Variation of 46 Innate Immune Genes Evaluated for their Contribution in Pneumococcal Meningitis Susceptibility and Outcome
Bart Ferwerda,
Mercedes Valls Serón,
Aldo Jongejan,
Aeilko H. Zwinderman,
Madelijn Geldhoff,
Arie van der Ende,
Frank Baas,
Matthijs C. Brouwer,
Diederik van de Beek
Affiliations
Bart Ferwerda
Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, P.O. Box 22660, Amsterdam, The Netherlands
Mercedes Valls Serón
Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, P.O. Box 22660, Amsterdam, The Netherlands
Aldo Jongejan
Bioinformatics Laboratory, Academic Medical Center, P.O. Box 22660, Amsterdam, The Netherlands
Aeilko H. Zwinderman
Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, University of Amsterdam, P.O. Box 22660, Amsterdam, The Netherlands
Madelijn Geldhoff
Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, P.O. Box 22660, Amsterdam, The Netherlands
Arie van der Ende
Department of Medical Microbiology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, P.O. Box 22660, Amsterdam, The Netherlands
Frank Baas
Department of Clinical Genetics, Academic Medical Center, P.O. Box 22660, Amsterdam, The Netherlands
Matthijs C. Brouwer
Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, P.O. Box 22660, Amsterdam, The Netherlands
Diederik van de Beek
Department of Neurology, Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, P.O. Box 22660, Amsterdam, The Netherlands
Pneumococcal meningitis is the most common and severe form of bacterial meningitis. Early recognition of the pathogen and subsequent innate immune response play a vital role in disease susceptibility and outcome. Genetic variations in innate immune genes can alter the immune response and influence susceptibility and outcome of meningitis disease. Here we conducted a sequencing study of coding regions from 46 innate immune genes in 435 pneumococcal meningitis patients and 416 controls, to determine the role of genetic variation on pneumococcal meningitis susceptibility and disease outcome. Strongest signals for susceptibility were rs56078309 CXCL1 (p = 4.8e−04) and rs2008521 in CARD8 (p = 6.1e−04). For meningitis outcome the rs2067085 in NOD2 (p = 5.1e−04) and rs4251552 of IRAK4 were the strongest associations with unfavorable outcome (p = 6.7e−04). Haplotype analysis showed a haplotype block, determined by IRAK4 rs4251552, significantly associated with unfavorable outcome (p = 0.004). Cytokine measurements from cerebrospinal fluid showed that with the IRAK4 rs4251552 G risk allele had higher levels of IL-6 compared to individuals with A/A genotype (p = 0.04). We show that genetic variation within exons and flanking regions of 46 innate immunity genes does not yield significant association with pneumococcal meningitis. The strongest identified signal IRAK4 does imply a potential role of genetic variation in pneumococcal meningitis.
