TY - JOUR
T1 - Association between surfactant protein B + 1580 polymorphism and the risk of respiratory failure in adults with community-acquired pneumonia
AU - Quasney, Michael W.
AU - Waterer, Grant W.
AU - Dahmer, Mary K.
AU - Kron, Grace K.
AU - Zhang, Qing
AU - Kessler, Lori A.
AU - Wunderink, Richard G.
PY - 2004/5/1
Y1 - 2004/5/1
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 ≥18 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 T/T 183 of 402 (0.45), T/C 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 T/C 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 T/T (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 ≥18 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 T/T 183 of 402 (0.45), T/C 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 T/C 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 T/T (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.
KW - Acute respiratory distress syndrome
KW - Pneumonia
KW - Polymorphism
KW - Racial differences
KW - Respiratory failure
KW - Sepsis
KW - Surfactant protein B
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U2 - 10.1097/01.CCM.0000124872.55243.5A
DO - 10.1097/01.CCM.0000124872.55243.5A
M3 - Article
C2 - 15190959
AN - SCOPUS:2442508997
VL - 32
SP - 1115
EP - 1119
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 5
ER -