Epistatic Interactions Among Inflammasome Gene Variants Are Associated with Reduced Risk of Paracoccidioidomycosis.

da Silva Coelho, Sanderson; Amorim, Bárbara Casella; Ramos, Jeferson Vidart; da Costa Marques, Ana Paula; de Oliveira, Sandra Maria do Valle Leone; Pereira-Latini, Ana Carla; de Souza, Vânia Nieto Brito; de Rezende Romera, Grazielli Rocha et al. · J Infect Dis · 2026

case_control · Level III

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Abstract

Paracoccidioidomycosis (PCM) is an endemic systemic mycosis in Latin America with marked clinical heterogeneity, suggesting a role for host immunogenetic factors. The NLRP3 inflammasome and IL-1β signaling are important in antifungal immunity, but human genetic evidence remains limited. We evaluated whether single-nucleotide variants (SNVs) in inflammasome-related genes (NLRP1, NLRP3, CARD8, CASP1, and IL1B) are associated with PCM susceptibility, clinical form, and disease severity, including gene-gene interactions. We conducted a case-control study including 346 individuals (154 PCM patients and 192 gp43-reactive healthy controls). Genetic associations were tested under multiple inheritance models using logistic regression adjusted for age, sex, smoking, and alcoholism. Epistatic interactions were assessed within the inflammasome-IL-1β axis, with Firth penalized logistic regression as a sensitivity analysis. No single-SNV association with PCM susceptibility, clinical form, or severity remained significant after multiple-testing correction. Pairwise epistasis analysis identified an interaction between NLRP3 rs10754558 and IL1B rs1143634 associated with reduced PCM susceptibility (OR = 0.34; 95% CI: 0.17-0.69; pFDR = 0.015), supported by Firth regression. No significant epistatic interactions were found for clinical form or severity. Genetic interactions within the inflammasome-IL-1β axis may contribute to PCM susceptibility. The interaction between NLRP3 rs10754558 and IL1B rs1143634 warrants validation in larger, independent cohorts.