Associations of Toll-like Receptor Gene Polymorphisms with NETosis Activity as Prognostic Criteria for the Severity of Pneumonia

The aim of the study was to determine the molecular genetic prognostic criteria for the severity of the course pneumonia based on the analysis of the association of genetic polymorphism in toll-like receptors with the severity of NETosis. Materials and Methods. The study included 38 patients with the main diagnosis of community-acquired pneumonia with a severe course. All the patients underwent standard clinical laboratory examinations, computed tomography of the thoracic organs, microbiological examination of blood and tracheobronchial aspirate. The level of neutrophilic extracellular traps (NETs) in blood smears was determined on the 1st-2nd and 5th-7th days of hospitalization. Genotyping of rs5743551 (TLR1), rs5743708 (TLR2), and rs4986790 (TLR4) polymorphic loci was performed by pyrosequencing. Results. The level of NETs on the 1st day of admission was statistically significantly lower in heterozygous and homozygous carriers of rs4986790 (TLR4) polymorphism (AG and GG genotypes) compared with patients with the wild-type genotype (AA genotype) (p<0.05). When comparing the number of NETs with genotypes for rs5743708 (TLR2) and rs5743551 (TLR1) polymorphisms, no statistically significant correlation was found (p>0.05). The study of the NET level in dynamics demonstrated a decrease in the NETosis activity of neutrophils during the first week of hospitalization (p< 0.05). The presence of the G allele in the patient's genotype for rs5743551 (TLR1) polymorphism increases the risk of a poor outcome of the disease (p<0.0001) (OR=20.3; 95% CI (4.3-135.0)). Conclusion. The obtained data suggest that level of NETs is a marker of the activity of neutrophils which are closely related to the studied genetic polymorphisms, and affects the prognosis of the pneumonia outcome.

Karnaushkina M.A. 1 , Guryev A.S.2 , Mironov K.O. 3 , Dunaeva E.A. 3 , Korchagin V.I.3 , Bobkova O.Y.4 , Vasilyeva I.S.4 , Kassina D.V.2 , Litvinova M.M. 5, 6
Nizhny Novgorod State Medical Academy
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  • 1 Peoples Friendship Univ Russia, Dept Internal Dis Course Cardiol & Funct Diagnost, 6 Miklukho Maklaya St, Moscow 117198, Russia
  • 2 Moscow Reg Res Clin Inst, Res Lab, 61-2-1 Schepkina St, Moscow 129110, Russia
  • 3 Cent Res Inst Epidemiol Fed Serv Consumer Rights, Res Grp Dev New Methods Identifying Genet Polymor, 3a Novogireevskaya St, Moscow 111123, Russia
  • 4 IM Sechenov First Moscow State Med Univ, Sechenov Univ, Dept Hosp Therapy 2, 8-2 Trubetskaya St, Moscow 119991, Russia
  • 5 IM Sechenov First Moscow State Med Univ, Sechenov Univ, Dept Med Genet, 8-2 Trubetskaya St, Moscow 119991, Russia
  • 6 Moscow Clin Sci Ctr, Moscow Healthcare Dept, Ctr Personalized Med, 86 Shosse Entuziastov, Moscow 111123, Russia
Ключевые слова
gene polymorphism; TLR1; TLR2; TLR4; neutrophilic extracellular traps; pneumonia
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