gms | German Medical Science

80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

20.05. - 24.05.2009, Rostock

Insertion/deletion polymorphism in promoter of NFKB1 influences

Meeting Abstract

  • corresponding author Diana Arweiler-Harbeck - Universitäts-HNO-Klinik Duisburg-Essen, Essen, Germany
  • Ender Öztürk - Universitäts-HNO-Klinik Duisburg-Essen, Essen, Germany
  • Agnes Bankfalvi - Institut für Pathologie, Universitätsklinikum Duisburg-Essen, Essen, Germany
  • Kathrin Riemann - Institut für Pharmakogenetik, Universiätsklinikum Duisburg-Essen, Essen, Germany
  • Kurt Werner Schmid - Institut für Pathologie, Universitätsklinikum Duisburg-Essen, Essen, Germany
  • Jürgen Siffert - Institut für Pharmakognetik, Universitätsklinikum Essen, Essen, Germany
  • Stephan Lang - Universitäts-Hals-Nasen-Ohrenklinik Duisburg-Essen, Essen, Germany
  • Jürgen Peters - Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Duisburg-Essen, Essen, Germany
  • Michael Adamzik - Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Duisburg Essen, Essen, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Rostock, 20.-24.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09hno074

DOI: 10.3205/09hno074, URN: urn:nbn:de:0183-09hno0746

Published: July 22, 2009

© 2009 Arweiler-Harbeck et al.
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Outline

Text

Objective: This study investigated whether the insertionpolymorphism in the promoter of NFĸB1 is associated with the risk of bleeding after tonsillectomy. As Adamzik and coworkers could recently show, the nuclear factor ĸB which plays a critical role in host defense and in chronic inflammatory diseases influences the severity of acute respiratory distress syndrome and is associated with markedly increased LPS (lipopolysaccharid)-induced TNFα and tissue factor expression in human blood and therefore might influence the course of infectious diseases as well as disseminated intravascular coagulation [1]. We already know that in some cases major postoperative infection especially around blood vessels influences the risk of bleeding after tonsillectomy, although the special circumstances leading to postoperative haemorrhage have not been proven yet.

Design and setting: retrospective study of patient data and re-evaluation of tissue from tonsillectomy

Patients: 148 patients (male 68, female 80) who received tonsillectomy due to chronic tonsillitis. 56 patients suffered from bleeding after tonsillectomy, 92 patients had no complications.

Measurements and results: DNA-extraction from tonsillectomy tissue, genotyping for the insertion/deletion polymorphism in the promoter of NFKB1. Genotypes differed significantly between patients with post-tonsillectomy bleeding in contrast to patients with no bleeding after tonsillectomy. Patients all: 56 homozygote insertion [ins], 15 homozygote deletion [del], 77 heterozygote [het]. Patients with bleeding (56): 17 homozygote insertion, 10 homozygote deletion, 29 heterozygote. Patients without bleeding (92): 39 homozygote insertion, 5 homozygote deletion, 48 heterozygote. Evaluation by alleles: 1. bleeding: 63 (56, 3%) insertion, 49 (43,7%) deletion in contrast to 2. non bleeding: 126 (68,5%) insertion and 58 (31,5%) deletion. The Odds Ratio for patients with post operative bleeding carrying the deletion allele is 1,699 (95% CI 1.006-1.473). Data are independent from any pain medication or other risk factors for postoperative bleeding in general.

Conclusion: Carriers of the homozygote deletion allele have a 1,7 higher risk of post-operative bleeding after tonsillectomy than heterozygotes or insertion allele carriers.


References

1.
Adamzik M, Frey UH, Rieman K, Sixt S, Beiderlinden M, Siffert W, Peters J. Insertion/deletion polymorphism in the promoter of NF-κB1 influences severity but not mortality of acute respiratory distress syndrome. Intensive Care Med. 2007;33(7):1199-203.