ABSTRACT
Background: Spontaneous bacterial peritonitis [SBP], a common and severe complication in patients with advanced liver cirrhosis, assumed that can result from bacterial translocation from the intestine. Mutations in the Nucleotide-binding oligomerization domain containing 2 [NOD2] genes contribute to bacterial translocation and subsequently increased susceptibility to spontaneous bacterial peritonitis. Aim: The aim of this study was to investigate the association between the NOD2 gene variants and SBP in Egyptian patients with post-HCV cirrhotic as cites
Patients and Methods: Overall, 90 patients with post-HCV cirrhotic ascites were genotyped for the three common NOD2 variants, 1007fs, R702W and G908R and underwent diagnostic paracentesis, the ascitic fluid was analyzed for polymorphonuclear leucocytic count [PMN] and bacterial culture results
Results: NOD2 risk alleles were detected in 13 patients [14.4%] and all patients were heterozygous for one NOD2 polymorphism. Patients with SBP were more often carriers for NOD2 risk alleles than patients without SBP [Odds ratio [OR] = 4.7, P= 0.027]. The NOD2 risk variant R702Wwas significantly higher in patients with SBP than other variants [OR= 6.2, P=0.021]. Univariate analysis revealed that predictors of SBP were a previous episode of SBP, recent variceal hemorrhage and the presence of a NOD2 risk allele. Multivariate analysis confirmed NOD2 polymorphism [OR = 3.7, p = 0.03] as independent predictor of SBP
Conclusion: NOD2 risk variants specifically R702W are associated with SBP susceptibility in the Egyptian patients with cirrhosis