背景:丹兔血型变异可预防恶性疟原虫感染,但其更广泛的后果尚未被研究。这里,我们研究了丹毒对菌血症易感性的影响。
方法:我们在1998年至2010年间对肯尼亚基利菲县医院出现社区获得性菌血症的儿童进行了病例对照研究。我们使用逻辑回归来测试Dantu标记SNPrs186873296A>G与全因和病原体特异性菌血症之间的关联。我们使用入院日期作为疟疾传播强度的替代指标,鉴于在研究过程中已知的疟疾患病率差异。
结果:丹图与防止全因菌血症相关(OR=0.81,p=0.014),纯合子中的关联最大(OR=0.30,p=0.013)。这种保护在主要的细菌病原体中共享,但是,特别是,仅在2003年之前的高疟疾传播时代显着(OR=0.79,p=0.023)。
结论:与以前的研究一致,这些研究表明其他疟疾相关红细胞变异对菌血症风险的间接影响,我们的研究还表明,丹徒通过其对疟疾风险的影响对菌血症具有保护作用。Dantu似乎没有通过增加细菌感染的风险来平衡选择。
BACKGROUND: The
Dantu blood group variant protects against P. falciparum infections but its wider consequences have not been previously explored. Here, we investigate the impact of
Dantu on susceptibility to bacteraemia.
METHODS: We conducted a case-control study in children presenting with community-acquired bacteraemia to Kilifi County Hospital in Kenya between 1998 and 2010. We used logistic regression to test for associations between the
Dantu marker SNP rs186873296 A>G and both all-cause and pathogen-specific bacteraemia under an additive model. We used date of admission as a proxy measure of malaria transmission intensity, given known differences in malaria prevalence over the course of the study.
RESULTS: Dantu was associated with protection from all-cause bacteraemia (OR=0.81, p=0.014), the association being greatest in homozygotes (OR=0.30, p=0.013). This protection was shared across the major bacterial pathogens but, notably, was only significant during the era of high malaria-transmission pre-2003 (OR=0.79, p=0.023).
CONCLUSIONS: Consistent with previous studies showing the indirect impact on bacteraemia risk of other malaria-associated red cell variants, our study also shows that Dantu is protective against bacteraemia via its effect on malaria risk.
Dantu does not appear to be under balancing selection through an increased risk of bacterial infections.