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VOLUME 23 , ISSUE 3 ( March, 2019 ) > List of Articles
Shahla Siddiqui, Resham Lal Gurung, Sylvia Liu, Edwin Chuen Ping Seet, Su Chi Lim
Citation Information : Siddiqui S, Gurung RL, Liu S, Seet EC, Lim SC. Genetic Polymorphisms and Cytokine Profile of Different Ethnicities in Septic Shock Patients, and their Association with Mortality. Indian J Crit Care Med 2019; 23 (3):135-138.
License: CC BY-NC 4.0
Published Online: 01-03-2019
Copyright Statement: Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.
Objective: The outcomes of sepsis and septic shock patients are heterogonous, with a variable response despite standardized care. The aim of this study was to explore the racial differences in septic shock outcomes, and their association with genetic polymorphisms and cytokine levels in an Asian population. Design: This was an observational cohort study, Setting: Intensive Care units of a 500 bedded tertiary care hospital in Singapore. Patients: 198 patients (73 Chinese, 73 Malay and 52 Indian and others) admitted to the Khoo Teck Puat Hospital Intensive Care Unit between August 2016 and June 2017, with a diagnosis of severe sepsis (according to) were enrolled. Interventions: Plasma interlukin-6 (IL-6), interlukin-10 (IL-10) and Tumour necrosis factor-a (TNFa) were measured using a highly sensitive quantitative sandwich enzyme-linked immunosorbent assay (ELISA) (BioVendor, Modrice, Czech Republic). The gene panel studied included 16 genes. Measurements and Main Results: The rs7038903 common variant in SVEP1 gene showed significant association with sepsis severity independent of other variants in ordinal logistic and linear regression model (p=0.001 and p=0.002 respectively). Moreover, the association between rs7038903 and increased hazard for death remained significant after further adjusting for cytokines level. Interestingly, significant differences were seen in plasma IL6 in individuals with or without rs7038903 C allele (28pg/ml (IQR 12-86) vs 90pg/ml (IQR 49-155); P=0.022) in patients with severe sepsis in the Malay ethnic group. Conclusions: Our study shows a promising polymorphism in SVEP1 gene (rs7038903) which is associated with sepsis shock and 28 days mortality, independent of age, gender, and method of diagnosis and SOFA score. Collectively, while our findings so far have shown the additional value or measuring cytokines and genetic markers in sepsis outcomes in the local population, further large scare studies are needed in a heterogeneous septic population with a rigorous analysis to know the significance of our findings.
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