Racial variation in toll-like receptor variants among women with pelvic inflammatory disease

J Infect Dis. 2013 Mar 15;207(6):940-6. doi: 10.1093/infdis/jis922. Epub 2012 Dec 18.

Abstract

Background: Racial disparities exist in gynecological diseases. Variations in Toll-like receptor (TLR) genes may alter signaling following microbial recognition.

Methods: We explored genotypic differences in 6 functional variants in 4 TLR genes (TLR1, TLR2, TLR4, TLR6) and the adaptor molecule TIRAP between 205 African American women and 51 white women with clinically suspected pelvic inflammatory disease (PID). A permutated P < .007 was used to assess significance. Associations between race and endometritis and/or upper genital tract infection (UGTI) were explored. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

Results: The TT genotype for TLR1 rs5743618, the GG genotype for TLR1 rs4833095, the CC genotype for TLR2 rs3804099, the TLR6 rs5743810 T allele, and the CC genotype for TIRAP rs8177374 significantly differed between races (P < .007). African American race was associated with endometritis and/or UGTI (OR, 4.2 [95% CI, 2.0-8.7]; P = .01). Among African Americans, the TLR6 rs5743810 T allele significantly decreased endometritis and/or UGTI (OR, 0.4 [95% CI, .2-.9]; P = .04). Additionally, rs5743618, rs4833095, and rs8177374 increased endometritis and/or UGTI, albeit not significantly.

Conclusions: Among women with PID, TLR variants that increase inflammation are associated with African American race and may mediate the relationship between race and endometritis and/or UGTI.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Black or African American / genetics*
  • Chlamydia Infections / ethnology
  • Chlamydia Infections / genetics
  • Chlamydia trachomatis
  • Confidence Intervals
  • Endometritis / ethnology
  • Endometritis / genetics
  • Female
  • Genotype
  • Gonorrhea / ethnology
  • Gonorrhea / genetics
  • Humans
  • Logistic Models
  • Membrane Glycoproteins / genetics*
  • Mycoplasma Infections / ethnology
  • Mycoplasma Infections / genetics
  • Mycoplasma genitalium
  • Odds Ratio
  • Pelvic Inflammatory Disease / ethnology*
  • Pelvic Inflammatory Disease / genetics*
  • Polymorphism, Single Nucleotide
  • Receptors, Interleukin-1 / genetics*
  • Reproductive Tract Infections / ethnology
  • Reproductive Tract Infections / genetics
  • Signal Transduction / genetics
  • Toll-Like Receptors / genetics*
  • White People / genetics*
  • Young Adult

Substances

  • Membrane Glycoproteins
  • Receptors, Interleukin-1
  • TIRAP protein, human
  • Toll-Like Receptors