Complement C4 deficiency--a plausible risk factor for non-tuberculous mycobacteria (NTM) infection in apparently immunocompetent patients.
Complement C4 deficiency--a plausible risk factor for non-tuberculous mycobacteria (NTM) infection in apparently immunocompetent patients.
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DOI：
10.1371/journal.pone.0091450
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Järvinen A
中科院分区：
文献类型：
--
作者：
Kotilainen H;Lokki ML;Paakkanen R;Seppänen M;Tukiainen P;Meri S;Poussa T;Eskola J;Valtonen V;Järvinen A
非结核分枝杆菌 (NTM) 在环境中普遍存在，主要感染患有潜在肺部疾病的人，但也感染原本健康的老年妇女。导致 NTM 肺部感染的宿主抵抗力缺陷相对未知。一些遗传缺陷与肺部和播散性分枝杆菌感染有关。罕见的播散性 NTM 感染与家族中 T 细胞介导的免疫和细胞因子信号传导的遗传缺陷有关。我们研究了 NTM 感染与主要组织相容性复合体 (MHC) 编码的补体成分 C4A 或 C4B 缺陷之间是否存在关联。招募了 50 名 NTM 培养呈阳性且具有 NTM 疾病症状和发现的成年患者。收集患者的临床病史，并根据美国胸科学会（ATS）2007年的诊断标准对症状和临床表现进行分类。为了研究补体缺陷，分析了 C4A 和 C4B 基因拷贝数以及 C4 同种异型的表型频率。未经选择的 149 名健康芬兰成年人被用作对照。 NTM 患者比对照组更常见 C4 缺陷（C4A 或 C4B）（36/50 [72%] vs 83/149 [56%]，OR = 2.05，95%CI = 1.019–4.105，p = 0.042）。女性 NTM 患者的 C4 缺乏症比对照组更常见（29/36 [81%] vs 55/100 [55%]，OR = 3.39，95% CI = 1.358–8.460，p = 0.007）。 C4 缺乏似乎与任何特定的潜在疾病或 C4 表型无关。 C4 缺乏可能是 NTM 感染的危险因素，尤其是老年女性患者。
Non-tuberculous mycobacteria (NTM) are ubiquitous in the environment and they infect mainly persons with underlying pulmonary diseases but also previously healthy elderly women. Defects in host resistance that lead to pulmonary infections by NTM are relatively unknown. A few genetic defects have been associated with both pulmonary and disseminated mycobacterial infections. Rare disseminated NTM infections have been associated with genetic defects in T-cell mediated immunity and in cytokine signaling in families. We investigated whether there was an association between NTM infections and deficiencies of complement components C4A or C4B that are encoded by major histocompatibility complex (MHC). 50 adult patients with a positive NTM culture with symptoms and findings of a NTM disease were recruited. Patients' clinical history was collected and symptoms and clinical findings were categorized according to 2007 diagnostic criteria of The American Thoracic Society (ATS). To investigate the deficiencies of complement, C4A and C4B gene copy numbers and phenotype frequencies of the C4 allotypes were analyzed. Unselected, healthy, 149 Finnish adults were used as controls. NTM patients had more often C4 deficiencies (C4A or C4B) than controls (36/50 [72%] vs 83/149 [56%], OR = 2.05, 95%CI = 1.019–4.105, p = 0.042). C4 deficiencies for female NTM patients were more common than for controls (29/36 [81%] vs 55/100 [55%], OR = 3.39, 95% CI = 1.358–8.460, p = 0.007). C4 deficiences seemed not to be related to any specific underlying disease or C4 phenotype. C4 deficiency may be a risk factor for NTM infection in especially elderly female patients.
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影响因子：
5.8
作者：
Haverkamp, MH;van Dissel, JT;Holland, SM
通讯作者：
Holland, SM
影响因子：
3.1
作者：
Holland, SM
通讯作者：
Holland, SM
影响因子：
158.5
作者：
PRINCE, DS;PETERSON, DD;FISH, JE
通讯作者：
FISH, JE
影响因子：
11.8
作者：
Thomson RM;NTM working group at Queensland TB Control Centre and Queensland Mycobacterial Reference Laboratory
通讯作者：
NTM working group at Queensland TB Control Centre and Queensland Mycobacterial Reference Laboratory
影响因子：
--
作者：
Kotilainen, Hannele;Valtonen, Ville;Jarvinen, Asko
通讯作者：
Jarvinen, Asko