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Lung India. 2019 Jul-Aug;36(4):319-323. doi: 10.4103/lungindia.lungindia_355_18.

Prognostic influence of toll-like receptor 4 gene polymorphism into community-acquired pneumonia course among young patients with cytomegalovirus persistence.

Author information

1
Department of Infectious Diseases, National Pirogov Memorial Medical University, Vinnytsia, Ukraine.
2
Department of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsia, Ukraine.
3
Department of Paediatric, National Pirogov Memorial Medical University, Vinnytsia, Ukraine.

Abstract

Objectives:

The aim of this study was to determine the predictive role of TLR4 polymorphism in CAP course among young cytomegalovirus-positive patients.

Subjects and Methods:

One hundred and five patients with pneumonia (age range: 18-44 years) and 61 healthy respondents were observed clinically and specifically (by cytomegalovirus markers and TLR4 + 3725 G/C polymorphism).

Results:

Among CAP patients, there were 51 male (48.6%) and 54 female (51.4%), with average age 34.1 ± 0.8 years, and there were 19 (18.1%) patients with Pneumonia Patient Outcomes Research Team (PORT) I, 46 (43.8%) patients with PORT II, 31 (29.5%) patients with PORT III, and 9 (8.6%) patients with PORT IV. Cytomegalovirus persistence was detected in 80 (48.2%) patients and 34 (20.5%) healthy respondents (P = 0.003). G/G genotype of TLR4 signaling was found in 78 (74%) patients with pneumonia, G/C in 24 (23%) patients, and C/C in 3 (3%) patients. Among G/C patients, there were 16.2% cytomegalovirus-positive patients versus 6.7% negative patients (P < 0.05), as well as among G/G patients, and there were 59% versus 15,2%, accordingly (P < 0.01). The patients of the main group with G/G genotype were characterized by mostly mild (PORT I - 15 [14.3%]) and moderate pneumonia severity (PORT II - 32 [30.5%] and PORT III - 26 [24.8%] patients). The patients with G/C genotype were characterized by mostly PORT II (11 [10.5%] patients). All C/C genotype patients have PORT II (P < 0.05).

Conclusions:

Cytomegalovirus persistence worsens the pneumonia course. G/G and G/C TLR4 genotypes are associated with mild pneumonia severity.

KEYWORDS:

Community-acquired pneumonia; TLR4; cytomegalovirus persistence; risk class

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