Genetic polymorphism in postoperative sepsis after open heart surgery in infants

Asian Cardiovasc Thorac Ann. 2016 May;24(4):326-31. doi: 10.1177/0218492316640128. Epub 2016 Mar 21.

Abstract

Background: Sepsis is one of the complications following open heart surgery. Toll-like receptor 2 and toll-interacting protein polymorphism influence the immune response after open heart surgery. This study aimed to assess the genetic distribution of toll-like receptor 2 N199N and toll-interacting protein rs5743867 polymorphism in the development of postoperative sepsis.

Methods: A prospective cohort study was conducted in 108 children <1-year old who underwent open heart surgery with a Basic Aristotle score ≥6. Patients with an accompanying congenital anomaly, human immunodeficiency virus infection, or history of previous open heart surgery were excluded. The patients' nutritional status and genetic polymorphism were assessed prior to surgery. The results of genetic polymorphism were obtained through genotyping. Patients' ages on the day of surgery and cardiopulmonary bypass times were recorded. The diagnosis of sepsis was established according to Surviving Sepsis Campaign criteria.

Results: Postoperative sepsis was observed in 21% of patients. There were 92.6% patients with toll-like receptor 2 N199N polymorphism and 52.8% with toll-interacting protein rs5743867 polymorphism.

Conclusions: Toll-like receptor 2 N199N polymorphism tends to increase the risk of sepsis (odds ratio = 1.974; 95% confidence interval: 0.23-16.92; p = 0.504), while toll-interacting protein rs5743867 polymorphism tends to decrease the risk of sepsis (odds ratio = 0.496; 95% confidence interval: 0.19-1.27; p = 0.139) in infants <1-year old undergoing complex open heart surgery.

Keywords: Genetic predisposition to disease; Immune system; Infant; Sepsis; TOLLIP protein; Toll-like receptor 2; human.

MeSH terms

  • Age Factors
  • Cardiac Surgical Procedures / adverse effects*
  • Cardiopulmonary Bypass / adverse effects
  • Chi-Square Distribution
  • Female
  • Genetic Association Studies
  • Genetic Predisposition to Disease
  • Humans
  • Infant
  • Infant, Newborn
  • Intracellular Signaling Peptides and Proteins / genetics*
  • Male
  • Odds Ratio
  • Phenotype
  • Polymorphism, Single Nucleotide*
  • Prospective Studies
  • Protective Factors
  • Risk Assessment
  • Risk Factors
  • Sepsis / diagnosis
  • Sepsis / genetics*
  • Sepsis / immunology
  • Toll-Like Receptor 2 / genetics*
  • Treatment Outcome

Substances

  • Intracellular Signaling Peptides and Proteins
  • TLR2 protein, human
  • TOLLIP protein, human
  • Toll-Like Receptor 2