Abstract
Melioidosis is a severe infection caused by the flagellated bacterium Burkholderia pseudomallei. The nonsense polymorphism TLR51174C>T is associated with improved outcome in Thais with melioidosis. We hypothesized that other TLR5 variants may modulate the host response and determine outcome in melioidosis. We genotyped 12 TLR5 variants selected de novo from the HapMap database and examined the association of each with cytokines induced by flagellin stimulation of whole blood from healthy Thai subjects. We found a blunted cytokine response for three related markers that were in linkage disequilibrium (LD) with a non-synonymous variant, TLR51846T>C. Carriers of TLR51846T>C had broadly impaired cytokine responses induced by flagellin. TLR51846T>C was associated with protection against death in melioidosis patients (odds ratio: 0.62, 95% confidence interval: 0.42–0.93, P=0.021). We observed no impairment in TLR51846C-dependent nuclear factor κB activation, however, suggesting an alternative mechanism for the effect. We found that TLR51846T>C was in strong LD with TLR51174C>T. Many of the blunted cytokine responses observed and the association of TLR51846T>C with survival in melioidosis patients may be attributable to TLR51174C>T, but we could not exclude an independent effect of TLR51846T>C. These data identify novel associations for TLR51846T>C, enhance our understanding of TLR5 genetic architecture in Thais and highlight the role of TLR5 in melioidosis.
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Acknowledgements
We acknowledge the support of the staff and patients at Sappasithiprasong Hospital and Mahidol-Oxford Tropical Medicine Research Unit; DNA extraction by Premjit Amornchai, Aunchalee Thanwisai, and Malinee Oyuchua; and assistance generating immuno-assays from Mark Wurfel.
This work was supported by the Wellcome Trust (087769/Z/08/Z to NC); the NIHR Cambridge Biomedical Research Centre (to SJP); National Institutes of Health awards (K08HL094759 and R01HL113382 to TEW) and by the Doris Duke Charitable Foundation (to TEW).
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Chantratita, N., Tandhavanant, S., Myers, N. et al. Screen of whole blood responses to flagellin identifies TLR5 variation associated with outcome in melioidosis. Genes Immun 15, 63–71 (2014). https://doi.org/10.1038/gene.2013.60
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DOI: https://doi.org/10.1038/gene.2013.60
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