title: Racial variation in toll-like receptor variants among women with pelvic inflammatory disease.
abstract: BACKGROUND
  Racial disparities exist in gynecological diseases. Variations in Toll-like receptor (TLR) genes may alter signaling following microbial recognition.
  
  
  METHODS
  We explored genotypic differences in 6 functional variants in 4 TLR genes (TLR1, TLR2, TLR4, TLR6) and the adaptor molecule TIRAP between 205 African American women and 51 white women with clinically suspected pelvic inflammatory disease (PID). A permutated P < .007 was used to assess significance. Associations between race and endometritis and/or upper genital tract infection (UGTI) were explored. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  The TT genotype for TLR1 rs5743618, the GG genotype for TLR1 rs4833095, the CC genotype for TLR2 rs3804099, the TLR6 rs5743810 T allele, and the CC genotype for TIRAP rs8177374 significantly differed between races (P < .007). African American race was associated with endometritis and/or UGTI (OR, 4.2 [95% CI, 2.0-8.7]; P = .01). Among African Americans, the TLR6 rs5743810 T allele significantly decreased endometritis and/or UGTI (OR, 0.4 [95% CI, .2-.9]; P = .04). Additionally, rs5743618, rs4833095, and rs8177374 increased endometritis and/or UGTI, albeit not significantly.
  
  
  CONCLUSIONS
  Among women with PID, TLR variants that increase inflammation are associated with African American race and may mediate the relationship between race and endometritis and/or UGTI.
authors.affiliation: Department of Epidemiology, University of Pittsburgh, 130 Desoto St, 513 Parran Hall, Pittsburgh, PA 15261, USA. depaolib@edc.pitt.edu
authors.forename: Brandie D
authors.initials: BD
authors.lastname: Taylor
authors.forename: Toni
authors.initials: T
authors.lastname: Darville
authors.forename: Robert E
authors.initials: RE
authors.lastname: Ferrell
authors.forename: Roberta B
authors.initials: RB
authors.lastname: Ness
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Haggerty
mesh_terms: D000328:Adult; D001741:Black or African American / Q000235:genetics*; D002690:Chlamydia Infections / Q000208:ethnology / Q000235:genetics; D002692:Chlamydia trachomatis; D016001:Confidence Intervals; D004716:Endometritis / Q000208:ethnology / Q000235:genetics; D005260:Female; D005838:Genotype; D006069:Gonorrhea / Q000208:ethnology / Q000235:genetics; D006801:Humans; D016015:Logistic Models; D008562:Membrane Glycoproteins / Q000235:genetics*; D009175:Mycoplasma Infections / Q000208:ethnology / Q000235:genetics; D045704:Mycoplasma genitalium; D016017:Odds Ratio; D000292:Pelvic Inflammatory Disease / Q000208:ethnology* / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D017472:Receptors, Interleukin-1 / Q000235:genetics*; D060737:Reproductive Tract Infections / Q000208:ethnology / Q000235:genetics; D015398:Signal Transduction / Q000235:genetics; D051193:Toll-Like Receptors / Q000235:genetics*; D044465:White People / Q000235:genetics*; D055815:Young Adult
chemical_list: D008562:Membrane Glycoproteins; D017472:Receptors, Interleukin-1; C434984:TIRAP protein, human; D051193:Toll-Like Receptors