title: Associations between Fc gamma receptor IIA polymorphisms and the risk and prognosis of meningococcal disease.
abstract: BACKGROUND
  In vitro studies have shown that the neutrophil Fc gamma receptor IIA (FcgammaRIIA) polymorphism influences the phagocytic capacity of neutrophils and the removal of encapsulated bacteria from the bloodstream. In particular, the R/R131 allotype is associated with less phagocytic activity.
  
  
  METHODS
  We performed a case-control study to determine the influence of the FcgammaRIIA polymorphism (R/R131, R/H131, H/H131) on the risk and outcome of meningococcal disease. The polymorphisms were measured in 130 patients with microbiologically proven meningococcal disease diagnosed from 1987 to 1998 (cases) and 260 asymptomatic sex-matched blood donors (controls). Clinical manifestations and complications of meningococcal disease were recorded, and a prognostic score (based on age, hemorrhagic diathesis, neurologic signs, and the absence of preadmission antibiotic) therapy was calculated.
  
  
  RESULTS
  The distributions of FcgammaRIIA allotypes were similar in cases and controls. However, among patients with meningococcal infection, fulminant meningococcal disease (odds ratio [OR] = 3.9; 95% confidence interval [CI]: 1.0 to 16; P = 0.04) and meningococcemia without meningitis (OR = 3.0; 95% CI: 1.4 to 7.8; P = 0.004) were more common in those with the FcgammaRIIA-R/R131 allotype. Complications were also significantly more frequent in these patients. Of the 42 patients with the R/R131 allotype, 31 (74%) had an adverse prognostic score, compared with 7% (4 of 59) of those with the R/H131 allotype and 3% (1 of 29) of those with the H/H131 allotype (P <0.0001).
  
  
  CONCLUSIONS
  The FcgammaRIIA-R/R131 allotype is associated with more severe forms of meningococcal disease.
authors.affiliation: Department of Internal Medicine (Infectious Diseases Unit), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
authors.forename: Eduardo
authors.initials: E
authors.lastname: Muñiz-Diaz
authors.forename: Maria A
authors.initials: MA
authors.lastname: Baraldès
authors.forename: Marina
authors.initials: M
authors.lastname: Arilla
authors.forename: Nicolau
authors.initials: N
authors.lastname: Barquet
authors.forename: Roser
authors.initials: R
authors.lastname: Pericas
authors.forename: Cándido
authors.initials: C
authors.lastname: Juárez
authors.forename: Pedro
authors.initials: P
authors.lastname: Madoz
authors.forename: Guillermo
authors.initials: G
authors.lastname: Vázquez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000235:genetics*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015941:Complement Hemolytic Activity Assay; D003165:Complement System Proteins / Q000032:analysis; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007223:Infant; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology*; D008875:Middle Aged; D010587:Phagocytosis; D011110:Polymorphism, Genetic; D011379:Prognosis; D017452:Receptors, IgG / Q000235:genetics*; D011971:Receptors, Immunologic; D012307:Risk Factors
chemical_list: D015703:Antigens, CD; C080568:Fc gamma receptor IIA; D007136:Immunoglobulins; D017452:Receptors, IgG; D011971:Receptors, Immunologic; C028495:phagocytosis receptor; D003165:Complement System Proteins