MUC1突变导致常染色体显性小管间质肾病患者COVID-19死亡率增加8倍:一项观察性研究

IF 2.2 4区 医学 Q2 UROLOGY & NEPHROLOGY BMC Nephrology Pub Date : 2024-12-18 DOI:10.1186/s12882-024-03896-1
Kendrah O Kidd, Adrienne H Williams, Abbigail Taylor, Lauren Martin, Victoria Robins, John A Sayer, Eric Olinger, Holly R Mabillard, Gregory Papagregoriou, Constantinos Deltas, Christoforos Stavrou, Peter J Conlon, Richard Edmund Hogan, Elhussein A E Elhassan, Drahomíra Springer, Tomáš Zima, Claudia Izzi, Alena Vrbacká, Lenka Piherová, Michal Pohludka, Martin Radina, Petr Vylet'al, Katerina Hodanova, Martina Zivna, Stanislav Kmoch, Anthony J Bleyer
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引用次数: 0

摘要

背景:MUC1和UMOD致病变异可引起常染色体显性小管间质肾病(ADTKD)。MUC1在肾脏、鼻黏膜和呼吸道均有表达,而UMOD仅在肾脏中表达。由于单倍体功能不全,ADTKD-MUC1患者产生的粘蛋白-1约为正常的50%。方法:为了确定粘蛋白-1生成减少是否与COVID-19风险增加相关,我们于2021年9月向ADTKD登记处的成员发送了一项调查,当时是在最初的严重COVID-19浪潮之后。我们将结果与先前获得的ADTKD基因型和血浆CA15-3(粘蛋白-1)水平联系起来,并创建了COVID-19相关死亡的纵向登记。结果:通过电子邮件向637个人发送了调查问卷,其中89名ADTKD-MUC1和132名ADTKD-UMOD个人做出了回应。ADTKD-MUC1调查对象中有19/83(23%)报告既往感染过COVID-19,而ADTKD-UMOD调查对象中有14/125(11%)报告既往感染过COVID-19(比值比(OR) 2.35 (95%CI 1.60-3.11, P = 0.0260)。包括调查对象报告的其他家族病例,10/41 (24%)ADTKD-MUC1个体死于COVID-19,而1/30 (3%)ADTKD-UMOD, OR为9.21 (95%CI 1.22-69.32), P = 0.03。14例ADTKD-MUC1感染者和27例未感染者感染前血浆粘蛋白-1平均水平分别为7.06±4.12和10.21±4.02 U/mL (P = 0.035)。在三年的时间里,我们的纵向登记发现360例ADTKD-MUC1个体中有19例COVID-19死亡(5%),478例ADTKD-UMOD个体中有3例死亡(0.6%)(P = 0.0007)。多因素logistic回归显示,COVID-19死亡的比值比(95%置信区间)如下:ADTKD-MUC1 8.4(2.9-29.5),肾移植5.5(1.6-9.1),体重指数(kg/m2) 1.1(1.0-1.2),年龄1.04(1.0-1.1)。结论:ADTKD-MUC1患者的COVID-19死亡率比ADTKD-UMOD患者高8倍。单倍体粘蛋白-1产生不足可能是原因。
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Eight-fold increased COVID-19 mortality in autosomal dominant tubulointerstitial kidney disease due to MUC1 mutations: an observational study.

Background: MUC1 and UMOD pathogenic variants cause autosomal dominant tubulointerstitial kidney disease (ADTKD). MUC1 is expressed in kidney, nasal mucosa and respiratory tract, while UMOD is expressed only in kidney. Due to haplo-insufficiency ADTKD-MUC1 patients produce approximately 50% of normal mucin-1.

Methods: To determine whether decreased mucin-1 production was associated with an increased COVID-19 risk, we sent a survey to members of an ADTKD registry in September 2021, after the initial, severe wave of COVID-19. We linked results to previously obtained ADTKD genotype and plasma CA15-3 (mucin-1) levels and created a longitudinal registry of COVID-19 related deaths.

Results: Surveys were emailed to 637 individuals, with responses from 89 ADTKD-MUC1 and 132 ADTKD-UMOD individuals. 19/83 (23%) ADTKD-MUC1 survey respondents reported a prior COVID-19 infection vs. 14/125 (11%) ADTKD-UMOD respondents (odds ratio (OR) 2.35 (95%CI 1.60-3.11, P = 0.0260). Including additional familial cases reported from survey respondents, 10/41 (24%) ADTKD-MUC1 individuals died of COVID-19 vs. 1/30 (3%) with ADTKD-UMOD, with OR 9.21 (95%CI 1.22-69.32), P = 0.03. The mean plasma mucin-1 level prior to infection in 14 infected and 27 uninfected ADTKD-MUC1 individuals was 7.06 ± 4.12 vs. 10.21 ± 4.02 U/mL (P = 0.035). Over three years duration, our longitudinal registry identified 19 COVID-19 deaths in 360 ADTKD-MUC1 individuals (5%) vs. 3 deaths in 478 ADTKD-UMOD individuals (0.6%) (P = 0.0007). Multivariate logistic regression revealed the following odds ratios (95% confidence interval) for COVID-19 deaths: ADTKD-MUC1 8.4 (2.9-29.5), kidney transplant 5.5 (1.6-9.1), body mass index (kg/m2) 1.1 (1.0-1.2), age (y) 1.04 (1.0-1.1).

Conclusions: Individuals with ADTKD-MUC1 are at an eight-fold increased risk of COVID-19 mortality vs. ADTKD-UMOD individuals. Haplo-insufficient production of mucin-1 may be responsible.

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来源期刊
BMC Nephrology
BMC Nephrology UROLOGY & NEPHROLOGY-
CiteScore
4.30
自引率
0.00%
发文量
375
审稿时长
3-8 weeks
期刊介绍: BMC Nephrology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of kidney and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
期刊最新文献
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