Abstract
Objective:
To investigate whether single nucleotide polymorphisms (SNPs) in genes encoding the Toll-like receptor (TLR) signaling pathway modulate susceptibility to preterm birth (PTB).
Study Design:
Prospective case-control study examining the contribution of nine TLR SNPs to PTB (<37 weeks) and PTB <32 weeks. Genotyping was done on neonatal blood using a multiplexed single-base extension assay. Chi-square test, Fischer’s exact test and classification trees were used for data analysis.
Result:
Preterm infants (n=177) were more likely to be African American (P=0.02), and were more likely to be born to mothers who smoked (P=0.007), had pregnancy-induced hypertension (PIH; P=0.002) and placental abruption (P=0.0004) when compared with term infants (n=146). The TLR2, TLR4, TLR5, TLR9, nuclear factor-kappa B1 (NFκB1), NFκBIA and IRAK1 variants were not associated with PTB whereas the TIR domain receptor–associated protein (TIRAP) variant was more prevalent in term infants when compared with preterm infants born <32 weeks (P=0.004). PTB <32 weeks was more prevalent in infants without the TIRAP variant whose mothers had PIH and did not smoke (P=0.001). Presence of the TIRAP variant protected against PTB <32 weeks (P=0.015) in Caucasian infants.
Conclusion:
In our study, a TLR pathway adapter variant (TIRAP (rs8177374)) protected against PTB<32 weeks, supporting our hypothesis that genetic variation in the innate immune signaling pathway contributes to altered risk of PTB.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Goldenberg RL, Culhane JF, Iams JD, Romero R . Epidemiology and causes of preterm birth. The Lancet 2008; 371 (9606): 75–84.
Crider KS, Whitehead N, Buus RM . Genetic variation associated with preterm birth: a HuGE review. Genet Med 2005; 7 (9): 593–604.
Goldenberg RL, Goepfert AR, Ramsey PS . Biochemical markers for the prediction of preterm birth. Am J Obstet Gynecol 2005; 192 (5 Suppl): S36–S46.
Holst D, Garnier Y . Preterm birth and inflammation—the role of genetic polymorphisms. Eur J Obstet Gynecol Reprod Biol 2008; 141 (1): 3–9.
Heinzmann A, Mailaparambil B, Mingirulli N, Krueger M . Association of interleukin-13/-4 and Toll-like receptor 10 with preterm births. Neonatology 2009; 96 (3): 175–181.
Gupta M, Mestan KK, Martin CR, Pearson C, Ortiz K, Fu L et al. Impact of clinical and histologic correlates of maternal and fetal inflammatory response on gestational age in preterm births. J Matern Fetal Neonatal Med 2007; 20 (1): 39–46.
Varner MW, Esplin MS . Current understanding of genetic factors in preterm birth. BJOG 2005; 112 (Suppl 1): 28–31.
Romero R, Espinoza J, Kusanovic J, Gotsch F, Hassan S, Erez O et al. The preterm parturition syndrome. BJOG 2006; 113: 17–42.
Engel SA, Erichsen HC, Savitz DA, Thorp J, Chanock SJ, Olshan AF . Risk of spontaneous preterm birth is associated with common proinflammatory cytokine polymorphisms. Epidemiology 2005; 16 (4): 469–477.
Engel SA, Olshan AF, Savitz DA, Thorp J, Erichsen HC, Chanock SJ . Risk of small-for-gestational age is associated with common anti-inflammatory cytokine polymorphisms. Epidemiology 2005; 16 (4): 478–486.
Takeda K, Kaisho T, Akira S . Toll-like receptors. Annu Rev Immunol 2003; 21: 335–376.
Takeda K, Akira S . Toll receptors and pathogen resistance. Cell Microbiol 2003; 5 (3): 143–153.
Koga K, Mor G . Expression and function of Toll-like receptors at the maternal-fetal interface. Reprod Sci 2008; 15 (3): 231–242.
Zerhouni EA . Report of the Department of Health and Human Services, Eunice Kennedy Shriver National Institute of Health and Human Development, Prematurity Research at the NIH. Feb 2008; 1–14.
van Rijn BB, Franx A, Steegers EA, de Groot CJ, Bertina RM, Pasterkamp G et al. Maternal TLR4 and NOD2 gene variants, pro-inflammatory phenotype and susceptibility to early-onset preeclampsia and HELLP syndrome. PLoS One 2008; 3 (4): e1865.
Koukouritaki SB, Poch MT, Cabacungan ET, McCarver DG, Hines RN . Discovery of novel flavin-containing monooxygenase 3 (FMO3) single nucleotide polymorphisms and functional analysis of upstream haplotype variants. Mol Pharmacol 2005; 68 (2): 383–392.
