Bactericidal permeability increasing protein gene variants in children with sepsis

Objective: To evaluate the role of genetic polymorphisms of the bactericidal permeability increasing protein (BPI) in pediatric patients with sepsis. Design: Prospective, single-center, case-control study at the pediatric intensive care unit (PICU) of a university hospital. Patients: 345 consecutive pediatric patients admitted to the PICU with fever, systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, septic shock, or multiple organ distress syndrome (MODS). Interventions: DNA was isolated and two BPI gene polymorphisms BPI (G545 > C) Taq and BPI (A645 > G) 216 were studied in patients and compared with healthy controls. Measurements and results: Genetic analysis of the BPI Taq gene revealed significant differences between healthy controls and the subgroup of febrile patients (p = 0.0243), the subgroup of SIRS and sepsis (p = 0.0101), and the subgroup of severe sepsis, septic shock, andMODS (p = 0.0027), respectively. No statistically significant differences for the BPI 216 gene polymorphism were found between patient and healthy control groups. A statistically significant predisposition to Gram-negative sepsis in patients carrying the BPI Taq GG variant together with the BPI 216 AG or GG variant was revealed (p = 0.0081), and these haplotypes were also associated with death due to sepsisrelated complications. Conclusion: BPI Taq gene polymorphism is the accurate predictor of the severity of sepsis in children admitted to the PICU.