Variations in the NRAMP1 Gene and Susceptibility to Tuberculosis in West Africans
Richard Bellamy, M.R.C.P., Cyril Ruwende, D.Phil., Tumani Corrah, Ph.D., Keith P.W.J. McAdam, F.R.C.P., Hilton C. Whittle, F.R.C.P., and Adrian V.S. Hill, D.Phil., D.M.
Background Genetic factors may affect the susceptibility totuberculosis, but no specific genes governing susceptibilityhave been identified. In mice, natural resistance to infectionwith some mycobacteria is influenced by the gene for natural-resistanceassociatedmacrophage protein 1 (Nramp1 ), but the role of the human homologueof this gene, NRAMP1, in tuberculosis is unknown. We typed polymorphismsin NRAMP1 in a casecontrol study of tuberculosis in theGambia, West Africa.
Methods Sequence-specific oligonucleotide hybridization andmicrosatellite analysis were used to type NRAMP1 polymorphismsin 410 adults (mean age, 34.7 years) with smear-positive pulmonarytuberculosis and 417 ethnically matched, healthy controls. Patientswith human immunodeficiency virus infection were excluded.
Results Four NRAMP1 polymorphisms were each significantly associatedwith tuberculosis. Subjects who were heterozygous for two NRAMP1polymorphisms in intron 4 and the 3' untranslated region ofthe gene were particularly overrepresented among those withtuberculosis, as compared with those with the most common NRAMP1genotype (odds ratio, 4.07; 95 percent confidence interval,1.86 to 9.12; chi-square = 14.58; P<0.001).
Conclusions Genetic variation in NRAMP1 affects susceptibilityto tuberculosis in West Africans.
Source Information
From the Wellcome Trust Centre for Human Genetics, Oxford University, Oxford, United Kingdom (R.B., C.R., A.V.S.H.), and the Medical Research Council Laboratories, Fajara, the Gambia (T.C., K.P.W.J.M., H.C.W.).
Address reprint requests to Professor Hill at the Wellcome Trust Centre for Human Genetics, Windmill Rd., Oxford OX3 7BN, United Kingdom.
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