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Title: The Fcγ receptor IIA-H/H131 genotype is associated with bacteremia in pneumococcal community-acquired pneumonia
Authors: Solé-Violán, Jordi
García-Laorden, M. Isabel
Marcos-Ramos, José Alberto
Rodríguez De Castro, Felipe 
Rajas, Olga
Borderías, Luis
Briones, M. Luisa
Herrera-Ramos, Estefanía
Blanquer, José
Aspa, Javier
Florido, Yanira
García-Bello, Miguel Angel
Ferrer-Agüero, José María
Sologuren, Ithaisa
Rodriguez-Gallego, Carlos 
UNESCO Clasification: 32 Ciencias médicas
320508 Enfermedades pulmonares
320505 Enfermedades infecciosas
Keywords: C-Reactive Protein
Mannose-Binding Lectin
Igg Subclasses
Capsular Polysaccharide, et al
Issue Date: 2011
Journal: Critical Care Medicine 
Abstract: Objective: To assess the potential association of the functional polymorphism rs1801274 in the receptor IIa for the Fc portion of immunoglobin G (Fc gamma RIIa) gene (FCGR2A-H131R) with the susceptibility to and the severity of community-acquired pneumonia (CAP).Design: Multicenter prospective and observational study.Setting: Four university hospitals in Spain.Patients: FCGR2A-H131R polymorphism was determined in 1,262 patients with CAP and in 1,224 in the subject control group.Measurements and Main Results: Severe sepsis was recorded in 366 patients. No significant differences in genotype or allele frequencies were seen among patients with CAP or pneumococcal CAP (PCAP) and controls. Patients with bacteremic PCAP (B-PCAP) had significantly higher frequencies of FCGR2A-H/H131 genotypes than those with nonbacteremic PCAP (p = .00016, odds ratio = 2.9, 95% confidence interval 1.58-5.3). The differences remained significant when adjusting for pneumonia severity index, hospital of origin, and intensive care unit admission (p = .0012, odds ratio = 2.83, 95% confidence interval 1.51-5.32). B-PCAP was associated with a significantly higher severity of the disease, evaluated as sepsis severity (p = .000007, odds ratio = 4.40, 95% confidence interval 2.31-8.39), multiorgan dysfunction syndrome (0.00048, odds ratio = 3.29, 95% confidence interval 1.69-6.41), intensive care unit admission, acute renal failure, and acute respiratory distress syndrome.Conclusions: Our results do not support a role of FCGR2A-H131R polymorphism in susceptibility to CAP or PCAP. However, we provide the insight that homozygosity for FCGR2A-H131 predisposes B-PCAP, which was associated with higher severity in our study.
ISSN: 0090-3493
DOI: 10.1097/CCM.0b013e31820eda74
Source: Critical Care Medicine[ISSN 0090-3493],v. 39, p. 1388-1393
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