Insertion/deletion polymorphism in the promoter of NFKB1 influences severity but not mortality of acute respiratory distress syndrome

Objective: This study investigated whether the insertion/deletion polymorphism in the promoter of NFKB1 is associated with severity and/or mortality in ARDS. Design and setting: Prospective study in a mixed anesthesiological ICU of the University Hospital Essen. Patients and participants: 103 adult patients with ARDS (white Germans). Measurements and results: Patients with ARDS were genotyped for the insertion/deletion polymorphism in the promoter of NFKB1 (-94ins/delATTG). In ARDS patients genotypes differed significantly between those with severe ARDS [Lung Injury Score (LIS) >= 3; 23 homozygote deletion (DD), heterozygote (ID) 31, and homozygote insertion wildtype (II) 23], and those with LIS below 3 (1 DD, 9 ID, 16 II). Likewise, the frequency of the D allele was significantly less in patients with higher LIS (50% D) than lower LIS (21% D). Using these values produces a significantly higher OR of 16.0 (95% CI 1.96-130.9) for DD than for II, while the OR for ID vs. II was 2.4 (95% CI 0.9-6.4). Genotypes of the NFKB1 promoter polymorphism were associated neither with 30-day survival nor with duration of ICU stay. Conclusions: The insertion/deletion polymorphism in the promoter of NFKB1 influences the severity but not the mortality of ARDS.