[Nosocomial sepsis and polymorphism of the NOD-2 gene]

Sepsis is a clinical syndrome resulting from a systemic inflammatory response to infection. Genetic factors may be important risk factors for sepsis. The present study determines whether the most frequent polymorphism of NOD2, a cytosol sensor of peptidoglycan, are independent risk factors for nosocomial sepsis. 80 sepsis patients and 90 unmatched controls admitted to the Campus Bio-Medico School of Medicine Hospital in Rome were studied. NOD2 polymorphisms were determined by Amplification Refractory Mutation System (ARMS) PCR, while TLR4 polymorphisms were determined by Allele-Specific PCR. 25% of sepsis patients and 7.77% of controls had NOD2 mutations. This resulted in an Odds Ratio (OR) of 3.95 for sepsis and NOD2 mutation patients and in an OR of 4.26 adjusting for cancer incidence and age in a logistic model. NOD2 mutations are an independent risk factor for nosocomial sepsis. The present study has shown, for the first time, the association between NOD2 mutations and sepsis, and it has determined NOD2 essential part of the innate immunity response to bacteria.