LARGE-SCALE CANDIDATE GENE STUDY OF TUBERCULOSIS SUSCEPTIBILITY IN THE KARONGA DISTRICT OF NORTHERN MALAWI

JODENE FITNESS Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Department of Tropical Hygiene, London School of Hygiene and Tropical Medicine, London, United Kingdom; Karonga Prevention Study, Chilumba, Karonga District, Malawi

Search for other papers by JODENE FITNESS in
Current site
Google Scholar
PubMed
Close
,
SIAN FLOYD Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Department of Tropical Hygiene, London School of Hygiene and Tropical Medicine, London, United Kingdom; Karonga Prevention Study, Chilumba, Karonga District, Malawi

Search for other papers by SIAN FLOYD in
Current site
Google Scholar
PubMed
Close
,
DAVID K. WARNDORFF Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Department of Tropical Hygiene, London School of Hygiene and Tropical Medicine, London, United Kingdom; Karonga Prevention Study, Chilumba, Karonga District, Malawi

Search for other papers by DAVID K. WARNDORFF in
Current site
Google Scholar
PubMed
Close
,
LIFTED SICHALI Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Department of Tropical Hygiene, London School of Hygiene and Tropical Medicine, London, United Kingdom; Karonga Prevention Study, Chilumba, Karonga District, Malawi

Search for other papers by LIFTED SICHALI in
Current site
Google Scholar
PubMed
Close
,
SIMON MALEMA Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Department of Tropical Hygiene, London School of Hygiene and Tropical Medicine, London, United Kingdom; Karonga Prevention Study, Chilumba, Karonga District, Malawi

Search for other papers by SIMON MALEMA in
Current site
Google Scholar
PubMed
Close
,
AMELIA C. CRAMPIN Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Department of Tropical Hygiene, London School of Hygiene and Tropical Medicine, London, United Kingdom; Karonga Prevention Study, Chilumba, Karonga District, Malawi

Search for other papers by AMELIA C. CRAMPIN in
Current site
Google Scholar
PubMed
Close
,
PAUL E. M. FINE Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Department of Tropical Hygiene, London School of Hygiene and Tropical Medicine, London, United Kingdom; Karonga Prevention Study, Chilumba, Karonga District, Malawi

Search for other papers by PAUL E. M. FINE in
Current site
Google Scholar
PubMed
Close
, and
ADRIAN V. S. HILL Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Department of Tropical Hygiene, London School of Hygiene and Tropical Medicine, London, United Kingdom; Karonga Prevention Study, Chilumba, Karonga District, Malawi

Search for other papers by ADRIAN V. S. HILL in
Current site
Google Scholar
PubMed
Close
Restricted access

Twenty-seven polymorphisms from 12 genes have been investigated for association with tuberculosis (TB) in up to 514 cases and 913 controls from Karonga district, northern Malawi. Homozygosity for the complement receptor 1 (CR1) Q1022H polymorphism was associated with susceptibility to TB in this population (odds ratio [OR] = 3.12, 95% Confidence interval [CI] = 1.13–8.60, P = 0.028). This association was not observed among human immunodeficiency virus (HIV)–positive TB cases, suggesting either chance association or that HIV status may influence genetic associations with TB susceptibility. Heterozygosity for a newly studied CAAA insertion/deletion polymorphism in the 3′-untranslated region of solute carrier family 11, member 1 (SLC11A1, formerly NRAMP1) was associated with protection against TB in both HIV-positive (OR = 0.70, 95% CI = 0.49–0.99, P = 0.046) and HIV-negative (OR = 0.65, 95% CI = 0.46–0.92, P = 0.014) TB cases, suggesting that the SLC11A1 protein may have a role in innate TB immune responses that influence susceptibility even in immunocompromised individuals. However, associations of other variants of SCLA11A with TB reported from other populations were not replicated in Malawi. Furthermore, associations with vitamin D receptor, interferon-γ, and mannose-binding lectin observed elsewhere were not observed in this Karonga study. Genetic susceptibility to TB in Africans appears polygenic. The relevant genes and variants may vary significantly between populations, and may be affected by HIV infection status.

