TOLL-LIKE RECEPTOR 4 D299G POLYMORPHISM AND INCIDENCE OF INFECTIONS IN CIRRHOTIC PATIENTS

Carlos Guarner-Argente (1) , Elisabet Sánchez (1, 2) , Sílvia Vidal (3) , Eva Román (1, 2) , Mar Concepción (1) , Maria Poca (1) , Diego Sánchez (3) , Cándido Juárez (3) , Germán Soriano (1, 2) , Carlos Guarner (1, 2)

1 Department of Gastroenterology
2 CIBERehd - Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas
3 Department of Immunology

BACKGROUND. Toll-like receptor (TLR) 4 genetic polymorphisms, mainly D299G, have been associated with increased predisposition to infection in several populations. AIM. To retrospectively analyze the relationship between the presence of the TLR4 D299G polymorphism and the incidence of bacterial infections in cirrhotic patients. PATIENTS AND METHODS. We included 111 consecutive cirrhotic patients hospitalized with ascites and we determined the presence of the TLR4 D299G polymorphism by PCR-RFLP and its relationship with the incidence of previous bacterial infections. RESULTS. Ten out of 111 (9%) cirrhotic patients presented the TLR4 D299G polymorphism. The mean follow-up from first decompensation of cirrhosis until present admission was longer in D299G polymorphism patients than in wild type patients (53.8±40.7 vs 35.4±48.3 months, p=0.03). D299G polymorphism patients showed a trend towards a higher incidence of previous infections (80% vs 56.4%, p=0.19), as well as a higher number of infections (2.8±2.3 vs 1.0±1.3, p=0.01) and bacteremias (0.4±1.0 vs 0.04±0.2, p=0.02) per patient than wild type patients. CONCLUSIONS. TLR4 D299G polymorphism could influence not only the predisposition to bacterial infections but also the evolution of the disease in cirrhotic patients. Further prospective studies in larger series of patients are warranted.

Mots clés: Medicine

Carlos Guarner-Argente, Elisabet Sánchez, Sílvia Vidal, Eva Román, Mar Concepción, et al.. TOLL-LIKE RECEPTOR 4 D299G POLYMORPHISM AND INCIDENCE OF INFECTIONS IN CIRRHOTIC PATIENTS. Alimentary Pharmacology and Therapeutics, 2010, 31 (11), pp.1192. ⟨10.1111/j.1365-2036.2010.04291.x⟩. ⟨hal-00552544⟩