Published online Jan 27, 2018. doi: 10.4254/wjh.v10.i1.124
Peer-review started: November 17, 2017
First decision: December 1, 2017
Revised: December 16, 2017
Accepted: December 29, 2017
Article in press: December 29, 2017
Published online: January 27, 2018
Toll-like receptor (TLR) 4 genetic polymorphisms, particularly D299G, have been previously associated with an increased predisposition to infection in several populations. However, few data regarding the role of these polymorphisms in patients with cirrhosis are available.
Few data regarding the role of TLR4 genetic polymorphisms in patients with cirrhosis are available
The aim of this study was to prospectively assess the relationship between the presence of D299G and/or T399I TLR4 polymorphisms and the incidence of bacterial infections in cirrhotic patients with ascites.
The present study was designed to confirm the previous retrospective data and to further explore the relationship between the presence of TLR4 polymorphisms and bacterial infections in cirrhotic patients with ascites. The authors included consecutive patients with cirrhosis and ascites hospitalized during a 6-year period. The presence of D299G and/or T399I TLR4 polymorphisms was determined by sequencing and related to the incidence of infections during follow-up.
The authors included 258 patients: 28 (10.8%) were carriers of D299G and/or T399I TLR4 polymorphisms (polymorphism group) and 230 patients were not (wild-type group). The probability of developing any bacterial infection at one-year follow-up was 78% in the polymorphism group and 69% in the wild-type group (P = 0.54). The one-year probability of presenting infections caused by gram-negative bacilli (51% vs 44%, P = 0.68), infections caused by gram-positive cocci (49% vs 40%, P = 0.53), and spontaneous bacterial peritonitis (29% vs 34%, respectively, P = 0.99) did not differ between the two groups. The one-year probability of transplant-free survival was 55% in the polymorphism group and 66% in the wild-type group (P = 0.15).
The presence of the genetic polymorphisms D299G and/or T399I of TLR4 does not seem to play a relevant role in the predisposition of cirrhotic patients with ascites to develop bacterial infections.
To study the potential role of other genetic polymorphisms in the susceptibility to infections and the evolution of patients with cirrhosis.