NRAMP1基因多态性与结核易感性关系的Meta分析

[目的]应用Meta分析探讨NRAMP1基因3'UTR,D543N和INT4多态性位点与结核易感性的关系。[方法]在CNKI、CBM、万方数据资源系统、Medline和Pubmed中,应用关键词"结核"、"基因多态性"(或"遗传多态性")、"等位基因"、"NRAMP1"、"tuberculosis"或"alleles"搜索1980年1月～2007年11月发表的相关中英文文献,最终入选有关文献16篇。应用RevMan4.2软件包分别对16项研究结果进行数据分析。[结果]Meta分析计算得出合并OR值(95%CI)TGTG+-/++为1.50(1.29～1.75),TGTG——/++为0.89(0.59～1.34),GA/GG为1.39(1.20～1.61),AA/GG为1.07(0.69～1.67),GC/GG为1.30(1.09～1.56),CC/GG为1.64(0.90～3.00)。计算3'UTR、D543N和INT4基因的失安全系数为193.87、325.08和157.87,说明分析结果是可靠的。[结论]NRAMP1基因3'UTR(TGTG+-)和D543N(GA)多态性位点均可能是结核的易感因素,尚不能认为INT4多态性位点与结核易感性有关。     

自然抗性相关巨噬细胞蛋白1基因多态性与肺结核易感性的研究

目的　探讨自然抗性相关巨噬细胞蛋白 1基因 (NRAMP1)多态性与中国汉族人群肺结核发病的关系。方法　采用以医院为基础的病例对照研究设计 ,用聚合酶链反应 限制性片段长度多态性分析 (PCR RFLP)法检测NRAMP1基因中INT4、D5 4 3N及 3′UTR 3个多态性位点的基因型 ,并对结核病相关危险因素进行问卷调查 ,应用SPSS软件进行单因素和多因素非条件logistic回归分析。2 0 0 1年 4月至 2 0 0 2年 6月选择 110例肺结核病例 ,平均年龄为 (2 8± 13)岁 ;对照组为 180名健康体检者 ,平均年龄为 (2 7± 9)岁。对NRAMP1基因各多态性位点进行单因素分析。结果　病例组D5 4 3NG/A及 3′UTRTGTG +/del基因型频率显著高于对照组 ,OR值 (95 %CI)分别为 2 2 2 (1 0 3～ 4 78)和 1 93(1 14～ 3 2 6 )。病例组和对照INT4各基因型频率比较差异无显著性。多因素分析调整暴露史和疫苗接种史 2个因素后 ,D5 4 3NG/A及 3′UTRTGTG +/del基因型仍与结核病显著相关 ,调整OR值 (95 %CI)分别为 3 0 4 (1 12～ 8 2 7)和 2 36 (1 2 0～ 4 6 4 ) ,而病例和对照组INT4位点多态性比较差异未见显著性。结论　NRAMP1基因D5 4 3N及 3′UTR位点多态性可能是汉族人群肺结核的易感因素。     

NRAMP1基因INT4和3’UTR位点多态性与肺结核易感性的研究

目的 探讨人类自然抵抗相关巨噬细胞蛋白1（NRAMP1）基因INT4和3＇UTR位点多态性与中国北方汉族成人肺结核发病的关系.方法 采用1：1配对的病例对照研究设计,用聚合酶链反应-限制性片段长度多态性分析方法检测NRAMP1基因中INT4和3＇UTR两个多态性位点,对与肺结核相关的危险因素进行问卷调查,进行单因素和多因素条件logistic回归分析,同时对基因型与肺结核病变的性质和程度进行研究.结果 对124对研究对象进行了INT4和3＇UTR两个多态性位点的基因分型,3＇UTR TGTG＋/del基因型病例组频率显著高于对照组,粗OR值（95%CI）为2.923（1.557～5.487）.病例组和对照组INT4各基因型频率比较差异均无统计学意义.对17个环境危险因素进行了单因素分析,在多因素分析中调整卡痕、体重指数、人均居住面积、家族史4个因素后,3＇UTR TGTG＋/del基因型仍与肺结核显著相关,调整OR值（95%CI）为2.955（1.369～6.381）.在INT4不同基因型中,病例组和对照组肺结核病变性质差异具有统计学意义（x2=9.634,P＜0.05）.结论 NRAMP1基因3＇UTR位点多态性可能是中国北方汉族成人肺结核的易感因素,而INT4多态性可能与肺结核的病变性质有关系.     

