Epidemiology Study On Environmental Risk Factors And Hereditary Susceptibility To Pulmonary Tuberculosis

Objective To explore the possible environmental risk factors of pulmonary tuberculosis and relationship between the -336 G/A single nucleotide polymorphisms(SNP) in CD209,the +874 T/A SNP in interferon-γ(IFN-γ) gene, the -251 T/A SNP in interleukin-8(IL-8) gene,the -2518 A/G SNP in monocyte chemoattactant protein-1(MCP-1)gene of Chinese Han population and susceptibility to pulmonary tuberculosis,and luther to explore the interaction,with environmental factors to pulmonary tuberculosis.Methods A paired case-control study was conducted.167 new pulmonary tuberculosis cases(110 male,57 female) meeting to standard coming from Qufu Center for Disease Control and Prevention and Renchen Tuberculosis Dispensary were paired with 167 outpatients coming from Affiliated Hospital of Jining Medical College and Jining First People's Hospital according to the same gender and similar age(no more than 3 years) from the March of 2008 to the August of 2008,and their general informations,current disease history,past medical history and related environmental factors informations of tuberculosis were collected using a questionnaire designed by ourselves.The -336 CD209 G/A,+874 IFN-γT/A,-251 IL-8 T/A and -2518 MCP-1 G/A SNP were detected in subjects by polymerase chain reaction(PCR) technique.Univariate and multivariate conditional logistic analyses were conducted in the end.Results Bacille Calmette-Guerin(BCG) immunization(P=0.015,OR= 1.607,OR 95%CI:1.098～2.353),smoking history(P=0.035,OR=1.472, OR 95%CI:1.028～2.107),natural lighting in living environment(P=0.020, OR=1.318,OR 95%CI:1.044～1.662),dust in working environment(P=0.054, OR=1.204,OR 95%CI:0.997～1.454),average family income per month(P =0.021,OR=0.582,OR 95%CI:0.368～0.921),+874 IFN-γAA(P=0.012, OR=2.611,OR 95%CI:1.230～5.543),-251 IL-8 AA(P=0.000,OR=4.619, OR 95%CI:2.304～9.259),-2518 MCP-1 GG(P=0.000,OR=7.072,OR 95%CI: 3.510～14.248) were significantly associated with pulmonary tuberculosis in multivariate conditional logistic analyses after adjusting other factors.There were interactions of multiplicative model between +874 IFN-γAA and TA and BCG immunization(P=0.053,OR=0.325,OR 95%CI:0.104～1.017) or smoking history (P=0.059,OR=0.272,OR 95%CI:0.070～1.052),-251 IL-8 AA and TA and BCG immunization(P=0.025,OR=0.333,OR 95%CI:0.127～0.872),-2518 MCP-1 GG and GA and BCG immunization(P=0.001,OR=2.897,OR 95%CI: 1.529～5.490) or smoking history(P=0.010,OR=0.069,OR 95%CI:0.009～0.532).There was not interaction of multiplicative model between -251 IL-8 AA and TA and smoking history.Conclusion Without BCG immunization history,smoking history,bad natural lighting in living environment,dust in working environment,+874 IFN-γAA,-251 IL-8 AA,-2518 MCP-1 GG are risk factors of pulmonary tuberculosis in Chinese Han population,but high average family income level per month is protective factor.In Chinese Han population without BCG immunization history or with smoking history,these with genotype +874 IFN-γAA or TA may be less susceptible to pulmonary tuberculosis than those with genotype TT.In Chinese Han population without BCG immunization history,these with genotype -251 IL-8 AA or TA may be less susceptible to pulmonary tuberculosis than those with genotype TT,but in Chinese Han population with smoking history,these with genotype -251 IL-8 AA or TA may be same susceptible to pulmonary tuberculosis than those with genotype TT.In Chinese Han population without BCG immunization history,these with genotype -2518 MCP-1 GG or GA may be more susceptible to pulmonary tuberculosis than those with genotype AA,but in Chinese Han population with smoking history,these with genotype -2518 MCP-1 GG or GA may be less susceptible to pulmonary tuberculosis than those with genotype AA.