses. The episodes of CdC and CDI were the primary and secondary outcome, respectively.
Of the total of 509 eligible patients, 376 (73.9%) had neither CdC nor CDI, 104 (21.8%) had CdC without developing CDI, and 29 (4.3%) developed CDI during the study period. Through multivariate analyses, comorbid diabetes mellitus (adjusted odds ratio [AOR] 1.59, =0.04) and CC genotype in NLRP1 rs3744717 (AOR 1.70, =0.02) were recognized as the risk factor of CdC. After adjusting the independent predictors of CDI, in terms of comorbid diabetes mellitus (AOR 3.18, =0.005) and prior exposure to ceftazidime/ceftriaxone (AOR 2.87, =0.04) or proton pump inhibitors (AOR 3.86, =0.001), patients with CC+GC genotype in NLRP1, rs878329 (AOR 2.39, =0.03) remained a higher risk of CDI.
For hospitalized adults, the association of CC genotype in NLRP1 rs3744717 and CdC as well as the CC+GC genotype in NLRP1 rs878329 and CDI was respectively evidenced. We believed the prompt identification of patients having specific genotype in NLRP1 would prevent and improve the quality of care in CDI.
核苷酸结合寡聚化结构域样受体蛋白（NLRP）在炎性小体激活途径中起关键作用，这对宿主生存和清除[病原体]很重要。因此，分析了NLRP1基因多态性对艰难梭菌定植（CdC）或感染（CDI）的影响。
2011年1月至2013年1月对住院成人进行了一项前瞻性队列研究。纳入分析的NLRP1单核苷酸多态性（SNP）包括rs12150220、rs2670660、rs6502867、rs87,8329、rs8182352、rs3744717和rs11078571。CdC发作和CDI发作分别为主要和次要结局。
在总共509名符合条件的患者中，376名（73.9%）既无CdC也无CDI，104名（21.8%）有CdC但未发展为CDI，29名（4.3%）在研究期间发展为CDI。通过多变量分析，合并糖尿病（调整优势比[AOR]1.59，P = 0.04）和NLRP1 rs3744717中的CC基因型（AOR 1.70，P = 0.02）被确定为CdC的危险因素。在调整了CDI的独立预测因素后，就合并糖尿病（AOR 3.18，P = 0.005）、先前使用头孢他啶/头孢曲松（AOR 2.87，P = 0.04）或质子泵抑制剂（AOR 3.86，P = 0.001）而言，NLRP1 rs878329中CC + GC基因型的患者（AOR 2.39，P = 0.03）发生CDI的风险仍然较高。
对于住院成人，分别证实了NLRP1 rs3744717中的CC基因型与CdC以及NLRP1 rs878329中的CC + GC基因型与CDI之间的关联。我们认为，迅速识别NLRP1中具有特定基因型的患者将预防和改善CDI的护理质量。
