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Clinical and Vaccine Immunology, July 2009, p. 1087-1090, Vol. 16, No. 7
1071-412X/09/$08.00+0     doi:10.1128/CVI.00037-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

The Fc{gamma} Receptor IIA-R/R131 Genotype Is Associated with Severe Sepsis in Community-Acquired Pneumonia {triangledown}

Henrik Endeman,1,2,{dagger}* Marie Claire A. Cornips,3,{dagger} Jan C. Grutters,4 Jules M. van den Bosch,4 Hendrik J. T. Ruven,5 Heleen van Velzen-Blad,6 Ger T. Rijkers,6 and Douwe H. Biesma7

Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands,1 Department of Intensive Care Medicine, Diakonessenhuis, Utrecht, The Netherlands,2 Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands,3 Department of Pulmonology, St. Antonius Hospital, Nieuwegein, The Netherlands,4 Department of Clinical Chemistry, St. Antonius Hospital, Nieuwegein, The Netherlands,5 Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands,6 Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands7

Received 15 January 2009/ Returned for modification 14 April 2009/ Accepted 26 May 2009

Community-acquired pneumonia (CAP) can be caused by a variety of microorganisms but is most frequently associated with Streptococcus pneumoniae and gram-negative bacteria like Haemophilus influenzae. Encapsulated bacteria are able to escape phagocytosis, unless they are bound by immunoglobulin G2 subclass antibodies. These antibodies interact with Fc{gamma} receptor IIa (Fc{gamma}-RIIa), thereby facilitating opsonophagocytosis of the encapsulated bacteria. We studied the relationship between the Fc{gamma}-RIIa-R/H131 polymorphism and the clinical course of CAP and pathogen-specific susceptibility. Regarding methodology, the Fc{gamma}-RIIa genotype R/H131 was determined in 200 patients with CAP and in 313 healthy controls and was correlated with the clinical course, laboratory parameters, and causative microorganism. The Fc{gamma}-RIIa-R/R131 genotype was found more frequently in patients with severe sepsis (odds ratio [OR], 2.55; 95% confidence interval [CI], 1.30 to 5.00; P < 0.01). The majority of patients in this group suffered from invasive pneumococcal disease. The duration of hospital stay was longer for patients with the Fc{gamma}-RIIa-R/R131 genotype. Fc{gamma}-RIIa genotypes were not associated with an increased risk of CAP in general; however, the Fc{gamma}-RIIa-R/R131 genotype was found more frequently in patients with CAP caused by H. influenzae than in controls (OR, 3.03; CI, 1.04 to 9.09; P < 0.05). In conclusion, the Fc{gamma}-RIIa-R/R131 genotype is associated with severity of CAP and is more frequent in CAP caused by H. influenzae.

* Corresponding author. Mailing address: Department of Intensive Care Medicine, Diakonessenhuis Utrecht, P.O. Box 80250, 3508 TG Utrecht, The Netherlands. Phone: 31 30 256 65 66. Fax: 31 30 256 67 38. E-mail: henrik.endeman{at}planet.nl

{triangledown} Published ahead of print on 3 June 2009.

{dagger} Both authors attributed equally to this work.

Clinical and Vaccine Immunology, July 2009, p. 1087-1090, Vol. 16, No. 7
1071-412X/09/$08.00+0     doi:10.1128/CVI.00037-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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