an nfkb1 promoter insertiondeletion polymorphism influences risk and outcome in acute respiratory distress syndrome among caucasians一个nfkb1发起人insertiondeletion多态性影响风险和结果在急性呼吸窘迫综合征白种人.pdfVIP

An NFKB1 Promoter Insertion/Deletion Polymorphism Influences Risk and Outcome in Acute Respiratory Distress Syndrome among Caucasians 1 1 2 3 3 1 Ednan K. Bajwa , Paul C. Cremer , Michelle N. Gong , Rihong Zhai , Li Su , B. Taylor Thompson , David C. Christiani1,3* 1 Pulmonary and Critical Care Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America, 2 Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America, 3 Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, United States of America Abstract Background: Nuclear factor-kB (NF-kB) is required for transcription of many pro-inflammatory genes and has been implicated in the pathogenesis of acute respiratory distress syndrome (ARDS). We hypothesized that a known functional polymorphism in the promoter of the NFKB1 gene may affect susceptibility to and outcome from ARDS. Methods: A case control study was conducted among a cohort of patients admitted to the intensive care unit (ICU) with risk factors for the development of ARDS. 379 patients with ARDS and 793 at-risk controls were studied. Patients were followed for 60 days with development of ARDS as a primary outcome; ARDS-related mortality and organ dysfunction were secondary outcomes. Results: Patients homozygous for the 4 base pair deletion in the promoter of NFKB1 (del/del) did not have an increased odds ratio (OR) of developing ARDS in unadjusted analysis but were more likely to develop ARDS in the presence of a