人类NRAMP1基因单核苷酸多态与接尘工人肺结核易感性

目的 探讨人类自然抵抗相关巨噬细胞蛋白1（NRAMP1）基因多态性与接尘工人肺结核易感性的关系.方法 采用1：2病例对照设计,按年龄相差小于5岁,工种、吸烟、饮酒率、总粉尘接触量和矽肺患病同比例匹配,选择61例男性肺结核患者为病例组（矽肺50例、非矽肺11例）,122例男性无肺结核者为对照组（矽肺100例、非矽肺22例）.应用聚合酶链反应-限制性片段长度多态性分析（PCR-RFLP）技术检测NRAMP1 INT4和D543N位点的多态性.结果 NRAMP1 INT4多态位点野生纯合子（G/G）、杂合子（G/C）和突变纯合子（C/C）在病例组的分布频率分别为63.9%、34.4%、1.6%,与对照组比较,差异有统计学意义（P＜0.05）,NRAMP1 INT4 C等位基因携带者患肺结核的危险性升高（OR=2.73,95% CI：1.32～5.64）,D543N位点多态与接尘工人肺结核易感性之间无关联（P＞0.05）.结论 NRAMP1基因第4内含子G＞C单核苷酸可能是接尘工人肺结核的易感因素.     

NRAMP1基因和人类对结核分枝杆菌的易感性

NRAMP1基因,又称SLC11A1基因,位于2号染色体长臂35区(2q35),包括15个外显子及内含子4中交替出现的1个外显子,长13 604 bp.NRAMP1的常见多态性基因有D543N、3′UTR、INT4和5′(GT)n等,和结核易感性相关.NRAMP1蛋白由巨噬细胞表达,是一种H+/二价阳离子的反向转运体,对巨噬细胞的功能有多效性.此文对NRAMP1基因及其和MTB的易感相关性的研究结果进行综述.     

NRAMP1基因D543N和3''''UTR位点多态性与肺结核易感性的研究

目的探讨人类自然抵抗相关巨噬细胞蛋白1(NRAMP1)基因D543N和3'UTR位点多态性与我国北方汉族成人肺结核发病的关系.方法采用11配对的病例对照研究设计,用聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)的方法检测NRAMP1基因中D543N和3'UTR两个多态性位点,对与肺结核相关的环境因素进行问卷调查的同时对肺结核病变的性质和程度进行了研究,应用SPSS软件进行单因素和多因素条件Logistic回归分析.结果对124对研究对象进行了D543N和3'UTR两个多态性位点的基因分型,D543N G/A、3'UTR TGTG+/del基因型病例组频率显著高于对照组,粗OR值(95%CI)分别为2.625(1.123～6.134)、2.733(1.513～4.938).对17个环境危险因素进行了单因素分析,多因素分析中在调整卡痕、婚姻状况、体质指数、接触史4个因素后,D543N G/A、3'UTR TGTG+/del基因型仍与肺结核显著相关,调整OR值(95%CI)分别为3.151(1.225～8.105)和3.306(1.517～7.201).研究未发现,在不同基因型中,病例和对照组肺结核病变性质差异具有显著性.结论 NRAMP1基因D543N、3'UTR位点多态性可能是我国北方汉族成人肺结核的易感因素.     

