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Harding, David, Baines, Paul B., Brull, David, Vassiliou, Vassilis 
ORCID: https://orcid.org/0000-0002-4005-7752, Ellis, Ian, Hart, Anthony, Thomson, Alistair P. J., Humphries, Steve E. and Montgomery, Hugh E.
(2002)
Severity of meningococcal disease in children and the angiotensin-converting enzyme insertion/deletion polymorphism.
American Journal of Respiratory and Critical Care Medicine, 165 (8).
pp. 1103-1106.
ISSN 1073-449X
Abstract
Critical illness outcome may be causally related to inflammatory response severity. Given that tissue angiotensin-converting-enzyme (ACE) regulates such responses and that the deletion (D) [rather than insertion (I)] variant of the ACE gene is associated with higher tissue ACE levels, DD genotype might be associated with a poorer outcome in a uniform infectious disease state. Illness severity (Pediatric RIsk of Mortality score, the Glasgow Meningococcal Septicaemia Prognostic Score [GMSPS], and clinical course) was recorded for consecutive white patients with meningococcal disease (n = 110, 34 DD genotype, 61 male, aged 49.4 ± 5.4 months) referred to the Royal Liverpool Children's Hospital, UK. Compared with children with ⩾ I allele, DD genotype was associated with 14% higher predicted risk of mortality (p = 0.038), higher GMSPS (DD 9.4 ± 0.5, ID/II 7.7 ± 0.4 [mean ± SEM], p = 0.013), greater prevalence of inotropic support (76% versus 55%, p = 0.03) and ventilation (82% versus 63%, p = 0.04), and longer Pediatric Intensive Care Unit (PICU) stay (5.8 versus 3.9, p = 0.02). DD genotype frequency was 6% (1 case) for the 18 children who did not require PICU care, 33% for the 84 PICU survivors, and 45% for those who died (p = 0.01). ACE DD is associated with increased illness severity in meningococcal disease.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health |
| Related URLs: | |
| Depositing User: | Pure Connector |
| Date Deposited: | 29 Jun 2017 08:29 |
| Last Modified: | 19 Oct 2023 02:02 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/63965 |
| DOI: | 10.1164/ajrccm.165.8.2108089 |
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