Author Notes

  • 1

    Corbett EL, Watt CJ, Walker N, Maher D, Williams BG, Raviglione MC, Dye C, 2003. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med 163 :1009–1021.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Bloom BR, Small PM, 1998. The evolving relation between humans and Mycobacterium tuberculosis.N Engl J Med 338 :677–678.

  • 3

    Bellamy R, 2003. Interferon-gamma and host susceptibility to tuberculosis. Am J Respir Crit Care Med 167 :946–947.

  • 4

    Marquet S, Schurr E, 2001. Genetics of susceptibility to infectious diseases: tuberculosis and leprosy as examples. Drug Metab Dispos 29 :479–483.

  • 5

    Shaw MA, Collins A, Peacock CS, Miller EN, Black GF, Sibthorpe D, Lins-Lainson Z, Shaw JJ, Ramos F, Silveira F, Blackwell JM, 1997. Evidence that genetic susceptibility to Mycobacterium tuberculosis in a Brazilian population is under oligogenic control: linkage study of the candidate genes NRAMP1 and TNFA. Tuber Lung Dis 78 :35–45.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Gao PS, Fujishima S, Mao XQ, Remus N, Kanda M, Enomoto T, Dake Y, Bottini N, Tabuchi M, Hasegawa N, Yamaguchi K, Tiemessen C, Hopkin JM, Shirakawa T, Kishi F, 2000. Genetic variants of NRAMP1 and active tuberculosis in Japanese populations. International Tuberculosis Genetics Team. Clin Genet 58 :74–76.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Bellamy R, Ruwende C, Corrah T, McAdam KP, Whittle HC, Hill AV, 1998. Variations in the NRAMP1 gene and susceptibility to tuberculosis in west Africans. N Engl J Med 338 :640–644.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Ryu S, Park YK, Bai GH, Kim SJ, Park SN, Kang S, 2000. 3′UTR polymorphisms in the NRAMP1 gene are associated with susceptibility to tuberculosis in Koreans. Int J Tuberc Lung Dis 4 :577–580.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Cervino AC, Lakiss S, Sow O, Hill AV, 2000. Allelic association between the NRAMP1 gene and susceptibility to tuberculosis in Guinea-Conakry. Ann Hum Genet 64 :507–512.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Greenwood CM, Fujiwara TM, Boothroyd LJ, Miller MA, Frappier D, Fanning EA, Schurr E, Morgan K, 2000. Linkage of tuberculosis to chromosome 2q35 loci, including NRAMP1, in a large aboriginal Canadian family. Am J Hum Genet 67 :405–416.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Bellamy R, Ruwende C, Corrah T, McAdam KP, Thursz M, Whittle HC, Hill AV, 1999. Tuberculosis and chronic hepatitis B virus infection in Africans and variation in the vitamin D receptor gene. J Infect Dis 179 :721–724.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Selvaraj P, Narayanan PR, Reetha AM, 1999. Association of functional mutant homozygotes of the mannose binding protein gene with susceptibility to pulmonary tuberculosis in India. Tuber Lung Dis 79 :221–227.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Hoal-Van Helden EG, Epstein J, Victor TC, Hon D, Lewis LA, Beyers N, Zurakowski D, Ezekowitz AB, van Helden PD, 1999. Mannose-binding protein B allele confers protection against tuberculous meningitis. Pediatr Res 45 :459–464.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Pravica V, Perrey C, Stevens A, Lee JH, Hutchinson IV, 2000. A single nucleotide polymorphism in the first intron of the human IFN-gamma gene: absolute correlation with a polymorphic CA microsatellite marker of high IFN-gamma production. Hum Immunol 61 :863–866.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Rossouw M, Nel HJ, Cooke GS, van Helden PD, Hoal EG, 2003. Association between tuberculosis and a polymorphic NFkappaB binding site in the interferon gamma gene. Lancet 361 :1871–1872.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Lio D, Marino V, Serauto A, Gioia V, Scola L, Crivello A, Forte GI, Colonna-Romano G, Candore G, Caruso C, 2002. Genotype frequencies of the +874T→A single nucleotide polymorphism in the first intron of the interferon-gamma gene in a sample of Sicilian patients affected by tuberculosis. Eur J Immunogenet 29 :371–374.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Fitness J, Floyd S, Warndorff DK, Sichali L, Mwaungulu L, Crampin AC, Fine PEM, Hill AVS, 2004. Large-scale candidate gene study of leprosy susceptibility in the Karonga District of northern Malawi. Am J Trop Med Hyg 71 :330–340.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Kang TJ, Chae GT, 2001. Detection of Toll-like receptor 2 (TLR2) mutation in the lepromatous leprosy patients. FEMS Immunol Med Microbiol 31 :53–58.

