Association of the A Allele of the TNF-Alpha-308 G/A Gene Polymorphism with Radiographic Progression in Rheumatoid Arthritis - - - Udruženost A alela polimorfizma -308 G/A gena za TNF alfa sa radiografskom progresijom reumatoidnog artritisa
Journal Title: Acta Facultatis Medicae Naissensis - Year 2018, Vol 35, Issue 1
Abstract
To examine whether the presence of the rare A allele of the TNF-Alpha-308 G/A gene polymorphism is associated with erosive arthritis and rapid radiological progression of the disease. The examined group included 131 patients with early RA. Using the PCR-RFLP method, the TNF-Alpha-308 G/A gene polymorphism was determined for all patients. In relation to the presence of the A allele of the examined polymorphism, the patients were divided into two subgroups: subgroup A (G/A and A/A genotypes) and subgroup G (G/G genotype). Based on the presence of the destructive changes in joints found in the initial radiographs, the findings were classified as erosive and non-erosive RA. Radiological progression was assessed on the basis of the annual change in the Larsen score – LS (0-200). Group A comprised 62 (47.33%) patients, while group G comprised 69 (52.67%) patients. The presence of cysts and erosions in subgroups A and G was compared before the start of the methotrexate therapy. It was determined that erosions (erosive RA) were statistically significantly more frequent in group A (83.87% of patients) in comparison with group G (44.93% of patients), p < 0,001. Group A patients had a higher value of the Larsen score in relation to the group G both before and after methotrexate was administered for a year (before therapy, LS in group A: 48.58 ± 20.54; in group G 20.73 ± 12.31; p < 0.01; after MTX therapy, LS in group A: 58.32 ± 22.25; in group G 25.35 ± 14.57; p < 0.001). The average value of the annual LS change in group A was statistically significantly greater than the change in group G patients (9.98 ± 4.95 to 5.23 ± 2.72) (p < 0.05). The presence of the A allele of the TNF-Alpha-308 G/A gene polymorphism is associated with the occurrence of early erosive joint changes and more rapid radiological progression of the disease. - - - Cilj rada bio je ispitati da li je prisustvo retkog A alela polimorfizma -308 G/A gena za TNF alfa udruženo sa erozivnim artritisom i brzom radiološkom progresijom bolesti. Ispitivanu grupu činio je 131 bolesnik sa ranim reumatoidnim artritisom (RA). Svim bolesnicima je metodom PCR-RFLP određivan polimorfizam -308 G/A gena za TNF alfa. U odnosu na prisustvo A alela ispitivanog polimorfizma, bolesnici su podeljeni u dve podgrupe: podgrupu A (genotipovi G/A i A/A) i podgrupu G (G/G genotip). Na osnovu prisustva destruktivnih zglobnih promena na početnim radiografijama nalazi su kvalifikovani kao erozivni i neerozivni RA. Radiološka progresija procenjivana je na osnovu godišnje promene Larsen skora – LS (0-200). Grupi A pripadala su 62 (47,33%) bolesnika, G grupi 69 (52,67%) bolesnika. Grupe su bile homogene po starosnoj i polnoj distribuciji. Komparirali smo prisustvo cisti i erozija u A i G podgrupi pre početka terapije Metotreksatom. Utvrdili smo da su erozije (erozivni RA) statistički značajno češće u grupi A (83,87% bolesnika) u odnosu na G grupu (44,93% bolesnika), p < 0,001. Veću vrednost Larsen skora imali su bolesnici A grupe u odnosu na G grupu kako pre tako i nakon godinu dana od primene Metotreksata (pre th LS u A grupi: 48,58 ± 20,54; u G grupi 20,73 ± 12,31; p < 0,01, posle th MTX-om LS u A grupi 58,32 ± 22,25; u G grupi 25,35 ± 14,57; p < 0,001). U A grupi prosečna vrednost godišnje promene LS statistički je značajno veća u odnosu na promenu LS kod bolesnika G grupe (9,98 ± 4,95 prema 5,23 ± 2,72) (p < 0,05). Prisustvo A alela polimorfizma -308 G/A gena za TNF alfa udruženo je sa pojavom ranih erozivnih zglobnih promena i bržom radiološkom progresijom bolesti.
Authors and Affiliations
Sonja Stojanović, Bojana Stamenković, Jovan Nedović, Tatjana Jevtović-Stoimenov, Dušica Pavlović
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