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Defence against Neisseria meningitidis involves complement-mediated bactericidal activity. Factor H (fH) down-regulates complement activation. A putatively functional single-nucleotide-polymorphism (SNP) exists within a presumed nuclear-factor-kappa-B responsive element (NF-kB) in the fH gene (C-496T). Genetic and functional investigations were carried out to determine whether C-496T has a role in meningococcal disease (MD) susceptibility. Genetic susceptibility was investigated in 2 independent studies, a case-control and family-based transmission-disequilibrium-test (TDT), using 2 separate cohorts of UK Caucasian patients. MD susceptibility was both genetically associated with the C/C homozygous genotype (OR = 2.0, 95% CI 1.3 - 3.2, p = 0.001) and linked to the C allele (p = 0.04), the association being most significant in serogroup C infected patients (OR = 2.9, 95% CI 1.6 - 5.5, p = 0.0002). FH serum concentrations were also associated with C-496T genotype, with highest fH concentrations in C/C homozygous individuals (p = 0.01). Functional studies showed NF-kappa-B binding to the C-496T-containing region and that pre-incubation of fH with meningococci reduced bactericidal activity and increased meningococci B and C survival in blood. This study shows that C-496T is both associated and linked with MD and that individuals possessing the fH C-496T C/C genotype are more likely to have increased serum fH protein levels, have reduced bactericidal activity against meningococci and be at an increased risk of contracting MD.

Original publication




Journal article


Scandinavian journal of infectious diseases

Publication Date





764 - 771


Department of Clinical and Molecular Genetics, Institute of Child Health, University College, London, UK.


Humans, Meningococcal Infections, Disease Susceptibility, Genetic Predisposition to Disease, Complement Factor H, NF-kappa B, Case-Control Studies, Cohort Studies, Blood Bactericidal Activity, Protein Binding, Homozygote, Polymorphism, Single Nucleotide, Alleles, Adolescent, Adult, Aged, Middle Aged, Child, Child, Preschool, Infant, European Continental Ancestry Group, Family Health, Statistics as Topic, United Kingdom