Clinical Relevance of the TLR4 11367 Polymorphism in Patients With Major Trauma | Genetics and Genomics | JAMA Surgery | JAMA Network
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Original Article
December 21, 2009

Clinical Relevance of the TLR4 11367 Polymorphism in Patients With Major Trauma

Author Affiliations

Author Affiliations: State Key Laboratory of Trauma, Burns, and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing (Drs Duan, Gu, Zhang, Huang, Liu, Wang, and Jiang); Chongqing Emergency Medical Center, Chongqing (Drs Du and Hu); Kuming General Hospital of Chengdu Military Command, Yunnan (Dr Hao), China.

Arch Surg. 2009;144(12):1144-1148. doi:10.1001/archsurg.2009.211
Abstract

Objective  To investigate the clinical relevance of the TLR4 11367 polymorphism in patients with major trauma.

Design  Genetic functional and association study.

Setting  Daping Hospital and Chongqing Emergency Medical Center, Chongqing, China.

Patients  A total of 132 patients with major trauma were prospectively recruited.

Main Outcome Measures  The TLR4 11367 polymorphism was genotyped using single-tube, bidirectional, allele-specific amplification method. Whole peripheral blood samples obtained within 24 hours after admission were stimulated with lipopolysaccharide and then tested for production of tumor necrosis factor α and interleukin 6. Sepsis morbidity rate and multiple organ dysfunction scores were assessed.

Results  The 11367 polymorphism was shown to be strongly associated with less capacity of peripheral leukocytes to produce tumor necrosis factor α and interleukin 6 in response to ex vivo lipopolysaccharide stimulation in patients with trauma at admission. Results from association study indicated that patients with trauma who carry the 11367C allele were less likely to have sepsis and multiple organ dysfunction.

Conclusions  Combined with our previous in vitro functional study, the results suggest that the TLR4 11367 polymorphism might be a good predictor of who is more likely to develop complications such as sepsis or multiple organ dysfunction syndrome, depending on genotype.

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