Toll-like receptor 4 polymorphisms are associated with resistance to Legionnaires' disease

Thomas R. Hawn, Annelies Verbon, Marta Janer, Lue Ping Zhao, Bruce Beutler, Alan Aderem

Research output: Contribution to journalArticle

141 Citations (Scopus)

Abstract

The immunogenetic factors that influence susceptibility to pneumonia are poorly understood. Recent studies suggest an association of toll-like receptor 4 (TLR4) polymorphisms with increased susceptibility to some infections. Here, we examined whether polymorphisms in TLR4 influence susceptibility to Legionnaires' disease (LD) by using a case-control study to compare the allele frequencies of two SNPs (A896G and C1196T). Cases (n = 108) were obtained from a LD outbreak in The Netherlands in 1999. Controls were exposed at the same outbreak, did not develop pneumonia, and were either unmatched (n = 421) or matched (n = 89) to patients for age, sex, and geographic residence. Allele 896G was associated with LD susceptibility with a frequency of 6.5% in the combined control group (matched and unmatched) vs. 2.5% in patients [odds ratio (OR) of 0.36, 95% confidence interval (C.I.) 0.14-0.91, P = 0.025]. In the matched control group comparison, allele 896G also showed a protective association with an OR of 0.27 (95% C.I. 0.09-0.75, P = 0.008). An analysis of genotype frequencies (896 AA vs. AG and GG) demonstrated similar protective associations (patient vs. combined control group comparison, OR = 0.35, 95% C.I. 0.14-0.89, P = 0.02; matched control group comparison, OR = 0.25, 95% C.I. 0.09-0.71, P = 0.006). Allele 1196T cosegregated with allele 896G and, thus, had identical associations. Although previous studies suggest that these TLR4 SNPs are associated with an increased risk of infection, this study demonstrates an association with resistance. This protective association illustrates that an innate immune receptor can mediate either beneficial or deleterious inflammatory responses and that these outcomes vary with different pathogens.

Original languageEnglish (US)
Pages (from-to)2487-2489
Number of pages3
JournalProceedings of the National Academy of Sciences of the United States of America
Volume102
Issue number7
DOIs
StatePublished - Feb 15 2005

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Legionnaires' Disease
Toll-Like Receptor 4
Alleles
Odds Ratio
Confidence Intervals
Control Groups
Single Nucleotide Polymorphism
Disease Outbreaks
Pneumonia
Research Design
Immunogenetics
Disease Susceptibility
Infection
Gene Frequency
Netherlands
Case-Control Studies
Genotype

Keywords

  • Genetic markers
  • Immunity
  • Inflammation

ASJC Scopus subject areas

  • Genetics
  • General

Cite this

Toll-like receptor 4 polymorphisms are associated with resistance to Legionnaires' disease. / Hawn, Thomas R.; Verbon, Annelies; Janer, Marta; Zhao, Lue Ping; Beutler, Bruce; Aderem, Alan.

In: Proceedings of the National Academy of Sciences of the United States of America, Vol. 102, No. 7, 15.02.2005, p. 2487-2489.

Research output: Contribution to journalArticle

Hawn, Thomas R. ; Verbon, Annelies ; Janer, Marta ; Zhao, Lue Ping ; Beutler, Bruce ; Aderem, Alan. / Toll-like receptor 4 polymorphisms are associated with resistance to Legionnaires' disease. In: Proceedings of the National Academy of Sciences of the United States of America. 2005 ; Vol. 102, No. 7. pp. 2487-2489.
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abstract = "The immunogenetic factors that influence susceptibility to pneumonia are poorly understood. Recent studies suggest an association of toll-like receptor 4 (TLR4) polymorphisms with increased susceptibility to some infections. Here, we examined whether polymorphisms in TLR4 influence susceptibility to Legionnaires' disease (LD) by using a case-control study to compare the allele frequencies of two SNPs (A896G and C1196T). Cases (n = 108) were obtained from a LD outbreak in The Netherlands in 1999. Controls were exposed at the same outbreak, did not develop pneumonia, and were either unmatched (n = 421) or matched (n = 89) to patients for age, sex, and geographic residence. Allele 896G was associated with LD susceptibility with a frequency of 6.5{\%} in the combined control group (matched and unmatched) vs. 2.5{\%} in patients [odds ratio (OR) of 0.36, 95{\%} confidence interval (C.I.) 0.14-0.91, P = 0.025]. In the matched control group comparison, allele 896G also showed a protective association with an OR of 0.27 (95{\%} C.I. 0.09-0.75, P = 0.008). An analysis of genotype frequencies (896 AA vs. AG and GG) demonstrated similar protective associations (patient vs. combined control group comparison, OR = 0.35, 95{\%} C.I. 0.14-0.89, P = 0.02; matched control group comparison, OR = 0.25, 95{\%} C.I. 0.09-0.71, P = 0.006). Allele 1196T cosegregated with allele 896G and, thus, had identical associations. Although previous studies suggest that these TLR4 SNPs are associated with an increased risk of infection, this study demonstrates an association with resistance. This protective association illustrates that an innate immune receptor can mediate either beneficial or deleterious inflammatory responses and that these outcomes vary with different pathogens.",
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AU - Aderem, Alan

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AB - The immunogenetic factors that influence susceptibility to pneumonia are poorly understood. Recent studies suggest an association of toll-like receptor 4 (TLR4) polymorphisms with increased susceptibility to some infections. Here, we examined whether polymorphisms in TLR4 influence susceptibility to Legionnaires' disease (LD) by using a case-control study to compare the allele frequencies of two SNPs (A896G and C1196T). Cases (n = 108) were obtained from a LD outbreak in The Netherlands in 1999. Controls were exposed at the same outbreak, did not develop pneumonia, and were either unmatched (n = 421) or matched (n = 89) to patients for age, sex, and geographic residence. Allele 896G was associated with LD susceptibility with a frequency of 6.5% in the combined control group (matched and unmatched) vs. 2.5% in patients [odds ratio (OR) of 0.36, 95% confidence interval (C.I.) 0.14-0.91, P = 0.025]. In the matched control group comparison, allele 896G also showed a protective association with an OR of 0.27 (95% C.I. 0.09-0.75, P = 0.008). An analysis of genotype frequencies (896 AA vs. AG and GG) demonstrated similar protective associations (patient vs. combined control group comparison, OR = 0.35, 95% C.I. 0.14-0.89, P = 0.02; matched control group comparison, OR = 0.25, 95% C.I. 0.09-0.71, P = 0.006). Allele 1196T cosegregated with allele 896G and, thus, had identical associations. Although previous studies suggest that these TLR4 SNPs are associated with an increased risk of infection, this study demonstrates an association with resistance. This protective association illustrates that an innate immune receptor can mediate either beneficial or deleterious inflammatory responses and that these outcomes vary with different pathogens.

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