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Previous studies have reported the fundamental role of immunoregulatory
proteins in the clinical phenotype and outcome of sepsis. This study investigated two functional single
nucleotide polymorphisms (SNPs) of T cell immunoglobulin and mucin domain-containing protein 3
(TIM-3), which has a negative stimulatory function in the T cell immune response. Methods: Patients
with sepsis (n = 712) were prospectively enrolled from three intensive care units (ICUs) at the University
Medical Center Goettingen since 2012. All patients were genotyped for the TIM-3 SNPs rs1036199 and
rs10515746. The primary outcome was 28-day mortality. Disease severity and microbiological findings
were secondary endpoints. Results: Kaplan–Meier survival analysis demonstrated a significantly
lower 28-day mortality for TIM-3 rs1036199 AA homozygous patients compared to C-allele carriers
(18% vs. 27%, p = 0.0099) and TIM-3 rs10515746 CC homozygous patients compared to A-allele
carriers (18% vs. 26%, p = 0.0202). The TIM-3 rs1036199 AA genotype and rs10515746 CC genotype
remained significant predictors for 28-day mortality in the multivariate Cox regression analysis after
adjustment for relevant confounders (adjusted hazard ratios: 0.67 and 0.70). Additionally, patients
carrying the rs1036199 AA genotype presented more Gram-positive and Staphylococcus epidermidis
infections, and rs10515746 CC homozygotes presented more Staphylococcus epidermidis infections.
Conclusion: The studied TIM-3 genetic variants are associated with altered 28-day mortality and
susceptibility to Gram-positive infections in sepsis.