title: Clinical significance of the single nucleotide polymorphism TLR2 R753Q in heart transplant recipients at risk for cytomegalovirus disease.
abstract: The toll-like receptor 2 (TLR2) is a significant component of innate immunity against cytomegalovirus (CMV) infection but information on the clinical significance of the single nucleotide polymorphism (SNP) (R753Q) is conflicting.
  
  
  
  The inconsistent observations of the immunological and clinical significance of the TLR2 R753Q polymorphism for CMV infection indicates the influence of confounders.
  
  
  
  The presence of the TLR2 polymorphism was determined by a genotyping assay of 175 HTX patients and 281 healthy blood donors and evaluated in relation to selected virological and clinical parameters.
  
  
  
  Relative frequency of TLR2 polymorphism was similar in HTX patients and blood donors (homozygous wild-type, 94.3% vs. 94.0%; heterozygous, 5.1% vs. 5.7%; homozygous mutated, <1%). CMV viremia was detectable in 108 (61.7%) of HTX patients. The TLR2 polymorphism was neither associated with occurrence or level of CMV infection nor with survival, graft failure or rejection, or CMV serostatus of patient before transplantation. Nevertheless, CMV viremia occurred in 83.1% of R+/D+, 77.1% of R+/D-, and 64.3% of R-/D+ patients. Time of first CMV viremia was in R-/D+ patients later than in CMV-seropositive patients (median, 182days versus 23 days; P<0.001) corresponding to the duration of antiviral prophylaxis in R-/D+ patients.
  
  
  
  The TLR2 R753Q polymorphism is extremely rare in the general population and HTX patients. Screening for this risk factor of CMV disease may not be cost-effective in contrast to testing for CMV viremia.
authors.affiliation: Department of Medicine I, Div. of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Austria.
authors.forename: Martina
authors.initials: M
authors.lastname: Schneider
authors.affiliation: Department of Medicine I, Div. of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Austria.
authors.forename: Teresa
authors.initials: T
authors.lastname: Matiqi
authors.affiliation: Institutes of Environmental Health, Center for Public Health, Medical University of Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Kundi
authors.affiliation: Department of Medicine I, Div. of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Austria.
authors.forename: Franz J J
authors.initials: FJ
authors.lastname: Rieder
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Andreas
authors.affiliation: Department of Laboratory Medicines, Division of Clinical Virology, Medical University of Vienna, Austria.
authors.forename: Robert
authors.initials: R
authors.lastname: Strassl
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Zuckermann
authors.affiliation: Blood Service for Vienna, Lower Austria and Burgenland, Austrian Red Cross, Vienna, Austria.
authors.forename: Christof
authors.initials: C
authors.lastname: Jungbauer
authors.affiliation: Department of Medicine I, Div. of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Austria. Electronic address: christoph.steininger@meduniwien.ac.at.
authors.forename: Christoph
authors.initials: C
authors.lastname: Steininger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000209:etiology / Q000235:genetics* / Q000517:prevention & control / Q000821:virology; D005260:Female; D005838:Genotype; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D012307:Risk Factors; D051195:Toll-Like Receptor 2 / Q000235:genetics*; D066027:Transplant Recipients; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; C495342:TLR2 protein, human; D051195:Toll-Like Receptor 2
keywords: CMV infection; Heart transplantation; TLR2 polymorphism