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The aim of this study is to compare genotype distributions of two<jats:italic>TLR9<\/jats:italic>polymorphisms between clinical severity variables in MM survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used DNA samples of a cohort of 390 children who survived MM. Next, we determined the genotype frequencies of<jats:italic>TLR9<\/jats:italic>-1237 and<jats:italic>TLR9<\/jats:italic>+2848 polymorphisms and compared these between thirteen clinical variables associated with prognostic factors predicting adverse outcome of bacterial meningitis in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The<jats:italic>TLR9 -<\/jats:italic>1237 TC and CC genotypes were associated with a decreased incidence of a positive blood culture for<jats:italic>Neisseria (N.) meningitidis<\/jats:italic>(<jats:italic>p<\/jats:italic>\u2009=\u20090.014, odds ratio (OR) 0.5. 95% confidence interval (CI) 0.3 \u2013 0.9). The<jats:italic>TLR9 +<\/jats:italic>2848 AA mutant was associated with a decreased incidence of a positive blood culture for<jats:italic>N. meningitidis<\/jats:italic>(<jats:italic>p<\/jats:italic>\u2009=\u20090.017, OR 0.6, 95% CI 0.3 \u2013 0.9). Cerebrospinal fluid (CSF) leukocytes per \u03bcL were higher in patients carrying the<jats:italic>TLR9 -<\/jats:italic>1237 TC or CC genotypes compared to carriers of the TT wild type (WT) (<jats:italic>p<\/jats:italic>\u2009=\u20090.024, medians: 2117, interquartile range (IQR) 4987 versus 955, IQR 3938). CSF blood\/glucose ratios were lower in<jats:italic>TLR9 -<\/jats:italic>1237 TC or CC carriers than in carriers of the TT WT (<jats:italic>p<\/jats:italic>\u2009=\u20090.017, medians: 0.20, IQR 0.4 versus 0.35, IQR 0.5). CSF leukocytes\/\u03bcL were higher in patients carrying the<jats:italic>TLR9 +<\/jats:italic>2848 AA mutant compared to carriers of GG or GA (<jats:italic>p<\/jats:italic>\u2009=\u20090.0067, medians: 1907, IQR 5221 versus 891, IQR 3952).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We identified TLR9 genotypes associated with protection against meningococcemia and enhanced local inflammatory responses inside the central nervous system, important steps in MM pathogenesis and defense.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1471-2334-12-112","type":"journal-article","created":{"date-parts":[[2012,5,11]],"date-time":"2012-05-11T10:14:30Z","timestamp":1336731270000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Toll-like receptor 9polymorphisms are associated with severity variables in a cohort of meningococcal meningitis survivors"],"prefix":"10.1186","volume":"12","author":[{"given":"Marieke S","family":"Sanders","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gijs TJ","family":"van Well","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sander","family":"Ouburg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Servaas A","family":"Morr\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A Marceline","family":"van Furth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2012,5,11]]},"reference":[{"issue":"3","key":"1943_CR1","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/S1473-3099(05)70023-2","volume":"5","author":"NW Schroder","year":"2005","unstructured":"Schroder NW, Schumann RR: Single nucleotide polymorphisms of Toll-like receptors and susceptibility to infectious disease. 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