Associations between Fc gamma receptor IIA polymorphisms and the risk and prognosis of meningococcal disease.
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.
Domingo
Pere
P
Department of Internal Medicine (Infectious Diseases Unit), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
Muñiz-Diaz
Eduardo
E
Baraldès
Maria A
MA
Arilla
Marina
M
Barquet
Nicolau
N
Pericas
Roser
R
Juárez
Cándido
C
Madoz
Pedro
P
Vázquez
Guillermo
G
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
D015703:Antigens, CD; C080568:Fc gamma receptor IIA; D007136:Immunoglobulins; D017452:Receptors, IgG; D011971:Receptors, Immunologic; C028495:phagocytosis receptor; D003165:Complement System Proteins