To determine whether known variants of the interleukin-1 (IL-1) and tumor necrosis factor (TNF) gene families are associated with severe manifestations of meningococcal disease, 276 white patients 4–70 years of age (median, 17 years) were genotyped. All patients had microbiologically proven Neisseria meningitidis infection; 39 died and 237 survived. A significant association (P < .001) was found between fatal outcome and genotype at IL1B (nucleotide position −511). Homozygous individuals, both for the common (1/1) and the rare (2/2) alleles, had increased odds ratios (ORs) for death, compared with heterozygous individuals (1/2): ORs (95% confidence intervals [CIs]) were 3.39 (1.39–8.29) and 7.35 (2.51–21.45), respectively. The mortality rates according to genotype at IL1B (−511) were 18.0% (1/1), 6.1% (1/2), and 32.3% (2/2), compared with 14.2% overall. The composite genotype, consisting of heterozygosity of IL1B (−511) together with homozygosity of the common allele of the IL-1 receptor antagonist gene (IL1RN) at +2018, was significantly associated with survival (P = .018; OR, 7.78 [95% CI, 1.05–59.05]). There was no association between TNF genotype and fatal outcome. These data suggest that IL-1 genotype influences the severity of meningococcal disease.
为了确定白细胞介素-1(IL-1)和肿瘤坏死因子(TNF)
基因家族的已知变体是否与脑膜炎球菌病的严重表现有关,我们对 276 名 4-70 岁(中位 17 岁)的白人患者进行了
基因分型。所有患者均经微
生物学证实感染了奈瑟氏脑膜炎球菌,其中 39 人死亡,237 人存活。死亡结果与 IL1B
基因型(核苷酸位置 -511)之间存在明显关联(P < .001)。与杂合子个体(1/2)相比,普通等位基因(1/1)和稀有等位基因(2/2)的同基因个体的死亡几率比(ORs)都有所增加:ORs(95% 置信区间 [CIs])分别为 3.39(1.39-8.29)和 7.35(2.51-21.45)。IL1B(-511)基因型的死亡率分别为18.0%(1/1)、6.1%(1/2)和32.3%(2/2),而总体死亡率为14.2%。复合基因型包括 IL1B (-511) 杂合子和 +2018 处的 IL-1 受体拮抗基因 (IL1RN) 共等位基因的同源杂合子,与生存率显著相关(P = .018;OR,7.78 [95% CI,1.05-59.05])。TNF 基因型与死亡结果之间没有关联。这些数据表明,IL-1
基因型会影响脑膜炎球菌疾病的严重程度。