Cytokine gene polymorphisms and the outcome of invasive candidiasis: a prospective cohort study.

dc.contributor.author

Johnson, MD

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Plantinga, TS

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van de Vosse, E

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Velez Edwards, DR

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Smith, PB

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Alexander, BD

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Yang, JC

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Kremer, D

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Laird, GM

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Oosting, M

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Joosten, LA

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van der Meer, JW

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van Dissel, JT

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Walsh, TJ

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Perfect, JR

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Kullberg, BJ

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Scott, WK

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Netea, MG

dc.date.accessioned

2022-10-27T16:38:29Z

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2022-10-27T16:38:29Z

dc.date.issued

2012-02

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2022-10-27T16:38:28Z

dc.description.abstract

BACKGROUND:  Candida bloodstream infections cause significant morbidity and mortality among hospitalized patients. Although clinical and microbiological factors affecting prognosis have been identified, the impact of genetic variation in the innate immune responses mediated by cytokines on outcomes of infection remains to be studied. METHODS:  A cohort of 338 candidemia patients and 351 noninfected controls were genotyped for single-nucleotide polymorphisms (SNPs) in 6 cytokine genes (IFNG, IL10, IL12B, IL18, IL1β, IL8) and 1 cytokine receptor gene (IL12RB1). The association of SNPs with both candidemia susceptibility and outcome were assessed. Concentrations of pro- and antiinflammatory cytokines were measured in in vitro peripheral blood mononuclear cell stimulation assays and in serum from infected patients. RESULTS:  None of the cytokine SNPs studied were associated with susceptibility to candidemia. Persistent fungemia occurred in 13% of cases. In the multivariable model, persistent candidemia was significantly associated with (odds ratio [95% confidence interval]): total parenteral nutrition (2.79 [1.26-6.17]), dialysis dependence (3.76 [1.46-8.64]), and the SNPs IL10 rs1800896 (3.45 [1.33-8.93]) and IL12B rs41292470 (5.36 [1.51-19.0]). In vitro production capacity of interleukin-10 and interferon-γ was influenced by these polymorphisms, and significantly lower proinflammatory cytokine concentrations were measured in serum from patients with persistent fungemia. CONCLUSIONS:  Polymorphisms in IL10 and IL12B that result in low production of proinflammatory cytokines are associated with persistent fungemia in candidemia patients. This provides insights for future targeted management strategies for patients with Candida bloodstream infections.

dc.identifier

cir827

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1537-6591

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1537-6591

dc.identifier.uri

https://hdl.handle.net/10161/26106

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English

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Oxford University Press (OUP)

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Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

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10.1093/cid/cir827

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Adult Aged Candidiasis

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Invasive Cells

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Cultured Cohort Studies Cytokines Female Genetic Association Studies Genetic Predisposition to Disease* Humans Leukocytes

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Mononuclear Male Middle Aged Polymorphism

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Single Nucleotide* Prospective Studies Treatment Outcome genetics* immunology immunology* mortality pathology* secretion

dc.title

Cytokine gene polymorphisms and the outcome of invasive candidiasis: a prospective cohort study.

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Journal article

duke.contributor.orcid

Johnson, MD|0000-0002-6606-9460

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Alexander, BD|0000-0001-5868-0529

duke.contributor.orcid

Perfect, JR|0000-0002-6606-9460|0000-0003-3465-5518

pubs.begin-page

502

pubs.end-page

510

pubs.issue

4

pubs.organisational-group

Duke

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School of Medicine

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Molecular Genetics and Microbiology

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Medicine

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Pathology

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Pediatrics

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Medicine, Infectious Diseases

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Pediatrics, Neonatology

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Duke Clinical Research Institute

pubs.publication-status

Published

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54

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