TY - JOUR
T1 - Association between surfactant protein B + 1580 polymorphism and the risk of respiratory failure in adults with community-acquired pneumonia
AU - Quasney, M.W.
AU - Waterer, Grant
AU - Dahmer, M.K.
AU - Kron, G.K.
AU - Zhang, Q.
AU - Kessler, L.A.
AU - Wunderink, R.G.
PY - 2004
Y1 - 2004
N2 - Objective: Pulmonary surfactant protein (SP)-B plays a vital role in the formation and function of surfactant in the lung. A genetic polymorphism (SP-B + 1580) is postulated to result in diminished activity of SP-B. The objective was to determine whether the SP-B + 1580 CC genotype is associated with an increased risk of respiratory failure and ARDS in adults with community-acquired pneumonia.Design: Prospective cohort of adults diagnosed with community-acquired pneumonia.Setting: Hospital system.Patients: We enrolled 402 adults greater than or equal to18 yrs of age with community-acquired pneumonia; 158 were white, 243 were African American, and one was Asian.Interventions: Genotypic analysis was performed on DNA isolated from whole blood using polymerase chain reaction amplification and Ddel restriction enzyme digestion.Measurements and Main Results: We recorded the requirement for mechanical ventilation, the presence of acute respiratory distress syndrome (ARDS) or septic shock, and mortality. Sixty-three patients required mechanical ventilation, 12 patients developed ARDS, and 35 patients developed septic shock. Genotypic frequencies at the SP-B + 1580 site were TIT 183 of 402 (0.45), TIC 160 of 402 (0.40), and C/C 59 of 402 (0.15). Of the 59 patients who were C/C at the SP-B + 1580 site, 21 (0.356) required mechanical ventilation, compared with 26 of 160 patients (0.163) who were T/C and 16 of 183 (0.087) patients who were T/T (p < .001). ARDS developed in five of 59 (0.085) patients with the C/C genotype, compared with six of 160 (.038) patients with TIC and one of 183 patients with T/T (0.005, p < .009). Septic shock occurred in 12 of 59 (0.203) patients with the C/C genotype, compared with 13 of 160 (0.081) patients with T/C and ten of 183 (0.055) patients with TIT (p < .001). Mortality rate was not different between the three genotypes.Conclusion: Carriage of the C allele at the SP-B + 1580 site is associated with ARDS, septic shock, and the need for mechanical ventilation in adults with community-acquired pneumonia.
AB - Objective: Pulmonary surfactant protein (SP)-B plays a vital role in the formation and function of surfactant in the lung. A genetic polymorphism (SP-B + 1580) is postulated to result in diminished activity of SP-B. The objective was to determine whether the SP-B + 1580 CC genotype is associated with an increased risk of respiratory failure and ARDS in adults with community-acquired pneumonia.Design: Prospective cohort of adults diagnosed with community-acquired pneumonia.Setting: Hospital system.Patients: We enrolled 402 adults greater than or equal to18 yrs of age with community-acquired pneumonia; 158 were white, 243 were African American, and one was Asian.Interventions: Genotypic analysis was performed on DNA isolated from whole blood using polymerase chain reaction amplification and Ddel restriction enzyme digestion.Measurements and Main Results: We recorded the requirement for mechanical ventilation, the presence of acute respiratory distress syndrome (ARDS) or septic shock, and mortality. Sixty-three patients required mechanical ventilation, 12 patients developed ARDS, and 35 patients developed septic shock. Genotypic frequencies at the SP-B + 1580 site were TIT 183 of 402 (0.45), TIC 160 of 402 (0.40), and C/C 59 of 402 (0.15). Of the 59 patients who were C/C at the SP-B + 1580 site, 21 (0.356) required mechanical ventilation, compared with 26 of 160 patients (0.163) who were T/C and 16 of 183 (0.087) patients who were T/T (p < .001). ARDS developed in five of 59 (0.085) patients with the C/C genotype, compared with six of 160 (.038) patients with TIC and one of 183 patients with T/T (0.005, p < .009). Septic shock occurred in 12 of 59 (0.203) patients with the C/C genotype, compared with 13 of 160 (0.081) patients with T/C and ten of 183 (0.055) patients with TIT (p < .001). Mortality rate was not different between the three genotypes.Conclusion: Carriage of the C allele at the SP-B + 1580 site is associated with ARDS, septic shock, and the need for mechanical ventilation in adults with community-acquired pneumonia.
U2 - 10.1097/01.CCM.0000124872.55243.5A
DO - 10.1097/01.CCM.0000124872.55243.5A
M3 - Article
SN - 0090-3493
VL - 32
SP - 1115
EP - 1119
JO - Critical Care Medicine
JF - Critical Care Medicine
IS - 5
ER -