IL-18-607C/A位点基因多态性与儿童EV71脑炎严重程度的关系

The relationship between the polymorphism of interleukin-18-607C/A gene and the severity of enterovirus 71 encephalitis in Chinese children

目的探讨白细胞介素18(IL-18)基因-607位点单核苷酸多态性与EV71相关性脑炎严重程度的关系。方法选取2014年5月至2016年6月青岛大学附属医院及青岛市妇女儿童医院收治的EV71检测为阳性的患儿185例,同期收集无感染症状的健康体检儿童214例作为研究对象进行病情研究。根据感染患儿是否患有脑炎分为脑炎组(93例)、非脑炎组(92例),脑炎组按照病情严重程度分为轻症(49例)和重症组(44例);提取全样本外周血DNA,利用多重高温连接酶反应(iMLDR)技术测定IL-18基因rs1946519位点单核苷酸多态性,比较各组IL-18-607SNP的基因型和等位基因频率的分布以及临床特征和实验室结果的差异。结果EV71感染患儿IL-18rs1946519AA基因型和A等位基因的频率显著高于对照组,IL-18rs1946519AA基因型和A等位基因分布频率在重症EV71脑炎患儿中明显高于轻症组(P<0.05)。EV71感染患儿CC、CA、AA基因型分组中,C反应蛋白(CRP)、白细胞计数(WBC)、发热持续时间、血糖等检测指标存在显著差异(P<0.05)。结论IL-18基因-607A携带者对EV71感染具有明显的易感性,易发生重症EV71脑炎。IL-18-607位点基因多态性与EV71感染脑炎的严重程度有关。

Objective To explore the connection between the promoter region polymorphisms(-607C/A)of IL-18 gene and the severity of EV71 encephalitis in Chinese children.Methods We analyzed the polymorphisms in IL-18-607C/A gene of 185 EV71 infected patients and 214 controls for genetic association research from May 2014 to June 2016.The patients in EV71 group were divided into encephalitis group(93 cases)and non-encephalitis group(92 cases),while the encephalitis group was divided into mild(49 cases)and severe encephalitis group(44 cases)according to severity.The clinical features and auxiliary examination results were collected and compared in cases.Results The frequency of IL-18-607 AA genotype and IL-18-607A allele in EV71 infected patients was significantly higher than in controls(32.4%vs.21.5%,P=0.042,55.1%vs.46.0%,P=0.001).Furthermore,similar difference was found in severe EV71 encephalitis and mild encephalitis cases(53.0%vs.20.5%,P=0.003,67.3%vs.50%,P=0.016).The duration of fever and blood glucose(BG)level was visibly higher in AA genotype than CA and CC genotypes.Conclusion The children with IL-18-607AA genotype were much easier to develop severe EV71 associated encephalitis in China.