TLR9 -1486T/C and 2848C/T SNPs Are Associated with Human Cytomegalovirus Infection in Infants.

Toll-like receptor 9 (TLR9) recognizes non-methylated viral CpG-containing DNA and serves as a pattern recognition receptor that signals the presence of human cytomegalovirus (HCMV). Here, we present the genotype distribution of single-nucleotide polymorphisms (SNPs) of the TLR9 gene in infants and the relationship between TLR9 polymorphisms and HCMV infection. Four polymorphisms (-1237T/C, rs5743836; -1486T/C, rs187084; 1174G/A, rs352139; and 2848C/T, rs352140) in the TLR9 gene were genotyped in 72 infants with symptomatic HCMV infection and 70 healthy individuals. SNP genotyping was performed by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Digested fragments were separated and identified by capillary electrophoresis. The HCMV DNA copy number was measured by a quantitative real-time PCR assay. We found an increased frequency of heterozygous genotypes TLR9 -1486T/C and 2848C/T in infants with HCMV infection compared with uninfected cases. Heterozygous variants of these two SNPs increased the risk of HCMV disease in children (P = 0.044 and P = 0.029, respectively). In infants with a mutation present in at least one allele of -1486T/C and 2848C/T SNPs, a trend towards increased risk of cytomegaly was confirmed after Bonferroni's correction for multiple testing (Pc = 0.063). The rs352139 GG genotype showed a significantly reduced relative risk for HCMV infection (Pc = 0.006). In contrast, the -1237T/C SNP was not related to viral infection. We found no evidence for linkage disequilibrium with the four examined TLR9 SNPs. The findings suggest that the TLR9 -1486T/C and 2848C/T polymorphisms could be a genetic risk factor for the development of HCMV disease

Demographic and clinical characteristics of study subjects with HCMV infection.

<p>Demographic and clinical characteristics of study subjects with HCMV infection.</p

<i>TLR9</i> SNP variance from Hardy-Weinberg equilibrium.

<p><i>TLR9</i> SNP variance from Hardy-Weinberg equilibrium.</p

Comparison of viremia levels in HCMV-infected infants without or with the <i>TLR9</i> -1486T/C SNP (N = 72).

<p>Bars in the scatter dot plot represent the mean viral loads. Bars in the box plots represent median viral loads, upper and lower borders represent the 25th and 75th percentiles, and whiskers represent the minimum to maximum values. <i>P</i> ≤ 0.05, Mann-Whitney U test.</p

The distribution of genotypes frequencies of <i>TLR9</i> SNPs in infants and relationship between polymorphisms and the risk of HCMV infection.

<p>The distribution of genotypes frequencies of <i>TLR9</i> SNPs in infants and relationship between polymorphisms and the risk of HCMV infection.</p

Visualization of selected PCR-RFLP products for <i>TLR9</i> -1486T/C genotyping.

<p>Gel image: 1 and 2, heterozygous TC genotype (192, 327, 490 bp); 3 and 4, TT genotype (192, 327 bp); 5 and 6, CC genotype (490 bp). Alignment markers (15 bp, 1 kbp).</p

Restriction enzymes and length of the restriction fragments.

<p>Restriction enzymes and length of the restriction fragments.</p