TIRAP基因多态性与儿童反复下呼吸道感染的关联性

Relationship between peripheral blood TIRAP gene polymorphism and recurrent lower respiratory tract infection in children and clinical value

目的探讨Toll/白细胞介素-1受体结构域衔接蛋白(TIRAP)与儿童反复下呼吸道感染(RRTI)易感性的关系及临床价值。方法选择酒泉市人民医院儿科2018年8月-2020年8月收治的反复呼吸道感染患儿102例纳入RRTI组。选择同期于医院进行治疗的社区获得肺炎(CAP)患儿80例为CAP组,选择同期医院进行体检的健康儿童80名作为对照组,聚合酶链式扩增反应检测TIRAP基因rs8177374位点基因分型。分析三组基因型及等位基因分布频率,将RRTI患儿按病情分为病情严重组和病情较轻组,比较不同病情程度RRTI患儿TIRAP基因rs8177374位点基因分布频率差异,并对不同基因RRTI患儿的临床特征进行分析。结果RRTI组TIRAP基因rs8177374位点CC、CT基因型、C等位基因频率分别为36.27%、34.31%、53.43%均高于CAP组及对照组(P<0.05);CAP组与对照组TIRAP基因rs8177374位点基因型、等位基因分布频率比较差异无统计学意义(P>0.05);RRTI组病情严重患儿CC基因型、C等位基因频率分别为51.28%、67.95%均高于病情较轻组(P<0.05),CC/CT型与TT型性别、年龄、病程、年平均发作次数、家族史、呼吸困难比较差异无统计学意义,CC/CT型C-反应蛋白(CRP)水平高于TT型(P<0.05)。结论外周血TIRAP基因rs8177374位点CC基因型、T等位基因频率显著增加本地区儿童RRTI的易感性。

OBJECTIVE To explore the relationship between Toll/interleukin-1receptor domain adaptor protein(TIRAP)and the susceptibility to recurrent lower respiratory tract infections(LRTI)and analyze its clinical value.METHODS A total of 102children with recurrent LRTI who were treated in pediatrics department of Jiuquan People′s Hospital from Aug 2018to Aug 2020were assigned as the RRTI group,meanwhile,80children with community-acquired pneumonia(CAP)were set as the CAP group,and 80healthy children who received physical examination were chosen as the control group.The genotypes at rs8177374locus of TIRAP gene were detected by using polymerase-chain-reaction-restriction-fragment-length polymorphism(PCR-RFLP).The frequencies of genotypes and alleles were compared among the three groups.The children with RRTI were divided into the severe illness condition group and the mild illness condition group according to the severity of illness condition,the frequencies of genotypes at rs8177374locus of TIRAP gene were compared between the severe illness condition group and the mild illness condition group,and the clinical characteristics of the RRTI children with different genotypes were observed.RESULTS The frequencies of CC,CT genotypes and C allele at the rs8177374locus of the TIRAP gene of the RRTI group were respectively 36.27%,34.31%,and 53.43%,significantly higher than those of the CAP group and the control group(P<0.05).There were no significant differences in the frequencies of genotypes and alleles at rs8177374locus of TIRAP gene between the CAP group and the control group(P>0.05).In the RRTI group,the frequencies of CC genotype and allele C of the children with severe illness condition were respectively 51.28%and 67.95%,significantly higher than those of the children with mild illness condition(P<0.05).There were no significant differences in the gender,age,course of disease,annual average number of attacks,family history and dyspnea between the children with CC/CT genotype and the children with TT genotype;the C-reactive protein(CRP)level of the children with CC/CT genotype was significantly higher than that of the children with TT genotype(P<0.05).CONCLUSIONThe frequencies of CC genotype and T allele at rs8177374locus of peripheral blood TIRAP gene remarkably increase the children′s susceptibility to RRTI.