Zhang Dianliang, Li Jieshou, Jiang Zhiwei, Yu Baojun, Tang Xingming
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China.
Zhonghua Yi Xue Za Zhi. 2002 Nov 25;82(22):1529-31.
To investigate the relation of the frequency of TNF2 allele, a TNF-alpha promoter polymorphism, and plasma concentrations of TNF-alpha and soluble tumor necrosis receptor (sTNF-R) to acute severe pancreatitis (ASP) and its severe complication--sepsis.
The DNA samples of peripheral white blood cells of 72 ASP patients, 16 of them being complicated by severe sepsis and the other 46 cases being without sepsis, and 89 healthy volunteers were extracted. PCR, NcoI digestion, and electrophoresis were used to examine the polymorphism of the TNF-alpha gene promoter region -308. Plasma concentrations of TNF-alpha, sTNF-R I and sTNF-R II were measured by EASIA.
The TNF2 allele frequency of ASP patients was 29.2% (21/72), not significantly different from that of healthy volunteers (25.7%, 25/89) (P > 0.05). The prevalence rate of TNF2 was 46.2% in patients with severe sepsis, significantly higher than that of the patients without asepsis (19.6%, P < 0.05). The plasma levels of TNF-alpha, sTNF-R I, and sTNF-R II were 36 +/- 30 ng/L, 5.4 +/- 3.5 micro g/L, and 11.2 +/- 7.9 micro g/L respectively in patients with ASP, not significantly different from those in the healthy controls (30 +/- 25 ng/L, 4.6 +/- 3.8 micro g/L, and 8.8 +/- 6.6 micro g/L respectively, P > 0.05). There was no significant difference in baseline TNF-alpha levels between the TNF2 group and TNF1 group (37 +/- 31 ng/L vs. 31 +/- 25 ng/L, P > 0.05).
TNF-2 is not related to the pathogenesis of ASP, and is associated with the susceptibility to severe sepsis complicating ASP. The baseline TNF-alpha and sTNF-R levels have little value in predicting the development of severe sepsis.
研究肿瘤坏死因子-α（TNF-α）启动子多态性TNF2等位基因频率、血浆TNF-α浓度及可溶性肿瘤坏死因子受体（sTNF-R）与急性重症胰腺炎（ASP）及其严重并发症——脓毒症之间的关系。
提取72例ASP患者外周血白细胞的DNA样本，其中16例并发严重脓毒症，46例未发生脓毒症，另取89名健康志愿者作为对照。采用聚合酶链反应（PCR）、NcoI酶切及电泳法检测TNF-α基因启动子区-308位点的多态性。采用酶联免疫吸附测定法（EASIA）检测血浆TNF-α、sTNF-R I及sTNF-R II的浓度。
ASP患者的TNF2等位基因频率为29.2%（21/72），与健康志愿者（25.7%，25/89）相比差异无统计学意义（P>0.05）。严重脓毒症患者中TNF2的发生率为46.2%，显著高于未发生脓毒症的患者（19.6%，P<0.05）。ASP患者血浆TNF-α、sTNF-R I及sTNF-R II水平分别为36±30 ng/L、5.4±3.5μg/L及11.2±7.9μg/L，与健康对照组（分别为30±25 ng/L、4.6±3.8μg/L及8.8±6.6μg/L）相比差异无统计学意义（P>0.05）。TNF2组与TNF1组的基线TNF-α水平差异无统计学意义（37±31 ng/L对31±25 ng/L，P>0.05）。
TNF-2与ASP的发病机制无关，但与ASP并发严重脓毒症的易感性有关。基线TNF-α及sTNF-R水平对预测严重脓毒症的发生价值不大。