5,10-亚甲基四氢叶酸还原酶基因多态性与结直肠癌易感性关系的Meta分析

目的探讨5,10-亚甲基四氢叶酸还原酶（MTHFR）基因多态性与结直肠癌易感性的关系，方法以结直肠癌组和健康对照组基因型分布的OR值为效应指标,全面检索相关文献,纳入符合入选标准的文献,应用REVMAN4，2软件对各研究结果进行异质性检验和效应值合并,并进行发表偏倚评估和敏感性分析，结果纳入677位点相关文献18篇,1 298位点9篇,两位点的各研究结果均无统计学意义,677位点TT/（CT＋CC）合并OR值为0，80（95%CI 0，74～0，87）,1 298位点CC/（AC＋AA）合并OR值为0，84（95% CI 0，72～0，97）,两位点均不存在显著发表偏倚,敏感性分析提示,677位点结果较稳定,1298位点结果不稳定，结论MTHFR基因多态性的677 TF为结直肠癌的保护因素,1298 CC亦可能与结直肠癌危险性降低有关联。     

NRAMP1基因3'UTR多态性与大理地区彝族肺结核易感相关性研究

目的 探讨NRAMP1基因3'UTR位点多态性与大理彝族肺结核病易感相关性及抗结核疗效的联系。方法 采用PCR - RFLP方法检测102例彝族肺结核病人及108例彝族健康人群的NRAMP1基因3'UTR位点的基因型,分析其与彝族人群患肺结核病的易感相关性,且对病人进行抗结核治疗1月后随访及不良反应观察,分析NRAMP1基因多态性与病人抗结核疗效的关系。结果 病例组中NRAMP1基因3'UTR位点AA基因型频率为20.59%,对照组中为5.55%,组间分布差异有统计学意义,χ2 = 14.135,P＜0.001。具有AA基因型的彝族患者肺结核的OR值为6.250,95% CI为2.404～16.247。抗结核治疗后,各基因型患者间胃肠道反应、肝损害及关节损害不良反应的发生率不同,突变型（GA + AA）患者比野生型（GG型）患者更易发生胃肠道反应、肝损伤、关节损害3种不良反应（P＜0.05）。需临床处理的较重不良反应在突变型（GA + AA）患者及野生型（GG型）患者中无统计学差异（P＞0.05）。结论 NRAMP1基因3'UTR位点多态性与大理彝族人群肺结核的易感性相关,可能是大理地区彝族人群肺结核易感的影响因素。A等位基因可能是大理彝族人群肺结核病发病危险因素（OR = 2.069,95% CI = 1.389～3.082 ）。患者抗结核治疗后发生的不良反应情况与NRAMP1基因3'UTR位点多态性存在相关性。     

CYP1A1基因多态性与女性子宫内膜癌易感性关系的Meta分析

目的综合评价CYP1A1基因多态性与女性子宫内膜癌遗传易感性的关联度。方法通过检索万方、CNKI、维普和PUBMED数据库,获取CYP1A1基因多态性与女性子宫内膜癌易感性关系的病例-对照研究。以子宫内膜癌组与对照组人群基因型分布的OR值为效应指标,采用REVMAN4．2软件进行Meta分析,并根据一致性检验的结果选用合适的模型进行数据的合并。结果入选文献共4篇,其中英文文献1篇,中文文献3篇,累计病例数和对照数分别为908和1585例。CYP1A1CC（纯合子模型）合并后OR值为1．19（95％CI：0．81～1．74）。CYP1A1（杂合子模型）合并后OR值为1．37（95％CI：1．12—1．67）,CYP1A1等位基因C合并后OR值为1．19（95％CI：1．03—1．39）。结论CYP1A1的基因多态性与子宫内膜癌的易感性有关。     

