title: LTA4H genotype is associated with susceptibility to bacterial meningitis but is not a critical determinant of outcome.
abstract: Adjunctive dexamethasone saves lives in the treatment of tuberculous meningitis but this response is influenced by the patient's LTA4H genotype. Despite less certain benefit, adjunctive dexamethasone is also frequently used in the treatment of pyogenic bacterial meningitis, but the influence of LTA4H genotype on outcomes has not been previously investigated. We genotyped the LTA4H promoter region SNP (rs17525495) in 390 bacterial meningitis patients and 751 population controls. rs17525495 was associated with susceptibility to bacteriologically confirmed bacterial meningitis (P = 0.01, OR 1.27 95% confidence interval [CI] 1.05-1.54) but did not influence clinical presentation, disease severity or survival following dexamethasone treatment.
authors: Oxford University Clinical Research Unit, Ho Chi Minh City, District 5, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, OX3 7LJ, United Kingdom; Nossal Institute of Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, 3010, Australia.
authors: Sarah J
authors: SJ
authors: Dunstan
authors: Oxford University Clinical Research Unit, Ho Chi Minh City, District 5, Vietnam.
authors: Trinh Thi Bich
authors: TT
authors: Tram
authors: Oxford University Clinical Research Unit, Ho Chi Minh City, District 5, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, OX3 7LJ, United Kingdom.
authors: Guy E
authors: GE
authors: Thwaites
authors: Hospital for Tropical Diseases, Ho Chi Minh City, District 5, Vietnam.
authors: Tran Thi Hong
authors: TT
authors: Chau
authors: Hospital for Tropical Diseases, Ho Chi Minh City, District 5, Vietnam.
authors: Nguyen Hoan
authors: NH
authors: Phu
authors: Oxford University Clinical Research Unit, Ho Chi Minh City, District 5, Vietnam.
authors: Tran Tinh
authors: TT
authors: Hien
authors: Oxford University Clinical Research Unit, Ho Chi Minh City, District 5, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, OX3 7LJ, United Kingdom.
authors: Jeremy J
authors: JJ
authors: Farrar
authors: Oxford University Clinical Research Unit, Ho Chi Minh City, District 5, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, OX3 7LJ, United Kingdom.
authors: Marcel
authors: M
authors: Wolbers
authors: Oxford University Clinical Research Unit, Ho Chi Minh City, District 5, Vietnam.
authors: Nguyen Thi Hoang
authors: NT
authors: Mai
mesh_terms: D000328:Adult; D003907:Dexamethasone / Q000627:therapeutic use; D018450:Disease Progression; D004851:Epoxide Hydrolases / Q000235:genetics*; D005260:Female; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000235:genetics / Q000276:immunology; D017572:Leukotriene A4 / Q000276:immunology; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D014390:Tuberculosis, Meningeal / Q000188:drug therapy* / Q000235:genetics* / Q000276:immunology / Q000382:microbiology
chemical_list: D017572:Leukotriene A4; D003907:Dexamethasone; D004851:Epoxide Hydrolases; C043134:leukotriene A4 hydrolase