Tumor necrosis factor -308 polymorphism (rs1800629) is associated with mortality and ventilator duration in 1057 Caucasian patients.
Tumor necrosis factor -308 polymorphism (rs1800629) is associated with mortality and ventilator duration in 1057 Caucasian patients.
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DOI：
10.1016/j.cyto.2012.06.016
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发表时间：
2012-10
期刊：
影响因子：
3.8
通讯作者：
Buchman, Timothy G.
中科院分区：
文献类型：
--
作者：
Watanabe, Eizo;Zehnbauer, Barbara A.;Oda, Shigeto;Sato, Yasunori;Hirasawa, Hiroyuki;Buchman, Timothy G.
重症患者脓毒症的管理仍然很困难，需要长期重症监护。基因检测已被提议作为一种战略，以确定病人的风险，为不良后果的严重疾病。因此，我们希望确定遗传因素对重症监护室（ICU）患者预后不良倾向和呼吸机支持持续时间的影响。从2001年7月至2005年12月，在来自12个US ICU的异质患者人群中进行了一项研究，这些患者由严重脓毒症遗传易感性（GenPSS）档案代表。在美国1057例SAPS II生存概率>0.2的高加索重症患者中，根据死亡率和无呼吸机天数评价了与炎性细胞因子和先天免疫相关的6种功能性单核苷酸多态性（rs 1800629、rs 16944、rs 1800795、rs 1800871、rs 2569190和rs 909253）。TNF（-308）（rs 1800629）的AA纯合子在死亡患者组中最多（隐性模型P = 0.015）。经协变量校正后，携带TNF（−308）* AA基因型的优势比显著更高，为2.67（1.29-5.55）（P = 0.008）。然而，存在1、2或3个急性器官功能障碍是不良结局的较大预后因素（OR（95%CI）= 2.98（2.00-4.45）、4.01（2.07-7.77）或19.95（4.99-79.72），P均< 0.001）。TNF（−308）* AA患者的呼吸机持续时间Kaplan-Mayer图与TNF（−308）*（GG + GA）显著不同（（AA v GG + GA），校正HR（95%CI）= 2.53（1.11-5.79），考克斯回归，P = 0.028）。TNF（−308）* AA与不良结局易感性和较长呼吸机持续时间显著相关。因此，遗传可能影响ICU预后的倾向以及资源利用。
Management of sepsis in critically ill patients remains difficult and requires prolonged intensive care. Genetic testing has been proposed as a strategy to identify patients at risk for adverse outcome of critical illnesses. Therefore, we wished to determine the influence of heredity on predisposition to poor outcome and on duration of ventilator support of intensive care unit (ICU) patients. A study was conducted from July 2001 to December 2005 in heterogeneous population of patients from 12 US ICUs represented by the Genetic Predisposition to Severe Sepsis (GenPSS) archive. In 1057 Caucasian critically ill patients with SAPS II probability of survival of >0.2 in the US, six functional single nucleotide polymorphisms in relation to inflammatory cytokines and innate immunity (rs1800629, rs16944, rs1800795, rs1800871, rs2569190, and rs909253) were evaluated in terms of mortality and ventilator free days. The AA homozygote of TNF(−308) (rs1800629) was most over-represented in the deceased patient group (P = 0.015 with recessive model). The carriage of the TNF(−308)* AA genotype showed significantly higher odds ratio of 2.67(1.29–5.55) (P = 0.008) after adjustment with the covariates. However, the presence of 1, 2, or 3 acute organ dysfunctions was larger prognostic factors for the adverse outcome (OR(95%CI) = 2.98(2.00–4.45), 4.01(2.07–7.77), or 19.95(4.99–79.72), P < 0.001 for all). Kaplan–Mayer plot on ventilator duration of TNF(−308)* AA patient significantly diverged from that of TNF(−308)* (GG + GA) ((AA v GG + GA), Adjusted HR(95%CI) = 2.53(1.11–5.79) with Cox regression, P = 0.028). TNF(−308)* AA is significantly associated with susceptibility to adverse outcome and to longer ventilator duration. Therefore, heredity likely affects both predisposition to ICU prognosis as well as the resource utilization.
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影响因子：
8.8
作者：
Watanabe, E;Hirasawa, H;Tokuhisa, T
通讯作者：
Tokuhisa, T
影响因子：
120.7
作者：
Kilgannon, J. Hope;Jones, Alan E.;Trzeciak, Stephen
通讯作者：
Trzeciak, Stephen
影响因子：
64.8
作者：
Foster, Simmie L.;Hargreaves, Diana C.;Medzhitov, Ruslan
通讯作者：
Medzhitov, Ruslan
影响因子：
158.5
作者：
Keane, J;Gershon, S;Braun, MM
通讯作者：
Braun, MM
DOI：
10.1186/cc10069
发表时间：
2011
期刊：
Critical care (London, England)
影响因子：
--
作者：
Heininger A;Haeberle H;Fischer I;Beck R;Riessen R;Rohde F;Meisner C;Jahn G;Koenigsrainer A;Unertl K;Hamprecht K
通讯作者：
Hamprecht K