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首页> 外文期刊>Sao Paulo Medical Journal >Prediction of sepsis-related outcomes in neonates through systematic genotyping of polymorphisms in genes for innate immunity and inflammation: a narrative review and critical perspective
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Prediction of sepsis-related outcomes in neonates through systematic genotyping of polymorphisms in genes for innate immunity and inflammation: a narrative review and critical perspective

机译：通过对先天性免疫和炎症基因多态性进行系统基因分型来预测新生儿败血症相关结局：叙事综述和批判性视角

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CONTEXT AND OBJECTIVE: Neonatal sepsis is associated with premature birth and maternal infection. Large-scale studies seek to define markers that identify neonates at risk of developing sepsis. Here, we examine whether the scientific evidence supports systematic use of polymorphism genotyping in cytokine and innate immunity genes, to identify neonates at increased risk of sepsis. DESIGN AND SETTING: Narrative literature review conducted at Fernandes Figueira Institute, Brazil. METHODS: The literature was searched in PubMed, Embase (Excerpta Medica Database), Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde), SciELO (Scientific Electronic Library Online) and Cochrane Library. From 400,000 references, 548 were retrieved based on inclusion/exclusion criteria; 22 were selected for detailed analysis after quality assessment. RESULTS: The studies retrieved addressed the impact of gene polymorphisms relating to immune mechanisms (most often TNF-a, LT-a, IL-6, IL-1β, IL-1ra, L-selectin, CD14 and MBL) or inflammatory mechanisms (ACE and angiotensin II receptors; secretory PLA2; and hemostatic factors). Despite initial reports suggesting positive associations between specific polymorphisms and increased risk of sepsis, the accumulated evidence has not confirmed that any of them have predictive power to justify systematic genotyping. CONCLUSIONS: Sepsis prediction through systematic genotyping needs to be reevaluated, based on studies that demonstrate the functional impact of gene polymorphisms and epidemiological differences among ethnically distinct populations.
机译：背景与目的：败血症与早产和母亲感染有关。大规模研究试图确定可识别有败血症风险的新生儿的标志物。在这里，我们检查了科学证据是否支持系统地利用细胞因子和先天免疫基因中的多态性基因分型，以鉴定败血症风险增加的新生儿。设计与场景：在巴西的费尔南德斯·菲盖拉研究所进行的叙事文学评论。方法：在PubMed，Embase（Excerpta Medica数据库），Lilacs（拉丁美洲拉丁美洲的CiúnciasdaSaúde图书馆），SciELO（科学在线电子图书馆）和Cochrane图书馆中进行文献检索。根据纳入/排除标准，从> 400,000个参考文献中检索到548个;经过质量评估后，选择了22个进行详细分析。结果：获得的研究解决了与免疫机制（最常见的是TNF-a，LT-a，IL-6，IL-1β，IL-1ra，L-选择素，CD14和MBL）相关的基因多态性的影响（ ACE和血管紧张素II受体，分泌型PLA2和止血因子）。尽管最初的报道表明特定多态性与败血症风险增加呈正相关，但累积的证据尚未证实它们中的任何一种都具有预测力，可以证明进行系统基因分型。结论：基于研究表明基因多态性的功能影响和种族差异人群之间的流行病学差异，需要通过系统的基因分型对败血症的预测进行重新评估。

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