Open AccessThe Fcγ Receptor IIA-R/R131 Genotype Is Associated with Severe Sepsis in Community-Acquired Pneumonia
Author(s) -
Henrik Endeman,
Marie Claire A. Cornips,
Jan C. Grutters,
J.L.H. Ruud Bosch,
Henk J.T. Ruven,
Heleen van VelzenBlad,
Ger T. Rijkers,
Douwe H. Biesma
Publication year - 2009
Publication title -
clinical and vaccine immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.649
H-Index - 77
eISSN - 1556-6811
pISSN - 1556-679X
DOI - 10.1128/cvi.00037-09
Subject(s) - genotype , streptococcus pneumoniae , pneumonia , immunology , haemophilus influenzae , antibody , odds ratio , microbiology and biotechnology , sepsis , biology , community acquired pneumonia , pathogen , medicine , genetics , antibiotics , gene
Community-acquired pneumonia (CAP) can be caused by a variety of microorganisms but is most frequently associated withStreptococcus pneumoniae and gram-negative bacteria likeHaemophilus influenzae . Encapsulated bacteria are able to escape phagocytosis, unless they are bound by immunoglobulin G2 subclass antibodies. These antibodies interact with Fcγ receptor IIa (Fcγ-RIIa), thereby facilitating opsonophagocytosis of the encapsulated bacteria. We studied the relationship between the Fcγ-RIIa-R/H131 polymorphism and the clinical course of CAP and pathogen-specific susceptibility. Regarding methodology, the Fcγ-RIIa genotype R/H131 was determined in 200 patients with CAP and in 313 healthy controls and was correlated with the clinical course, laboratory parameters, and causative microorganism. The Fcγ-RIIa-R/R131 genotype was found more frequently in patients with severe sepsis (odds ratio [OR], 2.55; 95% confidence interval [CI], 1.30 to 5.00;P < 0.01). The majority of patients in this group suffered from invasive pneumococcal disease. The duration of hospital stay was longer for patients with the Fcγ-RIIa-R/R131 genotype. Fcγ-RIIa genotypes were not associated with an increased risk of CAP in general; however, the Fcγ-RIIa-R/R131 genotype was found more frequently in patients with CAP caused byH. influenzae than in controls (OR, 3.03; CI, 1.04 to 9.09;P < 0.05). In conclusion, the Fcγ-RIIa-R/R131 genotype is associated with severity of CAP and is more frequent in CAP caused byH. influenzae .