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Background Ureaplasma spp. respiratory tract colonization is a risk factor for broncho-pulmonary dysplasia (BPD) in preterm infants, but differences in host susceptibility have not been elucidated. We hypothesized that variants in genes regulating the innate immune response are associated with altered risk for Ureaplasma spp. respiratory colonization and BPD in preterm infants. Methods Twenty-four tag SNPs from TLR1, TLR2, TLR4, and TLR6 were assayed in 298 infants <33 weeks gestation who had serial respiratory cultures for Ureaplasma species and were evaluated for BPD. Results The majority of subjects (N=205 [70%]) were African-American. One hundred and ten (37%) were Ureaplasma-positive. Four SNPs in TLR2 and TLR6 were significantly associated with Ureaplasma respiratory tract colonization. Single SNPs in TLR2, TLR4, and TLR6 were associated with BPD. TLR6 SNP rs5743827 was associated with both a decreased risk for Ureaplasma respiratory tract colonization and decreased risk for BPD (OR=0.54 [0.34-0.86] and OR=0.54 [0.31-0.95], respectively). There was a significant additive interaction between Ureaplasma colonization and genotype at TLR6 SNP rs5743827 (P additive = 0.023), with an attributable proportion due to interaction of 0.542. Conclusions Polymorphisms in host defense genes may alter susceptibility to Ureaplasma infection and severity of the inflammatory response contributing to BPD. These observations implicate host genetic susceptibility as a major factor in BPD pathogenesis in Ureaplasma-infected preterms.

Background We assessed whether 234 established dyslipidemia-associated loci modify the effects of metformin treatment and lifestyle intervention (vs. placebo control) on lipid and lipid sub-fraction levels in the Diabetes Prevention Program (DPP) randomized controlled trial. Methods and Results We tested gene-treatment interactions in relation to baseline adjusted follow-up blood lipid concentrations (high and low density lipoprotein cholesterol [HDL-C, LDL-C], total cholesterol, triglycerides) and lipoprotein sub-fraction particle concentrations and size in 2,993 participants with pre-diabetes. Of the previously reported SNP associations, 32.5% replicated at P<0.05 with baseline lipid traits. Trait-specific genetic risk scores (GRS) were robustly associated (3×10−4>P>1.1×10−16) with their respective baseline traits for all but two traits. Lifestyle modified the effect of the GRS for large HDL particle numbers, such that each risk allele of the GRSHDL-large was associated with lower concentrations of large HDL particles at follow-up in the lifestyle arm (β=−0.11 μmol/l per GRS risk allele; 95%CI −0.188, −0.033; P=5×10−3; Pinteraction=1×10−3 for lifestyle vs. placebo), but not in the metformin or placebo arms (P>0.05). In the lifestyle arm, participants with high genetic risk had more favorable or similar trait levels at 1-yr compared to participants at lower genetic risk at baseline for 17 of the 20 traits. Conclusions Improvements in large HDL particle concentrations conferred by lifestyle may be diminished by genetic factors. Lifestyle intervention, however, was successful in offsetting unfavorable genetic loading for most lipid traits.