Association between a genomic polymorphism within the CD14 locus and septic shock susceptibility and mortality rate.
OBJECTIVE
Genetic differences in immune responses may affect susceptibility to and outcome of septic shock. CD14 seems to be an important part of the innate immune system, initiating antimicrobial response. We evaluated the frequency of a recently discovered CD14 promoter gene polymorphism (C to T transition at base pair -159) among patients with septic shock compared with those in a control group.


METHODS
Multiple-center study.


METHODS
Hospital research department.


METHODS
Ninety consecutive white patients with septic shock were included. The control group consisted of 122 age- and gender-matched white subjects.


METHODS
In both groups, the C-159T CD14 promoter genetic polymorphism was determined by using polymerase chain reaction and subsequent Hae III restriction enzyme digestion of the polymerase chain reaction products.


RESULTS
The C-159T polymorphism and the TT genotype were significantly overrepresented among septic shock patients compared with controls. Within the septic shock group, the mortality of patients with TT genotype (71%) was significantly higher than in patients with other genotypes (48%; Pearson chi-square, p =.008). In a multiple logistic regression model, the TT genotype was independently associated with an increased relative risk of death (odds ratio, 5.30; 95% confidence interval, 1.20-22.50, p =.02).


CONCLUSIONS
The C-159T polymorphism affects susceptibility to septic shock and seems to be a new genetic risk factor for death.
Gibot
Sébastien
S
Service de Réanimation Médicale, Hôpital Central, Nancy, France. sebgibot@aol.com
Cariou
Alain
A
Drouet
Ludovic
L
Rossignol
Mathias
M
Ripoll
Laurent
L
D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011401:Promoter Regions, Genetic; D012772:Shock, Septic / Q000235:genetics* / Q000401:mortality
D018950:Lipopolysaccharide Receptors