The Influences of CD14 −260C>T Polymorphism on Survival in ICU Critically Ill Patients

Abstract

In order to analyze the effect of the two different versions of the cluster of differentiation 14 (CD14) receptor recognizing gene on survival, we determined the −260C>T single nucleotide polymorphism (SNP) frequencies in 514 critically ill patients. We compared the −260TT homozygotes with −260C allele carriers (−260CC and −260CT genotypes) and we demonstrated—260TT patients had the highest survival rate (82% vs 64%; p < 0.001; OR = 2.52, 95% CI = 1.43–4.46). We performed binary logistic regression, incorporating both −260C>T genotype groups and the main clinical predictors to exclude other risk factors that could influence the outcome from critical illness: higher age, APACHE II score, and length of stay at hospital, and the occurrence of sepsis and septic shock were risk factors to Intensive Care Unit (ICU) patient's mortality, but the −260TT genotype was protective factor toward survival (p = 0.001; OR = 3.08 95%CI = 1.54–5.98). Among septic and septic shock patients, −260TT genotype was also protective factor toward survival (p = 0.001; OR = 3.11 95%CI = 1.63–6.66 to septic patients, and p = 0.001; OR = 3.80 95%CI = 1.68–8.58 to patients with septic shock). Our results and our hypothesis suggest that the higher −260TT genotype frequency in ICU survivor patients is possibly explained by a beneficial effect on innate immunity signaling.

Keywords:

• CD14
• Polymorphism
• Sepsis
• Intensive Care Units
• Longevity
• Mortality

ACKNOWLEDGMENTS

We thank L.B. Miranda, C.B.C. Bonorino, and M.P. Garrido for their suggestions and L.R. Fraga, for technical assistance. This study was financed by Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq (process # 505536/2002-8), the Programa de Bolsa Pesquisa para Alunos da Graduação – Edital BPA PUCRS 2007–2008, and Faculdade de Biociências, PUCRS. The study is part of the Doctor's Degree thesis of the first author who had a fellowship from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – CAPES, Brazil.

Financial Support Used for the Study, Including any Institutional Departmental Funds:

This study was financed by Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq (process# 505536/2002-8), the Programa de Bolsa Pesquisa para Alunos da Graduação – Edital BPA PUCRS 2007-2008, Faculdade de Biociências – PUCRS, and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – CAPES, Brazil.