  • 19

    Glynn JR, Jenkins PA, Fine PE, Ponnighaus JM, Sterne JA, Mkandwire PK, Nyasulu S, Bliss L, Warndorff DK, 1995. Patterns of initial and acquired antituberculosis drug resistance in Karonga District, Malawi. Lancet 345 :907–910.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Ponninghaus JM, Fine PE, Bliss L, Sliney IJ, Bradley DJ, Rees RJ, 1987. The Lepra Evaluation Project (LEP), an epidemiological study of leprosy in Northern Malawi. I. Methods. Lepr Rev 58 :359–375.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Crampin AC, Mwinuka V, Malema SS, Glynn JR, Fine PE, 2001. Field-based random sampling without a sampling frame: control selection for a case-control study in rural Africa. Trans R Soc Trop Med Hyg 95 :481–483.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Glynn JR, Warndorff DK, Malema SS, Mwinuka V, Ponnighaus JM, Crampin AC, Fine PE, 2000. Tuberculosis: associations with HIV and socioeconomic status in rural Malawi. Trans R Soc Trop Med Hyg 94 :500–503.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Fitness J, Tosh K, Hill AV, 2002. Genetics of susceptibility to leprosy. Genes Immun 3 :441–453.

  • 24

    Marquet S, Sanchez FO, Arias M, Rodriguez J, Paris SC, Skamene E, Schurr E, Garcia LF, 1999. Variants of the human NRAMP1 gene and altered human immunodeficiency virus infection susceptibility. J Infect Dis 180 :1521–1525.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Schlesinger LS, Horwitz MA, 1990. Phagocytosis of leprosy bacilli is mediated by complement receptors CR1 and CR3 on human monocytes and complement component C3 in serum. J Clin Invest 85 :1304–1314.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Hirsch CS, Ellner JJ, Russell DG, Rich EA, 1994. Complement receptor-mediated uptake and tumor necrosis factor-alpha-mediated growth inhibition of Mycobacterium tuberculosis by human alveolar macrophages. J Immunol 152 :743–753.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Xiang L, Rundles JR, Hamilton DR, Wilson JG, 1999. Quantitative alleles of CR1: coding sequence analysis and comparison of haplotypes in two ethnic groups. J Immunol 163 :4939–4945.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Bellamy R, Ruwende C, McAdam KP, Thursz M, Sumiya M, Summerfield J, Gilbert SC, Corrah T, Kwiatkowski D, Whittle HC, Hill AV, 1998. Mannose binding protein deficiency is not associated with malaria, hepatitis B carriage nor tuberculosis in Africans. QJM 91 :13–18.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Kube D, Platzer C, von Knethen A, Straub H, Bohlen H, Hafner M, Tesch H, 1995. Isolation of the human interleukin 10 promoter. Characterization of the promoter activity in Burkitt’s lymphoma cell lines. Cytokine 7 :1–7.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30

    Rees LE, Wood NA, Gillespie KM, Lai KN, Gaston K, Mathieson PW, 2002. The interleukin-10-1082 G/A polymorphism: allele frequency in different populations and functional significance. Cell Mol Life Sci 59 :560–569.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Crawley E, Kay R, Sillibourne J, Patel P, Hutchinson I, Woo P, 1999. Polymorphic haplotypes of the interleukin-10 5′ flanking region determine variable interleukin-10 transcription and are associated with particular phenotypes of juvenile rheumatoid arthritis. Arthritis Rheum 42 :1101–1108.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32

