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Tumor Necrosis Factor-a Gene Polymorphism in Severe and Mild-Moderate Rheumatoid Arthritis
MARTINA FABRIS, EMMA DI POI, ANGELA D'ELIA, GIUSEPPE DAMANTE, LUIGI SINIGAGLIA, and GIANFRANCO FERRACCIOLI
ABSTRACT. Methods. We investigated 163 patients (66 with severe disease) and 67 healthy blood donor controls. Genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism. Results. Patients with severe RA (all active disease despite disease modifying antirheumatic drug combination therapy) disclosed the -238 GG genotype in 100% of cases versus 92.8% of the mild-moderates and 92.5% of controls (OR 11.7, CI 0.6-216, p = 0.03). The +489 AA genotype was seen less often in patients than in controls (OR 4.2, CI 0.97-18.4, p = 0.045), and the contribution to this trend appeared predominant in the anti-TNF treated subgroup. Conclusion. The -238 AG genotype was absent in severe RA; in contrast, patients with mild-moderate RA disclosed the same frequency as controls. Thus -238 GG homozygosity is associated with severe RA. The +489 AA genotype might instead protect against worse outcome in RA. (J Rheumatol 2002;29:29-33) Key Indexing Terms:
TUMOR NECROSIS FACTOR-a
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