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Functional polymorphisms of innate immunity receptors are not risk factors for the non‐ SBP type bacterial infections in cirrhosis
Author(s) -
Dinya Tamas,
Tornai Tamas,
Vitalis Zsuzsanna,
Tornai Istvan,
Balogh Boglárka,
Tornai David,
AntalSzalmas Peter,
Sumegi Andrea,
Andrikovics Hajnalka,
Bors Andras,
Tordai Attila,
Papp Maria
Publication year - 2018
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13664
Subject(s) - spontaneous bacterial peritonitis , cirrhosis , immunology , innate immune system , medicine , disease , biology , gastroenterology , immune system
Background & Aims Pattern recognition receptors ( PRR s) have a key role in the innate host defense. Functional polymorphisms of various PRR s have been established to contribute to an increased susceptibility to spontaneous bacterial peritonitis ( SBP ). Their role in the development of cirrhosis‐associated bacterial infections ( BI ), beyond SBP or progressive disease course related to pathological bacterial translocation ( BT ) remains unknown. Methods Three hundred and forty‐nine patients with cirrhosis were genotyped for common NOD 2 (R702W, G908R and L1007PfsinsC), TLR 2 (−16934T>A), and TLR 4 (D299G) variants. Incidence of BI s, decompensating events and liver‐related death were assessed in a 5‐year follow‐up observational study. Pathological BT was assessed based on the presence of antimicrobial antibodies or lipopolysaccharide‐binding protein ( LBP ) level. Results In patients with ascites (n = 88) only NOD 2 gene variants were associated with an increased cumulative probability of SBP (76.9% ± 19.9%) compared to wild‐type (30.9% ± 6.9%, P LogRank = .047). Individual or combined PRR genetic profiles were associated with the risk of non‐ SBP type BI . Advanced disease stage ( HR [95% CI ]: 2.11 [1.38‐3.25]) and prior history of a BI episode ( HR : 2.42 [1.58‐3.72]) were the major clinical risk factors of a subsequent BI . The risk of a non‐ SBP type BI in patients with advanced disease and a prior BI was even higher ( HR : 4.74 [2.68‐8.39]). The frequency of antimicrobial antibodies and LBP levels did not differ between various PRR genotypes. Correspondingly, PRR genetic profile was not able to predict the long‐term disease course. Conclusions In cirrhosis, functional polymorphisms of PRR s did not improve the identification of patients with high risk of BI beyond SBP or progressive diseases course.