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Effect of CD14 -260C>T polymorphism on the mortality of critically ill patients
Luiz C D'Avila1, Maria H Albarus, Carolina R Franco
1Biosciences Faculty and São Lucas Hospital, Catholic Pontifical University of Rio Grande do Sul, Porto Alegre, Brazil.
Abstract:
The CD14 receptor seems to be an important part of the innate immune system. A mutant CD14 can produce a reduced signal in response to infection, as a result of which an adequate inflammatory innate response is not induced, leading to a systemic infection. Defects in the innate immunity increase patient susceptibility to systemic infections and can produce a deregulated inflammatory response causing sepsis, organ failure or death in critically ill patients. We evaluated the CD14 -260C>T polymorphism genotyping as a genetic tool for risk evaluation of critically ill patients admitted to an intensive care unit (ICU) in Southern Brazil. We monitored the patients daily during their entire ICU and post-ICU (hospital) stay (measured from the ICU admission day to a maximum of 224 days). A total of 85 patients, aged 19-95 years (mean = 56 years, median = 58 years), were included in this study. Patient mortality was 58.8%. The genotypic (TT = 0.27, TC = 0.41, CC = 0.32) and allelic (T = 0.48, C = 0.52) frequencies did not differ from the values expected by the Hardy-Weinberg model and genotype distribution was random for all clinical characteristics at ICU admission. We found a statistically significant difference favouring the survival of patients with TT genotype (P = 0.042), suggesting that this CD14 gene polymorphism could be a candidate for further study in the search for a complementary prognostic tool for patient risk evaluation. Our study describes, for the first time, the effect of the CD14 gene polymorphism in critically ill Brazilian patients. Our data suggest that patients carrying the TT genotype have a better survival outcome.
Insights
The CD14 receptor is vital for innate immunity. Patients with the TT genotype of the CD14 gene polymorphism showed better survival outcomes in intensive care units (ICUs).
Area of Science:
- Immunology
- Genetics
- Critical Care Medicine
Background:
- The CD14 receptor plays a crucial role in the innate immune system.
- Mutations in CD14 can impair immune response, increasing susceptibility to infections and sepsis.
- Defects in innate immunity are linked to severe outcomes in critically ill patients.
Purpose of the Study:
- To investigate the CD14 -260C>T gene polymorphism as a prognostic tool for critically ill patients.
- To evaluate the association between CD14 genotypes and survival rates in an intensive care unit (ICU) population in Southern Brazil.
Main Methods:
- Genotyping of the CD14 -260C>T polymorphism in 85 critically ill patients.
- Daily monitoring of patients throughout their ICU and hospital stay (up to 224 days).
- Analysis of genotypic and allelic frequencies and their correlation with patient survival.
Main Results:
- Patient mortality was 58.8%.
- Genotypic frequencies (TT=0.27, TC=0.41, CC=0.32) and allelic frequencies (T=0.48, C=0.52) were consistent with Hardy-Weinberg equilibrium.
- Patients with the TT genotype showed a statistically significant survival advantage (P=0.042).
Conclusions:
- The CD14 -260C>T polymorphism may serve as a complementary prognostic marker for critically ill patients.
- This is the first study to examine the effect of CD14 gene polymorphism in Brazilian ICU patients.
- The TT genotype is associated with improved survival outcomes in this patient cohort.