| Summary: | <i>Background and Objectives:</i> Several studies inspected the impact of <i>P2X7</i> polymorphisms on individual susceptibility to tuberculosis (TB), but the findings are still controversial and inconclusive. To achieve a more precise estimation, we conducted a meta-analysis of all eligible studies on the association between <i>P2X7</i> polymorphisms and TB risk. <i>Materials and</i> <i>Methods:</i> Relevant studies were identified by searching the PubMed, Web of Science, Scopus and Google scholar databases up to November 2018. Twenty-four full-text articles were included in our meta-analysis. The strength of association between <i>P2X7</i> polymorphisms and TB risk was evaluated by odds ratios (ORs) and 95% confidence intervals (95% CIs) under five genetic models. <i>Results:</i> The findings of this meta-analysis revealed that the rs3751143 variant significantly increased the risk of TB in heterozygous codominant (OR = 1.44, 95%CI = 1.17−1.78, <i>p</i> = 0.0006, AC vs. AA), homozygous codominant (OR = 1.87, 95% CI = 1.40−2.49, <i>p</i> = 0.0004, CC vs. AA), dominant (OR = 1.50, 95% CI = 1.22−1.85, <i>p</i> = 0.0002, AC + CC vs. AA), recessive (OR = 1.61, 95% CI = 1.25−2.07, <i>p</i> = 0.001, CC vs. AC + AA), and allele (OR = 1.41, 95% CI = 1.19−1.67, <i>p</i> < 0.0001, C vs. A) genetic models. Stratified analysis showed that rs3751143 increased the risk of pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) in all genetic models. Furthermore, the rs3751143 increased risk of TB in the Asian population. The findings did not support an association between the rs2393799, rs1718119, rs208294, rs7958311, and rs2230911 polymorphisms of <i>P2X7</i> and TB risk. <i>Conclusions:</i> The findings of this meta-analysis suggest that <i>P2X7</i> rs3751143 polymorphism may play a role in susceptibility to TB in the Asian population. More well-designed studies are required to elucidate the exact role of <i>P2X7</i> polymorphisms on TB development.
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