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. 2013 Oct;39(10):1752-9.
doi: 10.1007/s00134-013-3018-5. Epub 2013 Jul 24.

Endothelial protein C receptor polymorphisms and risk of severe sepsis in critically ill patients

Alice G Vassiliou  1 , Nikolaos A Maniatis, Anastasia Kotanidou, Marina Kallergi, Foteini S Karystinaki, Eleftheria Letsiou, Constantinos Glynos, Petros Kopterides, Dimitra Vassiliadi, Nikitas Nikitas, Ioanna Dimopoulou, Apostolos Armaganidis, Stylianos E Orfanos
Affiliations

Endothelial protein C receptor polymorphisms and risk of severe sepsis in critically ill patients

Alice G Vassiliou et al. Intensive Care Med. 2013 Oct.

Abstract

Purpose: Endothelial protein C receptor (EPCR) is expressed mainly in endothelial cells and is involved in regulation of the cytoprotective and anticoagulant pathways of protein C. We assessed whether haplotypes in the EPCR gene modify the risk of severe sepsis and/or septic shock (SS/SS) development in critically ill patients.

Methods: Three polymorphisms in the EPCR gene were genotyped in 389 Caucasian critically ill patients, hospitalized in the intensive care units of two major hospitals in Athens, Greece. Multivariate logistic regression analysis controlling for age, acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores, sex, and diagnosis was performed to determine the effect of haplotypes H1 and H3 in the EPCR gene on the development of SS/SS.

Results: H2 carriers versus all other genotypes combined had a nonsignificant excess of SS/SS (p = 0.087). SS/SS occurred in 38.8% of critically ill patients carrying minor alleles belonging to both H1 and H3 haplotypes, in 58.0% of H1 carriers, 64.3% of H3 carriers, and 65.2% of patients carrying all common alleles (H2). Compared with H2 carriers, the odds ratios (OR) for developing SS/SS were 0.34 [95% confidence interval (CI) 0.16-0.76, p = 0.008] for simultaneous H1 and H3 carriers, 0.65 (95% CI 0.37-1.13, p = 0.123) for H1 carriers, and 0.82 (95 % CI 0.39-1.70, p = 0.590) for H3 carriers.

Conclusions: Our results indicate that simultaneous carriers of minor alleles belonging to both the H1 and H3 haplotypes may be at reduced risk of developing SS/SS in this cohort of critically ill patients.

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Figures

Fig. 1
Fig. 1
The three EPCR gene haplotypes. The three polymorphisms studied were C1651G (H3), A6936G (H3), and T6333C (H1) (bold). Nucleotides are numbered according to the GenBank sequence (accession number AF106202). Adapted from [20, 21]
See this image and copyright information in PMC

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