Surfactant protein-B polymorphisms and mortality in the acute respiratory distress syndrome.
OBJECTIVE
To determine whether polymorphisms of the surfactant protein B gene may be associated with increased mortality in patients with the acute respiratory distress syndrome.


METHODS
A prospective cohort study.


METHODS
Four adult intensive care units at a tertiary academic medical center.


METHODS
Two hundred fourteen white patients who had met criteria for acute respiratory distress syndrome.


METHODS
None.


RESULTS
Patients were genotyped for a variable nuclear tandem repeat polymorphism in intron 4 of the surfactant protein B gene and the surfactant protein B gene +1580 polymorphism. For the variable nuclear tandem repeat surfactant protein B gene polymorphism, patients were found to have either a homozygous wild-type genotype or a variant genotype consisting of either a heterozygous insertion or deletion polymorphism. Logistic regression was performed to analyze the relationship of the polymorphisms to mortality in patients with acute respiratory distress syndrome. In multivariate analysis, the presence of variable nuclear tandem repeat surfactant protein B gene polymorphism was associated with a 3.51 greater odds of death at 60 days in patients with acute respiratory distress syndrome as compared to those patients with the wild-type genotype (95% confidence interval 1.39-8.88, p = 0.008). There was no association found between the +1580 variant and outcome (p = 0.15).


CONCLUSIONS
In this study, the variable nuclear tandem repeat surfactant protein B gene polymorphism in intron 4 is associated with an increased 60 day mortality in acute respiratory distress syndrome after adjusting for age, severity of illness, and other potential confounders. Additional studies in other populations are needed to confirm this finding.
Currier
Paul F
PF
Pulmonary and Critical Care Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Gong
Michelle N
MN
Zhai
Rihong
R
Pothier
Lucille J
LJ
Boyce
Paul D
PD
Xu
Lilian
L
Yu
Chu-Ling
CL
Thompson
B Taylor
BT
Christiani
David C
DC
D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005838:Genotype; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D011446:Prospective Studies; D037701:Pulmonary Surfactant-Associated Protein B / Q000235:genetics*; D012128:Respiratory Distress Syndrome / Q000378:metabolism* / Q000401:mortality*; D012307:Risk Factors; D012737:Sex Factors; D020080:Tandem Repeat Sequences
D037701:Pulmonary Surfactant-Associated Protein B