OBJECTIVETo investigate association of CD14-159C/T polymorphism with expression of leukocyte CD14 mRNA and plasma soluble CD14 (sCDI4) level in severe burn patients.

METHODSSeventy-seven patients with total burn surface area equal to or over 30% TBSA were hospitalized in the First Hospital Affiliated to the PLA General Hospital and Beijing You'anmen Hospital from June 2004 to June 2006. Blood samples were collected on 1st, 3rd, 5th, 7th, 14th, 21st, and 28th postburn day (PBD) for determination of CD14-159C/T polymorphism by PCR-subsequent restriction fragment length polymorphism (RFLP) analysis,plasma level of sCD14 and leukocyte CD14 mRNA expression were measured by ELISA and RT-PCR.

RESULTSFrequency of the T and C allele was 59.1%, 40.9%, respectively. Seven cases (9.1%) were homozygote (CC genotype), 49 cases (63.6%) were heterozygote (TC genotype), and 2 cases (27.3%) were TT homozygous allele,which reached the Hard-Weinberg equilibrium. Three cases with CC homozygote, 38 cases with TC heterozygote, and 15 cases with TT homozygous allele were complicated with sepsis, ending in MODS in 1, 19, 10 cases, respectively. Expression of leukocyte CD14 mRNA +/- 35, re- spectively), which were markedly higher than that in patients with CC homozygote during 7th-21st PBD (P < 0.05 or 0.01). The plasma level of sCD14 in patients with CC homozygote was significantly lower than that in patients with TC heterozygote on 5 PBD (85 +/- 46 microg/L vs 134 +/-43 mmicrog/L, P < 0.01), which were higher in patients with TC heterozygote and TT homozygous allele than that in patients with CC homozygote on 21st, 28thh PBD (P < 0.01). Conclusions In CD14 gene promoter-159C/T polymorphism, the gene and protein expression of CD14 in patients with TT, TC genotype are much higher than those in patients with CC homozygote. CD14 gene promoter-159 C/T polymorphism with TT homozygote may be one of the major markers in extensive burn patients in whom infection may progress to MODS. Compared with other genetypes, the incidence of MODS in sepsis patients with TT genotype increase markedly.