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Table 1 Characteristics of included studies

From: The influence of single nucleotide polymorphisms of NOD2 or CD14 on the risk of Mycobacterium tuberculosis diseases: a systematic review

Author/year

Country

Study design

Ethnicity

Gene/studied SNP

TB diagnosis

Sample size

Type of study (Susceptibility/resistance to Mtb diseases or risk of Mtb diseases)

Type of control

TB screening controls (Tuberculin skin test (TST) or Interferon -gamma Release Assay (IGRA) )

Inclusion and exclusion criteria cases

Inclusion and exclusion criteria controls

Outcomes

Zheng et al., 2018 [23]

China

Case control

Chinese Han

CD14 rs2569190 C>T

Spinal

240 TB and 150 controls; N= 390

Risk of Mtb diseases

Healthy controls

Not reported

Patients diagnosed with extra-pulmonary TB, who tested negative for PTB. Every included patient is free of comorbidities. The spinal TB patients with comorbid disorders or other complications, such as rheumatoid arthritis, congenital cervical anomalies, trauma, prior spinal cervical surgery, HIV-positive, or ankylosing spondylitis were excluded from the present study.

Age- and sex-matched healthy subjects were enrolled as controls.

The frequency of the rs2569190 T allele was significantly higher in spinal TB patients than in controls (OR=1.97, 95% CI= 1.24–3.42) (p<0.01), and the frequency of the CT+TT genotypes (OR=2.10, 95% CI= 1.09–3.85) was also significantly higher in spinal TB patients than in controls (p<0.05).

Xue et al., 2012 [24]

China

Case control

Chinese Han

CD14 rs2915863 G>A; rs3138078 T>G; rs2569190 C>T; rs2569191 A>G; rs3138076 T>C; rs5744454 T>G, rs5744455 G>T

Pulmonary

318 TB and 380 controls; N= 698

Risk of Mtb diseases

The control group was unrelated blood donors with no history of TB or other immune diseases.

Not reported

Patients with PTB confirmed by clinical, radiological, and bacteriological investigation. Patients were excluded if they tested positive for HIV or if they were undergoing immunosuppressive agents.

Healthy individuals, with no history of TB or immune diseases.

The G allele of rs2915863 (OR=1.41, 95% CI=1.12–1.76), G allele of rs3138078 (OR=1.77, 95% CI=1.39–2.24), G allele of rs2569191 (OR=1.78, 95% CI=1.43–2.22), and T allele of rs2569190 (OR=1.73, 95% CI=1.40–2.15, respectively) were significantly associated with TB. rs3138076, rs5744454, and rs5744455, there were no statistically relevant associations

Zhao et al., 2012 [25]

China

Case control

Chinese Han

CD14 rs2569190 C>T; rs2569191 G>A

Pulmonary and extrapulmonary TB

432 TB and 404 controls; N= 836

Risk of Mtb diseases

The control group comprised unrelated blood donors with no history of TB or other immune diseases.

Not reported

Patients were undergoing standard TB treatment at the TB clinic of the Sixth Hospital of Shaoxing and Hangzhou Red Cross Hospital between October 2005 and October 2009. They were excluded if HIV+ or were taking immunosuppressive agents.

Healthy, unrelated blood donors with no history of TB or other immune diseases. All control subjects were from the same ethnic population and geographical origin and were living in the same region as the patients with TB.

Both the frequency of allele T in the rs2569190 (OR= 1.4, 95% CI = 1.148–1.708) and allele G in the rs2569191 (OR = 1.512, 95% CI = 1.236–1.849) were significantly more frequent in cases than in controls and were also significantly associated with TB. The frequencies of genotypes CT and CC in the rs2569190 (OR = 0.46 and 0.63, respectively; 95% CI = 0.34–0.63 and 0.42–0.93), as well as the frequencies of genotypes AG and AA in the rs2569191 (OR = 0.60 and 0.44, respectively; 95% CI = 0.44–0.83 and 0.29–0.65) were lower in cases than in controls and were also protective against the disease.

Alavi-Naini et al., 2012 [26]

Iran

Case control

Persian, Balouch, and Afghan Iranians

CD14 rs2569190 C>T

Pulmonary

120 TB and 131 controls; N= 251

Risk of Mtb diseases

The control group was healthy subjects with absence of clinical symptoms and signs suggestive of active pulmonary TB and normal chest X-ray.

Not reported

Culture-positive PTB patients were included. They had no other comorbidities such as myocardial infarction, septic shock, liver cirrhosis, or pancreatitis.

