A Polymorphism in the P2X7Gene Increases Susceptibility to Extrapulmonary Tuberculosis

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Abstract
Rationale: Genetic variation influences susceptibility to clinical tuberculosis (TB). Activation of the P2X7 receptor on human macrophages induces killing of mycobacteria. We have identified polymorphisms in the P2X7 gene that markedly reduce this killing.Objective: To determine if polymorphisms in P2X7 are associated with increased risk of TB, the prevalence of four polymorphisms was assessed in individuals from Southeast Asia, where the majority of patients with TB in our study originate. The association of these polymorphisms with clinical TB was subsequently investigated in two separate case-control cohorts and the function of P2X7 was assessed in subjects from one cohort.Methods: Genotyping of P2X7 polymorphisms was performed from subjects in a nested case-control study of a longitudinal refugee cohort and a separate case-control study. The functional capacity of P2X7 was investigated by measuring ATP-mediated mycobacterial killing and apoptosis.Results: Only the 1513A-C polymorphism was present in S...