Portal de Periódicos da CAPES

Genetic Predisposition to Acute Respiratory Distress Syndrome in Patients With Severe Sepsis

2013; Lippincott Williams & Wilkins; Volume: 39; Issue: 3 Linguagem: Inglês

10.1097/shk.0b013e3182866ff9

1540-0514

Pablo Cardinal‐Fernández, Antonio Ferruelo, Mariam El‐Assar, Catalina Santiago, Félix Gómez‐Gallego, Ana Martín-Pellicer, Fernando Frutos‐Vivar, Óscar Peñuelas, Nicolás Nín, Martin Dres, José A. Lorente,

Electrolyte and hormonal disorders

The objective of this study was to analyze the association between candidate gene polymorphisms and susceptibility to acute respiratory distress syndrome (ARDS) in patients with severe sepsis.Patients older than 18 years admitted to the intensive care unit (ICU) with the diagnosis of severe sepsis were prospectively included. A blood sample was drawn on the first day of ICU admission, and DNA was extracted. We genotyped the insertion/deletion polymorphism of the angiotensin-converting enzyme (ACE) gene (polymerase chain reaction) and the following single-nucleotide polymorphisms (TaqMan SNP genotyping assay): tumor necrosis factor α -376 G/A, -308 G/A, and -238 G/A; interleukin 8 -251 T/A; pre-B cell colony-enhancing factor -1001 G/T; and vascular endothelial growth factor +405 C/G and +936 C/T. Polymorphisms were selected based on reports on their association with ARDS. Variables associated in univariate analysis (P < 0.1) with the diagnosis of ARDS were included in a multiple logistic regression analysis.We studied 149 patients, of whom 35 presented ARDS. Variables included in the maximal multivariate model were male sex, chronic alcoholism, use of ACE inhibitors or angiotensin-receptor blockers, Simplified Acute Physiology Score II score, serum glucose concentration at ICU admission, and the presence of the allele D of the ACE gene. After adjustment for those variables, the presence of the allele D of the ACE gene (odds ratio, 4.75; 95% confidence interval, 1.02-22.20; P = 0.048) was significantly associated with the diagnosis of ARDS.The presence of the allele D of the ACE gene is associated with ARDS in patients with severe sepsis.