Romero R, Espinoza J, Goncalves LF, Kusanovic JP, Friel L, Hassan S . The role of inflammation and infection in preterm birth. Semin Reprod Med 2007; 25 (1): 21–39.
Lorenz E, Hallman M, Marttila R, Haataja R, Schwartz DA . Association between the Asp299Gly polymorphisms in the Toll-like receptor 4 and premature births in the Finnish population. Pediatr Res 2002; 52 (3): 373–376.
Krediet TG, Wiertsema SP, Vossers MJ, Hoeks SB, Fleer A, Ruven HJ et al. Toll-like receptor 2 polymorphism is associated with preterm birth. Pediatr Res 2007; 62 (4): 474–476.
Mann JR, McDermott S, Griffith MI, Hardin J, Gregg A . Uncovering the complex relationship between pre-eclampsia, preterm birth and cerebral palsy. Pediatr Perinat epidemiol 2010; 25: 100–110.
Fitzgerald KA, Palsson-McDermott EM, Bowie AG, Jefferies CA, Mansell AS, Brady G et al. Mal (MyD88-adapter-like) is required for Toll-like receptor-4 signal transduction. Nature 2001; 413 (6851): 78–83.
Horng T, Barton GM, Medzhitov R . TIRAP: an adapter molecule in the Toll signaling pathway. Nat Immunol 2001; 2 (9): 835–841.
Vogel SN, Fitzgerald KA, Fenton MJ . TLRs: differential adapter utilization by Toll-like receptors mediates TLR-specific patterns of gene expression. Mol Interv 2003; 3 (8): 466–477.
Nagpal K, Plantinga TS, Wong J, Monks BG, Gay NJ, Netea MG et al. A TIR domain variant of MyD88 adapter-like (Mal)/TIRAP results in loss of MyD88 binding and reduced TLR2/TLR4 signaling. J Biol Chem 2009; 284 (38): 25742–25748.
Khor CC, Chapman SJ, Vannberg FO, Dunne A, Murphy C, Ling EY et al. A Mal functional variant is associated with protection against invasive pneumococcal disease, bacteremia, malaria and tuberculosis. Nat Genet 2007; 39 (4): 523–528.
Ye RW, Li HT, Ma R, Ren AG, Liu JM . Passive Smoking, Metabolic Gene Polymorphisms, and Infant Birth Weight in a Prospective Cohort Study of Chinese Women, Vol 44. Surveillance and Data Management Department, Institute of Reproductive and Child Health, Peking University, Beijing, China, 2010, pp 70–74..
Wegmann TG, Lin H, Guilbert L, Mosmann TR . Bidirectional cytokine interactions in the maternal-fetal relationship: is successful pregnancy a TH2 phenomenon? Immunol Today 1993; 14 (7): 353–356.
Simhan HN, Krohn MA, Roberts JM, Zeevi A, Caritis SN . Interleukin-6 promoter -174 polymorphism and spontaneous preterm birth. Am J Obstet Gynecol 2003; 189 (4): 915–918.
Goepfert AR, Varner M, Ward K, Macpherson C, Klebanoff M, Goldenberg RL et al. Differences in inflammatory cytokine and Toll-like receptor genes and bacterial vaginosis in pregnancy. Am J Obstet Gynecol 2005; 193 (4): 1478–1485.
Simhan HN, MacPherson T, Caritis SN, Krohn MA . Maternal and fetal Toll-like receptor 4 genotype and chorionic plate inflammatory lesions. Am J Obstet Gynecol 2008; 199 (4): 400.e1–400.e4.
Acknowledgements
We would like to acknowledge the help and support of Sharon Nelson (NNP at Waukesha Memorial Hospital), research nurses (Kathleen Meskin and Laura Lane) at Children’s Hospital of Wisconsin and the NICU and labor and delivery staff in recruiting patients. Last but not the least, we would like to thank all the parents and their infants who agreed to participate in the study.
Project support: This study was partly supported by pilot grants from the Children’s Research Institute and NIEHS Children’s Environmental Health Sciences Core (ES004184) Center to V.S.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Karody, V., Le, M., Nelson, S. et al. A TIR domain receptor–associated protein (TIRAP) variant SNP (rs8177374) confers protection against premature birth. J Perinatol 33, 341–346 (2013). https://doi.org/10.1038/jp.2012.120
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jp.2012.120
Keywords
This article is cited by
-
Emerging role of toll-like receptors signaling and its regulators in preterm birth: a narrative review
Archives of Gynecology and Obstetrics (2022)
-
Ancestry informative markers and selected single nucleotide polymorphisms in immunoregulatory genes on preterm labor and preterm premature rupture of membranes: a case control study
BMC Pregnancy and Childbirth (2016)
-
Spontaneous preterm birth and single nucleotide gene polymorphisms: a recent update
BMC Genomics (2016)