Healthy subjects matched for age, sex, and ethnicity. The inclusion criteria were absence of clinical symptoms or signs for active TB and normal chest X-ray, no medical history of TB or other infectious or autoimmune diseases.

The frequency of the rs2569190 T allele was 57% in TB patients and 44% in controls and was significantly different (p < 0.002). The risk of Mtb diseases was 2.3-fold greater in individuals with the T-allele (CT + TT) than in those without (OR= 2.3, 95% CI= 1.2–4.3, p = 0.006).

Rosas-Taraco et al., 2007 [4]

Mexico

Case control

White and Mestizo Mexican

CD14 rs2569190 C>T

Pulmonary

111 TB and 174 controls; N = 285

Risk of Mtb diseases

Healthy individuals as control subjects

Not reported

All patients had active pulmonary TB diagnosed on the basis of clinical findings and smear or culture positive for PTB. Also, 67 were household contacts who were or were not genetically related to the patients. All participants were negative for HIV and diabetes and not treated with steroids or immunosuppressive agents.

114 healthy individuals. All of them were Mexican older than 18 years.

The frequency of the rs2569190 homozygous TT genotype was highest in patients with pulmonary TB (OR= 3.37, 95% CI= 1.58–7.19 p=<0.002). The frequency of the rs2569190 allele T had a significantly higher risk for the development of pulmonary TB (OR= 2.267; 95% CI= 1.5–3.3).

Ayaslioglu et al., 2012 [27]

Turkey

Case control

Turkish

CD14 rs2569190 C>T

Pulmonary and extrapulmonary TB

88 TB and 116 controls; N = 204

Risk of Mtb diseases

Control group was selected from the adult population who had no underlying comorbidity and no diagnosis of tuberculosis.

Tuberculin skin test (TST)

Subjects who had a diagnosis of tuberculosis; age ≥16 years; and consented to be included into the study. Patients who had infectious diseases in the last 6 weeks, had significant chronic immunosuppressive systemic diseases, was pregnant, or HIV+ were excluded.

Subjects with no known diseases. Patients who had infectious diseases in the last 6 weeks, had significant chronic immunosuppressive systemic diseases, was pregnant, or HIV+ were excluded.

There was no significant difference in terms of genotype distribution between patients with tuberculosis and controls.

Kang et al., 2009 [28]

South Korea

Case control

Korean

CD14 rs2569190 C>T

Pulmonary and extrapulmonary TB

274 TB and 422 controls; N = 696

Risk of Mtb diseases

A control group consisting of 422 healthy blood donors with normal chest X-ray and without respiratory symptoms and signs

Tuberculin skin test (TST)

Patients with confirmed tuberculosis were enrolled from Seoul National University Hospital in Korea. Patients with a positive HIV test were excluded.

A group of healthy blood donors with normal chest X-ray and without respiratory symptoms and signs were recruited from medical students and employees of Seoul National University College of Medicine/Seoul National University Hospital.

The frequency of the rs2569190 T allele was higher in tuberculosis patients than in healthy controls (64% vs. 57%; p = 0.01), and rs2569190 TT genotypes (OR= 1.60; 95% CI, 1.01–2.54) were over-represented among tuberculosis patients (43% vs. 32%; p = 0.016).

Druszczyñska et al., 2006 [29]

Poland

Case control

Caucasian Polish

CD14 rs2569190 C>T

Pulmonary TB

126 TB and 122 controls; N = 248

Risk of Mtb diseases

Healthy volunteers who had no past history of TB

Not reported

Not reported

Not reported

No association was found between the rs2569190 and the presence of TB.

Pacheco et al., 2004 [12]

Colombia

Case control

Caucasian and Mestizo Colombian

CD14 rs2569190 C>T

Pulmonary and extrapulmonary TB

267 TB and 112 controls; N = 379

Risk of Mtb diseases

Healthy control individuals were recruited

Tuberculin skin test (TST)

Patients were recruited from different health units in the metropolitan area of Medellin, Colombia. Individuals, who were HIV+, or with a history of cancer, autoimmune, metabolic, or endocrine diseases, as well as pregnant women, were excluded from the study.

Tuberculin-positive healthy control individuals were recruited from the Facultad de Medicina at the Universidad de Antioquia, and the institutions from where the patients were recruited.

No association was found between the allele and genotype frequencies and the presence of TB or between the different forms of the disease.

