Predisposition to Childhood Otitis Media and Genetic Polymorphisms within the Toll-Like Receptor 4 (TLR4) Locus

• Published in: PloS one Vol. 10; no. 7; p. e0132551
• Main Authors: Hafrén, Lena, Einarsdottir, Elisabet, Kentala, Erna, Hammarén-Malmi, Sari, Bhutta, Mahmood F., MacArthur, Carol J., Wilmot, Beth, Casselbrant, Margaretha, Conley, Yvette P., Weeks, Daniel E., Mandel, Ellen M., Vaarala, Outi, Kallio, Anna, Melin, Merit, Nieminen, Janne K., Leinonen, Eira, Kere, Juha, Mattila, Petri S.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 15.07.2015; Public Library of Science (PLoS)
• Subjects: Analysis; Asthma; Bioinformatics; Child; Childhood; Children; Cohort Studies; Correlation analysis; Dendritic cells; Dendritic Cells - metabolism; Ear diseases; Environmental factors; Family medical history; Finland; Gene Expression Regulation; Genes; Genetic aspects; Genetic Association Studies; Genetic polymorphisms; Genetic Predisposition to Disease; Genetics; Hospitals; Humans; Immune response; Immune system; Immunity; Innate immunity; Loci; Marking; Medicine; Otitis media; Otitis Media - genetics; Otolaryngology; Pathogenesis; Polymorphism, Single Nucleotide - genetics; Proteins; Reproducibility of Results; Risk; RNA, Messenger - genetics; RNA, Messenger - metabolism; Signaling; Single-nucleotide polymorphism; Studies; TLR4 protein; Toll-Like Receptor 4 - genetics; Toll-like receptors; Tumor Necrosis Factor-alpha - genetics; Tumor Necrosis Factor-alpha - metabolism; Tumor necrosis factor-α; United Kingdom; United States
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0132551

Predisposition to childhood otitis media (OM) has a strong genetic component, with polymorphisms in innate immunity genes suspected to contribute to risk. Studies on several genes have been conducted, but most associations have failed to replicate in independent cohorts. We investigated 53 gene polymorphisms in a Finnish cohort of 624 cases and 778 controls. A positive association signal was followed up in a tagging approach and tested in an independent Finnish cohort of 205 cases, in a British cohort of 1269 trios, as well as in two cohorts from the United States (US); one with 403 families and the other with 100 cases and 104 controls. In the initial Finnish cohort, the SNP rs5030717 in the TLR4 gene region showed significant association (OR 1.33, P = .003) to OM. Tagging SNP analysis of the gene found rs1329060 (OR 1.33, P = .002) and rs1329057 (OR 1.29, P = .003) also to be associated. In the more severe phenotype the association was stronger. This finding was supported by an independent Finnish case cohort, but the associations failed to replicate in the British and US cohorts. In studies on TLR4 signaling in 20 study subjects, the three-marker risk haplotype correlated with a decreased TNFα secretion in myeloid dendritic cells. The TLR4 gene locus, regulating the innate immune response, influences the genetic predisposition to childhood OM in a subpopulation of patients. Environmental factors likely modulate the genetic components contributing to the risk of OM.