    Gibson AW, Edberg JC, Wu J, Westendorp RG, Huizinga TW, Kimberly RP, 2001. Novel single nucleotide polymorphisms in the distal IL-10 promoter affect IL-10 production and enhance the risk of systemic lupus erythematosus. J Immunol 166 :3915–3922.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33

    Fernandez-Reyes D, Craig AG, Kyes SA, Peshu N, Snow RW, Berendt AR, Marsh K, Newbold CI, 1997. A high frequency African coding polymorphism in the N-terminal domain of ICAM-1 predisposing to cerebral malaria in Kenya. Hum Mol Genet 6 :1357–1360.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34

    Rook GA, Steele J, Fraher L, Barker S, Karmali R, O’Riordan J, Stanford J, 1986. Vitamin D3, gamma interferon, and control of proliferation of Mycobacterium tuberculosis by human monocytes. Immunology 57 :159–163.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35

    Barber Y, Rubio C, Fernandez E, Rubio M, Fibla J, 2001. Host genetic background at CCR5 chemokine receptor and vitamin D receptor loci and human immunodeficiency virus (HIV) type 1 disease progression among HIV-seropositive injection drug users. J Infect Dis 184 :1279–1288.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36

    Means TK, Wang S, Lien E, Yoshimura A, Golenbock DT, Fenton MJ, 1999. Human toll-like receptors mediate cellular activation by Mycobacterium tuberculosis.J Immunol 163 :3920–3927.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37

    Keane J, Gershon S, Wise RP, Mirabile-Levens E, Kasznica J, Schwieterman WD, Siegel JN, Braun MM, 2001. Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent. N Engl J Med 345 :1098–1104.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38

    Blackwell JM, Black GF, Peacock CS, Miller EN, Sibthorpe D, Gnananandha D, Shaw JJ, Silveira F, Lins-Lainson Z, Ramos F, Collins A, Shaw MA, 1997. Immunogenetics of leishmanial and mycobacterial infections: the Belem Family Study. Philos Trans R Soc Lond B Biol Sci 352 :1331–1345.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39

    Goldfeld AE, Delgado JC, Thim S, Bozon MV, Uglialoro AM, Turbay D, Cohen C, Yunis EJ, 1998. Association of an HLA-DQ allele with clinical tuberculosis. JAMA 279 :226–228.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40

    Selvaraj P, Sriram U, Mathan Kurian S, Reetha AM, Narayanan PR, 2001. Tumour necrosis factor alpha (−238 and −308) and beta gene polymorphisms in pulmonary tuberculosis: haplo-type analysis with HLA-A, B and DR genes. Tuberculosis (Edinb) 81 :335–341.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41

    Roach DR, Briscoe H, Saunders B, France MP, Riminton S, Britton WJ, 2001. Secreted lymphotoxin-alpha is essential for the control of an intracellular bacterial infection. J Exp Med 193 :239–246.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42

    Ozaki K, Ohnishi Y, Iida A, Sekine A, Yamada R, Tsunoda T, Sato H, Hori M, Nakamura Y, Tanaka T, 2002. Functional SNPs in the lymphotoxin-alpha gene that are associated with susceptibility to myocardial infarction. Nat Genet 32 :650–654.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43

    Carrington M, Nelson G, O’Brien SJ, 2001. Considering genetic profiles in functional studies of immune responsiveness to HIV-1. Immunol Lett 79 :131–140.

  • 44

    Al-Sharif FM, Makki RF, Ollier WE, Hajeer AH, 1999. A new microsatellite marker within the promoter region of the MIP-1A gene. Immunogenetics 49 :740–741.

  • 45

    Saukkonen JJ, Bazydlo B, Thomas M, Strieter RM, Keane J, Kornfeld H, 2002. Beta-chemokines are induced by Mycobacterium tuberculosis and inhibit its growth. Infect Immun 70 :1684–1693.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 1563 1460 76
Full Text Views 432 9 2
PDF Downloads 96 9 2
 

 

 

 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save