<italic>MyD88</italic>和<italic>TICAM1</italic>基因多态性及其交互作用与儿童社区获得性肺炎的关联研究

doi:10.7499/j.issn.1008-8830.2303062

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摘要目的探讨髓样分化因子88（myeloid differentiation factor 88，MyD88）和Toll样受体衔接分子1（Toll-like receptor adaptor molecule 1，TICAM1）基因的单核苷酸多态性及其交互作用与儿童社区获得性肺炎（community-acquired pneumonia，CAP）的相关性。方法前瞻性采用改良多重高温连接酶检测反应技术对2015年8月—2017年9月在延安大学医学院第二附属医院儿科就诊的375例CAP患儿和306例健康体检儿童的MyD88和TICAM1基因的9个标签位点进行分型，并采用logistic回归分析评价各位点基因型及其交互作用与儿童CAP的关联。结果 TICAM1基因rs11466711T/C位点多态性与儿童CAP易感性密切相关（P<0.05）；rs35747610G/A位点AA基因型可显著降低CAP患儿并发脓毒症的风险（P<0.05）；rs6510826G/A位点AA基因型与CAP患儿急性期C反应蛋白水平的增高显著关联（P<0.05）。MyD88基因rs7744A/G位点GG基因型能显著增加患儿发生呼吸衰竭和循环衰竭的风险（均P<0.05）。MyD88基因rs7744A/G位点与TICAM1基因的rs11466711T/C、rs2292151G/A、rs35299700C/T和rs35747610G/A位点之间存在多个与儿童CAP易感性、严重程度及并发脓毒症风险显著关联的相乘交互作用模式（均P<0.05）。结论 MyD88和TICAM1基因多态性及其交互作用与儿童CAP密切相关，对儿童CAP的发生及病情发展具有协同作用。

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	杨勇
	杨绥宇
	陈宗波
	刘俐

关键词 ：社区获得性肺炎, MyD88基因, TICAM1基因, 基因多态性, 儿童

Abstract：Objective To investigate the association of single nucleotide polymorphisms (SNPs) of myeloid differentiation factor 88 (MyD88) and Toll-like receptor adaptor molecule 1 (TICAM1) and their interactions with community-acquired pneumonia (CAP) in children. Methods Improved multiple ligase detection reaction assay was used for detecting the polymorphisms of nine tagging SNPs of the MyD88 and TICAM1 genes in 375 children with CAP who attended the Department of Pediatrics of the Second Affiliated Hospital of Yan'an University Medical School from August 2015 to September 2017 and 306 healthy children who underwent physical examination. A logistic regression analysis was used to evaluate the association between the distribution of genotypes and their interactions with CAP in children. Results The polymorphism of the TICAM1 gene at rs11466711T/C locus was closely associated with the susceptibility to CAP in children (P<0.05). The AA genotype of rs35747610G/A locus significantly reduced risk of sepsis in children with CAP (P<0.05). The AA genotype of rs6510826G/A locus was significantly associated with the increase in C-reactive protein level in children with CAP (P<0.05). The GG genotype of the MyD88 gene at rs7744A/G locus significantly increased the risk of respiratory failure and circulatory failure (P<0.05). The multiplicative interactions between MyD88 gene rs7744A/G and TICAM1 gene rs11466711T/C, rs2292151G/A, rs35299700C/T, and rs35747610G/A loci were significantly associated with the susceptibility to CAP, the severity of CAP, and the risk of sepsis in children (P<0.05). Conclusions The gene polymorphisms of MyD88 and TICAM1 and their interactions are closely associated with CAP in children, with a synergistic effect on the development and progression of CAP in children.

Key words： Community-acquired pneumonia MyD88 TICAM1 Gene polymorphism Child

收稿日期: 2023-03-13

基金资助:陕西省榆林市科学技术研究与发展项目（2014yyws-07）。

通讯作者: 刘俐，女，教授。Email：liuli918@163.com。 E-mail: liuli918@163.com

作者简介: 杨勇，男，博士，主任医师。现工作单位为西安市儿童医院；

引用本文:

杨勇,杨绥宇,陈宗波等. MyD88和TICAM1基因多态性及其交互作用与儿童社区获得性肺炎的关联研究[J]. 中国当代儿科杂志, 2023, 25(8): 791-799.

YANG Yong,YANG Sui-Yu,CHEN Zong-Bo et al. Association of gene polymorphisms of MyD88 and TICAM1 and their interactions with community-acquired pneumonia in children[J]. CJCP, 2023, 25(8): 791-799.

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