Epidemiologic Association Between FUT2 Secretor Status and Severe Rotavirus Gastroenteritis in Children in the United States.
Autor: | Payne DC; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Currier RL; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Staat MA; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Sahni LC; Texas Children's Hospital, Houston., Selvarangan R; Children's Mercy Hospitals and Clinics, Kansas City, Missouri., Halasa NB; Vanderbilt University Medical Center, Nashville, Tennessee., Englund JA; Seattle Children's Hospital, Seattle, Washington., Weinberg GA; University of Rochester School of Medicine and Dentistry, Rochester, New York., Boom JA; Texas Children's Hospital, Houston8Baylor College of Medicine, Houston, Texas., Szilagyi PG; University of Rochester School of Medicine and Dentistry, Rochester, New York., Klein EJ; Seattle Children's Hospital, Seattle, Washington., Chappell J; Vanderbilt University Medical Center, Nashville, Tennessee., Harrison CJ; Children's Mercy Hospitals and Clinics, Kansas City, Missouri., Davidson BS; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Mijatovic-Rustempasic S; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Moffatt MD; Children's Mercy Hospitals and Clinics, Kansas City, Missouri., McNeal M; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Wikswo M; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Bowen MD; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia., Morrow AL; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Parashar UD; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia. |
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Jazyk: | angličtina |
Zdroj: | JAMA pediatrics [JAMA Pediatr] 2015 Nov; Vol. 169 (11), pp. 1040-5. |
DOI: | 10.1001/jamapediatrics.2015.2002 |
Abstrakt: | Importance: A genetic polymorphism affecting FUT2 secretor status in approximately one-quarter of humans of European descent affects the expression of histo-blood group antigens on the mucosal epithelia of human respiratory, genitourinary, and digestive tracts. These histo-blood group antigens serve as host receptor sites necessary for attachment and infection of some pathogens, including norovirus. Objective: We investigated whether an association exists between FUT2 secretor status and laboratory-confirmed rotavirus infections in US children. Design, Setting, and Participants: Multicenter case-control observational study involving active surveillance at 6 US pediatric medical institutions in the inpatient and emergency department clinical settings. We enrolled 1564 children younger than 5 years with acute gastroenteritis (diarrhea and/or vomiting) and 818 healthy controls frequency matched by age and month, from December 1, 2011, through March 31, 2013. Main Outcomes and Measures: Paired fecal-saliva specimens were tested for rotavirus and for secretor status. Comparisons were made between rotavirus test-positive cases and healthy controls stratified by ethnicity and vaccination status. Adjusted multivariable analyses assessed the preventive association of secretor status against severe rotavirus gastroenteritis. Results: One (0.5%) of 189 rotavirus test-positive cases was a nonsecretor, compared with 188 (23%) of 818 healthy control participants (P < .001). Healthy control participants of Hispanic ethnicity were significantly less likely to be nonsecretors (13%) compared with healthy children who were not of Hispanic ethnicity (25%) (P < .001). After controlling for vaccination and other factors, children with the nonsecretor FUT2 polymorphism appeared statistically protected (98% [95% CI, 84%-100%]) against severe rotavirus gastroenteritis. Conclusions and Relevance: Severe rotavirus gastroenteritis was virtually absent among US children who had a genetic polymorphism that inactivates FUT2 expression on the intestinal epithelium. We observed a strong epidemiologic association among children with rotavirus gastroenteritis compared with healthy control participants. The exact cellular mechanism behind this epidemiologic association remains unclear, but evidence suggests that it may be rotavirus genotype specific. The lower prevalence of nonsecretors among Hispanic children may translate to an enhanced burden of rotavirus gastroenteritis among this group. Our findings may have bearing on our full understanding of rotavirus infections and the effects of vaccination in diverse populations. |
Databáze: | MEDLINE |
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