Clinical and genetic risk factors for pneumonia in systemic lupus erythematosus
| Autor: | K. E. Taylor, Talmadge E. King, Lindsey A. Criswell, Raymond F. Lum, Joanne Nititham, S. Louis Bridges, Brent W. Kinder, Jeffrey C. Edberg, Michelle M. Freemer |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Adolescent Genotype Immunology Comorbidity FCGR2A Mannose-Binding Lectin Polymorphism Single Nucleotide California Article Cohort Studies Rheumatology Risk Factors Immunopathology medicine Ethnicity Odds Ratio Immunology and Allergy Humans Lupus Erythematosus Systemic Pharmacology (medical) Clinical significance Genetic Predisposition to Disease Child Aged Aged 80 and over Univariate analysis Leukopenia business.industry Tumor Necrosis Factor-alpha Respiratory disease Receptors IgG Odds ratio Pneumonia Middle Aged medicine.disease Connective tissue disease Child Preschool Female medicine.symptom business |
| Zdroj: | Arthritis and rheumatism. 56(8) |
| ISSN: | 0004-3591 |
| Popis: | Objective To define the contribution of polymorphisms in genes encoding tumor necrosis factor (TNF), mannose-binding lectin (MBL), and Fcγ receptor IIa (FCGR2A) as well as clinical factors, to the development of pneumonia in patients with systemic lupus erythematosus (SLE). Methods We studied 282 SLE patients from a multiethnic cohort. Pneumonia events and clinical risk factors for pneumonia were identified through medical record review. Genotyping was performed for MBL (+223, +230, and +239), TNF (–308, –238, and +488), and FCGR2A (–131H/R) polymorphisms. Univariate analyses were performed to identify clinical and genetic risk factors for pneumonia. Covariates for multivariate analysis included sex, ethnicity, treatment with immunomodulators, and leukopenia. Results Forty-two patients (15%) had at least 1 episode of pneumonia. Polymorphism of the TNF gene, particularly the –238A allele and a related haplotype, revealed the most striking and consistent association with pneumonia in univariate analyses. Results of multivariate analyses indicated an odds ratio (OR) for the TNF –238A allele of 3.5 (P = 0.007) and an OR for the related haplotype of 5.4 (P = 0.001). Male sex, treatment with immunomodulators, and leukopenia also influenced the risk of pneumonia. Conclusion These findings suggest that specific TNF variants may identify SLE patients who are at particularly high risk of developing pneumonia. Given the prevalence and excessive morbidity associated with pneumonia in SLE, these findings have clinical relevance and provide insight into the pathogenesis. |
| Databáze: | OpenAIRE |
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