Martina Schneider1, Teresa Matiqi1, Michael Kundi2, Franz J J Rieder1, Martin Andreas3, Robert Strassl4, Andreas Zuckermann3, Christof Jungbauer5, Christoph Steininger6. 1. Department of Medicine I, Div. of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Austria. 2. Institutes of Environmental Health, Center for Public Health, Medical University of Vienna, Austria. 3. Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Austria. 4. Department of Laboratory Medicines, Division of Clinical Virology, Medical University of Vienna, Austria. 5. Blood Service for Vienna, Lower Austria and Burgenland, Austrian Red Cross, Vienna, Austria. 6. Department of Medicine I, Div. of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Austria. Electronic address: christoph.steininger@meduniwien.ac.at.
Abstract
BACKGROUND: The toll-like receptor 2 (TLR2) is a significant component of innate immunity against cytomegalovirus (CMV) infection but information on the clinical significance of the single nucleotide polymorphism (SNP) (R753Q) is conflicting. OBJECTIVES: The inconsistent observations of the immunological and clinical significance of the TLR2 R753Q polymorphism for CMV infection indicates the influence of confounders. STUDY DESIGN: The presence of the TLR2 polymorphism was determined by a genotyping assay of 175 HTX patients and 281 healthy blood donors and evaluated in relation to selected virological and clinical parameters. RESULTS: Relative frequency of TLR2 polymorphism was similar in HTX patients and blood donors (homozygous wild-type, 94.3% vs. 94.0%; heterozygous, 5.1% vs. 5.7%; homozygous mutated, <1%). CMV viremia was detectable in 108 (61.7%) of HTX patients. The TLR2 polymorphism was neither associated with occurrence or level of CMV infection nor with survival, graft failure or rejection, or CMV serostatus of patient before transplantation. Nevertheless, CMV viremia occurred in 83.1% of R+/D+, 77.1% of R+/D-, and 64.3% of R-/D+ patients. Time of first CMV viremia was in R-/D+ patients later than in CMV-seropositive patients (median, 182days versus 23 days; P<0.001) corresponding to the duration of antiviral prophylaxis in R-/D+ patients. CONCLUSIONS: The TLR2 R753Q polymorphism is extremely rare in the general population and HTX patients. Screening for this risk factor of CMV disease may not be cost-effective in contrast to testing for CMV viremia. Copyright Â
BACKGROUND: The toll-like receptor 2 (TLR2) is a significant component of innate immunity against cytomegalovirus (CMV) infection but information on the clinical significance of the single nucleotide polymorphism (SNP) (R753Q) is conflicting. OBJECTIVES: The inconsistent observations of the immunological and clinical significance of the TLR2 R753Q polymorphism for CMV infection indicates the influence of confounders. STUDY DESIGN: The presence of the TLR2 polymorphism was determined by a genotyping assay of 175 HTX patients and 281 healthy blood donors and evaluated in relation to selected virological and clinical parameters. RESULTS: Relative frequency of TLR2 polymorphism was similar in HTX patients and blood donors (homozygous wild-type, 94.3% vs. 94.0%; heterozygous, 5.1% vs. 5.7%; homozygous mutated, <1%). CMV viremia was detectable in 108 (61.7%) of HTX patients. The TLR2 polymorphism was neither associated with occurrence or level of CMV infection nor with survival, graft failure or rejection, or CMV serostatus of patient before transplantation. Nevertheless, CMV viremia occurred in 83.1% of R+/D+, 77.1% of R+/D-, and 64.3% of R-/D+ patients. Time of first CMV viremia was in R-/D+ patients later than in CMV-seropositive patients (median, 182days versus 23 days; P<0.001) corresponding to the duration of antiviral prophylaxis in R-/D+ patients. CONCLUSIONS: The TLR2 R753Q polymorphism is extremely rare in the general population and HTX patients. Screening for this risk factor of CMV disease may not be cost-effective in contrast to testing for CMV viremia. Copyright Â
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