XPC基因启动区单核苷酸多态与肺癌易感性的相关性

[目的]研究DNA修复基因XPC启动区-371和-27位点单核苷酸多态与肺癌易感性的关系。[方法]以401例肺癌患者为病例组，同时以383名年龄性别频数相匹配的非肿瘤患者作为对照组，采用Taqman MGB探针荧光标记的聚合酶链反应方法检测XPC基因启动区G-371A和G-27C的基因型；运用Phase2．0软件构建这两个多态位点的单体型；以比值比（OR）及其95％可信区间（CI）比较不同基因型的肺癌相对危险度。[结果]病例组与对照组间，XPC G-371A等位基因型和G-27C等位基因型分布差异具有显著性（Х^2=4．33，P〈0．05；Х^2=9．84，P〈0．01）。与携带XPC-371GG基因型的个体相比较，携带XPC-371GA＋AA基因型的个体患肺癌的风险明显降低（OR校正=0．69；95％CI：0．51—0．94）；而携带XPC-27GG基因型的个体相比较，XPC-27CG＋CC基因型患肺癌的风险明显增加（OR校正=2．18；95％CI：1．23—3．85）。进一步单体型分析显示，与人群中分布最广泛的GG单体型比较，AG单体型可以降低风险（OR=0．76；95％CI：0．60。0．96；P〈0．05）；GC单体型明显增加患肺癌的风险（OR=2．06；95％CI：1．20—3．54；P〈0．05）。[结论]XPC启动区．27位点CG＋CC基因型和．371位点GA＋AA基因型与中国人群肺癌易感性有关。     

Genetic polymorphisms in alveolar macrophage response-related genes, and risk of silicosis and pulmonary tuberculosis in Chinese iron miners

Alveolar macrophages (AMs) play a prominent role in influencing the development of lung inflammation and injury. The aim of this study is to investigate the roles of AMs response-related genes TNF-alpha, iNOS, and NRAMP1 (SLC11A1) in susceptibility to silicosis and pulmonary tuberculosis (PTB), and to analyze the interaction of dust exposure and genetic susceptibility to silicosis, interactions of TNF-alpha-308 and Natural Resistance-associated Macrophage Protein 1 (NRAMP1) INT4, D543N polymorphisms to PTB. Several epidemiological designs were used: retrospective investigations on dust exposure, case-control studies of 184 silicosis cases and 111 miners occupationally exposed to silica dust, and 1:2 matched case-control studies of 61 PTB cases and 122 PTB-free miners. The miners and controls were recruited from an iron mining operation in Anhui province, China. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was applied to detect single nucleotide polymorphisms. Despite the recruitment of high dust exposure among the controls, silicosis patients still had significantly higher dust exposure than controls (242.6 +/- 98.8 vs. 217.6 +/- 100.7 mg a/m(3)). The mutation of iNOS Ser608Leu is associated with protection against silicosis and against severity of silicosis in the miners. There is a 0.47-fold (95% CI: 0.28-0.79) decrease in risk of silicosis for individuals with C/T, T/T genotype compared with the wild-type homozygous (C/C) individuals after adjustment for occupational exposure, smoking, and drinking. The protection effect of the iNOS polymorphism was particularly detected in the > or = 150 mg a/m(3) exposure group (OR: 0.44, 95% CI: 0.22-0.91). However, no interaction of dust exposure with the iNOS polymorphism was observed. Furthermore, the variant NRAMP1 INT4 genotype is significantly associated with PTB in miners. No association of other polymorphisms (NRAMP1 D543N, TNF-alpha-308) and susceptibility to silicosis or PTB in Chinese miners was found. Our data showed a 3.26-fold (95% CI: 1.47-7.23) increased risk of PTB for miners carrying both the NRAMP1 D543N G/G and NRAMP1 INT4 G/C+C/C genotypes. Additionally, in miners with TNF-alpha-308 G/G genotype, the risk of PTB increased 2.38-fold if they carry the NRAMP1 INT4 G/C+C/C genotype (95% CI: 1.14-4.98). In conclusion, the C>T mutation of iNOS Ser608Leu may be an important protective factor to miners. On the other hand, the variant NRAMP1 INT4 may play a role in the development of PTB in Chinese miners. Therefore, the novel information can be used as guideline for further mechanistic investigations and for strengthening specific protection protocols for workers.     

Association between SLC11A1 polymorphisms and susceptibility to different clinical forms of tuberculosis in the Peruvian population.