Hall et al., 2015 [30]

Uganda

Case control

USA

NOD2 rs6500328 A>G, rs2111234 G>A and rs17313265 C>T

TBa

240 TB 595 controls; N= 835

Risk of Mtb diseases

Healthy household contacts without active disease were included in the control group

Tuberculin skin test (TST)

Analysis was gathered from two phases of a household contact study conducted in Kampala, Uganda. Subjects from the Household Contact Study were enrolled from 1995 to 1999. Individuals who presented at the study clinic with active culture-positive pulmonary TB were enrolled as index cases.

Analysis was gathered from two phases of a household contact study conducted in Kampala, Uganda. Subjects from the Household Contact Study were enrolled from 1995 to 1999. Healthy household contacts underwent a follow-up evaluation every 3 months for the first 6 months and were enrolled as control

rs17313265 association with TB in adults (examination of age-specific effects with TB) (OR= 2.82, 95% CI= 1.05–7.53). rs6500328 (OR= 2.44, 95% CI=1.01–5.88) and rs2111234 (OR= 1.56 95% CI= 1.07–2.28) showed a nominal association with resistance to Mycobacterium tuberculosis (Mtb) infection.

Zhao et al., 2012 [31]

China

Case control

Chinese Han, Uygur and Kazak

NOD2 rs1861759 T>G

Pulmonary

425 TB and 380 controls; N=805

Risk of Mtb diseases

Healthy controls were HIV negative and none was known to present any autoimmune, chronic inflammatory or any other disease conditions.

Not reported

Han population 219 PTB and 215 healthy controls; For the Uygur population 86 PTB patients and 72 controls; for the Kazak 120 PTB patients and 93 healthy controls. The patients were diagnosed based on the TST test, chest X-ray, or sputum smear culture results.

They were HIV-negative patients and controls without any auto immune, chronic inflammatory, or any other disease condition. All selected patients had no mixed descendants within 3 generations.

By comparing the TG genotype frequencies of rs1861759 in the Han population, a significant difference was observed between the patients with TB and the healthy controls (OR= 2.16; 95% CI= 1.31–3.58; p= 0.0023).

Pan et al., 2012 [32]

China

Case control

Chinese Han

NOD2 rs7194886 C>T and rs9302752 T>C

Pulmonary

1043 TB and 808 controls; N= 1851

Risk of Mtb diseases

The controls were selected from a pool of individuals who participated in the local community-based health examination programs. None of controls had a history of active tuberculosis and/or a malignancy

Not reported

Patients older than 15 years, Han Chinese. They were divided in 3 groups: clinical symptoms of TB, sputum smear positive, and bacteriologically confirmed TB. 234 of 1043 TB patients were sputum smear negative.

Every control was older than 15 years, without history of TB and/or a malignancy.

The individuals carrying the CT/TT genotype of rs7194886 had an increased risk of pulmonary tuberculosis (OR= 1.35, 95% CI= 1.05–1.72). Allele frequency analysis found that variant allele T of rs7194886 (OR= 1.25, 95% CI= 1.00–1.57) was associated with an increased risk of tuberculosis. Haplotype rs9302752 C–rs7194886 T was associated with an increased risk of being sputum culture-positive tuberculosis (p = 0.039).

Austin et al., 2008 [33]

USA

Case control

African Americans

NOD2 rs2066842 C>T rs2066844 C>T, and rs5743278 C>G

Pulmonary and extrapulmonary TB

377 TB and 187 controls; N = 564

Risk of Mtb diseases

Control subjects for this study were recruited without a history of TB, autoimmune disease, or other infectious diseases

Tuberculin skin test (TST)

All cases patients were HIV negative and had their ethnicities determined by self-indication. TB diagnosis was given based on bacille culture (286/312 PTB cases and 33/43 of EPTB); in these negative patients, diagnosis was based on clinical manifestations, chest X-ray, and clinical improvement to antimycobacterial treatment.

African Americans without history of TB, autoimmune disease, or other diseases.

Minor allele carriers (heterozygous and homozygous) of rs2066842 (OR= 0.55, 95% CI=0.32–0.94, p= 0.02) and rs2066844 (OR= 0.27, 95% CI= 0.08–0.88; p= 0.01) presented decreased risks for TB disease. Conversely, the minor allele carrier (heterozygous) of rs2066844 (OR= 2.16, 95% CI= 1.10–4.72; p= 0.03) showed an increased risk for TB disease.

  1. Abbreviations: NOD2 nucleotide-binding oligomerization domain-containing protein 2, CD14 Cluster Differentiation antigen 14, TB tuberculosis, PTB pulmonary tuberculosis, EPTB extrapulmonary tuberculosis, OR odds ratio, CI confidence intervals, USA United States of America
  2. aDid not specify the TB type