FOXO1单核苷酸多态性与小儿免疫性血小板减少症出血严重程度和糖皮质激素治疗敏感性有关

DNA and cell biology Pub Date : 2024-06-01 Epub Date: 2024-04-29 DOI:10.1089/dna.2023.0431
Xingjuan Xie, Hao Gu, Jingyao Ma, Lingling Fu, Jie Ma, Jialu Zhang, Runhui Wu, Zhenping Chen
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引用次数: 0

摘要

免疫性血小板减少症(ITP)是一种自身免疫介导的出血性疾病。新的证据表明,FOXO1 SNPs 与多种自身免疫性疾病的免疫失调有关,这表明 FOXO1 可能参与了 ITP 患者的炎症和病理活动。本研究旨在评估 FOXO1 基因单核苷酸多态性(SNPs)是否与 ITP 易感性相关,临床关注的重点包括出血严重程度和糖皮质激素治疗的敏感性。这项研究招募了 327 名新确诊的 ITP 患者和 220 名健康对照者。使用 Sequenom MassArray 系统检测了 FOXO1 基因的四个 SNPs(rs17446593、rs17446614、rs2721068 和 rs2721068)。根据出血评分将出血严重程度分为轻度组和重度组。根据《ITP实践指南》(2019年版),ITP患者被分为对糖皮质激素治疗敏感和不敏感两组。四个SNPs的频率在ITP组和健康对照组之间未显示出任何显著差异。rs17446593基因型为AA(p = 0.009)和rs17446614基因型为GG(p = 0.009)的患者比没有这两种基因型的患者出血更严重。单倍型Grs17446593Ars17446614Crs2721068Trs2755213携带者对严重出血具有保护作用(p = 0.002)。在对糖皮质激素治疗敏感的 ITP 患者中,rs17446593 的 AA 基因型明显高于对糖皮质激素治疗不敏感的患者(p = 0.03)。单倍型Grs17446593Grs17446614Trs2721068Trs2755213会增加糖皮质激素抵抗的风险(p = 0.007)。虽然 FOXO1 基因多态性与 ITP 易感性无关,但 rs17446593 的 AA 基因型和 rs17446614 的 GG 基因型与出血严重程度有关。单倍型 GACT 对严重出血有保护作用。rs17446593 基因型为 AA 的患者可能对糖皮质激素治疗反应良好。然而,FOXO1基因单倍型GGTT会增加糖皮质激素耐药的风险。试验注册:ChiCTR1900022419。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
FOXO1 Single-Nucleotide Polymorphisms Are Associated with Bleeding Severity and Sensitivity of Glucocorticoid Treatment of Pediatric Immune Thrombocytopenia.

Immune thrombocytopenia (ITP) is an autoimmune-mediated hemorrhagic disease. Emerging evidence indicates that FOXO1 SNPs are related to the immune dysregulation of several autoimmune diseases suggesting that FOXO1 may be involved in inflammation and pathologic activities in patients with ITP. This study aimed to evaluate whether FOXO1 gene single-nucleotide polymorphisms (SNPs) are associated with susceptibility to ITP and clinical priorities of concern include bleeding severity and sensitivity of glucocorticoid treatment. This study recruited 327 newly diagnosed ITP and 220 healthy controls. Four SNPs (rs17446593, rs17446614, rs2721068, and rs2721068) of the FOXO1 gene were detected using the Sequenom MassArray system. Bleeding severity were classified into the mild and severe groups based on the bleeding scores. ITP patients were classified as sensitive and insensitive to glucocorticoid treatment according to the practice guideline for ITP (2019 version). The frequencies of the four SNPs did not show any significant differences between the ITP and healthy control groups. Patients with AA genotype at rs17446593 (p = 0.009) and GG genotype at rs17446614 (p = 0.009) suffered more severe bleeding than patients without them. Carriers of haplotype Grs17446593Ars17446614Crs2721068Trs2755213 were protective to severe bleeding (p = 0.002). The AA genotype at rs17446593 was significantly higher in ITP patients sensitive to glucocorticoid treatment than in those insensitive to glucocorticoid treatment (p = 0.03). Haplotype Grs17446593Grs17446614Trs2721068Trs2755213 increases the risk of glucocorticoid resistance (p = 0.007). Although FOXO1 gene polymorphisms were not associated with susceptibility to ITP, the AA genotype at rs17446593 and GG genotype at rs17446614 were associated with bleeding severity. Haplotype GACT have a protective effect against severe bleeding. Patients with AA genotype at rs17446593 may tend to have good responds to glucocorticoid treatment. However, the FOXO1 gene haplotype GGTT increases the risk of glucocorticoid-resistant. Trial registration: ChiCTR1900022419.

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