Polymorphism in SLC11A1 has been implicated in host susceptibility to tuberculosis. We have studied associations between INT4, D543N, and 3'UTR polymorphisms of SLC11A1 and different clinical forms of TB. Analysis used 507 patients with pulmonary TB, 123 with extra pulmonary TB and 513 controls. INT4 and D543N showed allelic association with pulmonary TB (P=0.02 and 0.03 respectively). INT4-D543N-3'UTR haplotypes showed an association with pulmonary TB (P=0.03). No association of SLC11A1 with miliary TB was observed, and a possible association of D543N to the pleural form (P=0.08) was suggested. These results support association between SLC11A1 and TB, particularly to the common pulmonary form.     

NRAMP1 D543N and INT4 polymorphisms in susceptibility to pulmonary tuberculosis: A meta-analysis

The association of natural resistance associated macrophage protein 1 (NRAMP1) polymorphisms (D543N, INT4) with pulmonary tuberculosis (PTB) risk have been widely reported. However, the findings of previous studies were inconsistent. To clarify the role of these polymorphisms in PTB, we performed a meta-analysis of all available and relevant published studies. Based on comprehensive searches of the PubMed, Medline, Embase, Web of Science, Elsevier Science Direct and Cochrane Library database, we identified outcome data from all articles estimating the association between NRAMP1 polymorphisms and PTB risk. For D543NA/G polymorphism, no associations were found in all genetic models. For INT4C/G polymorphism, significant increased PTB risk was observed in recessive model (CC vs. GC + GG: P = 0.025, OR = 1.35, 95% CI = 1.04–1.75). In the subgroup analysis by ethnicity, significantly increased risk were observed for D543NA/G polymorphism in Americans (GA vs. GG: P = 0.03, OR = 1.31, 95% CI = 1.03–1.67; AA + AG vs. GG: P = 0.032, OR = 1.29, 95% CI = 1.02–1.63). Moreover, the INT4C/G polymorphism was also associated with increased risk of TB for Africans in allele model (A vs. G: P = 0.012, OR = 1.41, 95% CI = 1.08–1.85), heterozygous model (GA vs. GG: P = 0.004, OR = 1.53, 95% CI = 1.14–2.04) and dominant model (AA + AG vs. GG: P = 0.007, OR = 1.49, 95% CI = 1.12–1.98). This meta-analysis provides evidences that INT4C/G was associated with increased susceptibility to pulmonary tuberculosis in overall population in recessive model. D543NA/G polymorphism was associated with PTB increased risk in Americans, while INT4C/G polymorphism in Africans. Further well-designed, large scale studies are required to confirm this conclusion.     

Disparity of risk-adjusted inpatient outcomes among African American and white patients hospitalized with community-acquired pneumonia

The objectives of this study were to examine the associations between inpatient pneumonia outcomes, health care factors, and sociodemographics with an emphasis on race. African American and white patients from the 2008 National Hospital Discharge Survey who were admitted to nonprofit and for-profit hospitals with a principal diagnosis of pneumonia were sampled (n=1924). Three outcomes were measured: length of hospital stay, discharge to home, and deceased at discharge. Length of hospital stay was measured with negative binomial regression including incidence rate ratios (IRRs), while the remaining 2 outcomes were measured with logistic regression including odds ratios (ORs). Patients with longer hospital stays relative to peers were likely older (IRR=1.01, 95% confidence interval [CI]=1.01-1.01, P<0.001) and African American (IRR=1.19, 95% CI=1.10-1.30, P<0.001), but had fewer comorbidities (IRR=0.97, 95% CI=0.94-0.99, P=0.016). Patients were less likely to be discharged to home if they were older (OR=0.96, 95% CI=0.95-0.96, P<0.001), African American (OR=0.68, 95% CI=0.52-0.90, P=0.006), and had government insurance (OR=0.59, 95% CI=0.44-0.79, P<0.001). Patients deceased at discharge were more likely to be older (OR=1.03, 95% CI=1.01-1.05, P=0.001), African American (OR=1.97, 95% CI=1.10-3.53, P=0.023), and to have fewer comorbidities (OR=0.71, 95% CI=0.57-0.88, P=0.002). African Americans with pneumonia experience inequitable inpatient pneumonia-related outcomes relative to whites. Hospital interventions addressing equity are needed.