McGill International TB Centre and Departments of Human Genetics and Medicine, McGill University, Montreal, Quebec, Canada.
Clin Infect Dis. 2013 Oct;57(7):963-70. doi: 10.1093/cid/cit438. Epub 2013 Jun 25.
Tumor necrosis factor (TNF) is a key immune regulator of tuberculosis resistance, as exemplified by the highly increased risk of tuberculosis disease among individuals receiving TNF-blocker therapy.
We determined the extent of TNF production after stimulation with BCG or BCG plus interferon gamma (IFN-γ) using a whole blood assay in 392 children belonging to 135 nuclear families from an area hyperendemic for tuberculosis in South Africa. We conducted classical univariate and bivariate genome-wide linkage analysis of TNF production using the data from both stimulation protocols by means of an extension of the maximum-likelihood-binomial method for quantitative trait loci to multivariate analysis.
Stimulation of whole blood by either BCG or BCG plus IFN-γ resulted in a range of TNF release across subjects. Extent of TNF production following both stimulation protocols was highly correlated (r = 0.81). We failed to identify genetic linkage of TNF release when considering each stimulus separately. However, using a multivariate approach, we detected a major pleiotropic locus (P < 10(-5)) on chromosome region 11p15, termed TNF locus 1 (TNF1), that controlled TNF production after stimulation by both BCG alone and BCG plus IFN-γ.
The TNF1 locus was mapped in the vicinity of the TST1 locus, previously identified in the same family sample, that controls tuberculin skin test (TST) negativity per se, that is, T-cell-independent resistance to Mycobacterium tuberculosis infection. This suggested that there is a connection between TST negativity per se and TNF production.
肿瘤坏死因子(TNF)是结核病抵抗的关键免疫调节剂,这在接受 TNF 阻滞剂治疗的个体中结核病疾病风险显著增加的情况中得到了例证。
我们使用全血测定法,在南非一个结核病高度流行地区的 135 个核心家庭中的 392 名儿童中,确定了在刺激后 TNF 的产生程度,刺激物为卡介苗(BCG)或 BCG 加干扰素γ(IFN-γ)。我们使用两种刺激方案的数据,通过扩展最大似然二项式方法进行经典的单变量和双变量全基因组连锁分析,对 TNF 产生进行定量性状位点的多元分析。
BCG 或 BCG 加 IFN-γ 刺激全血会导致跨个体的 TNF 释放范围。两种刺激方案后 TNF 产生的程度高度相关(r = 0.81)。当分别考虑每个刺激物时,我们未能识别 TNF 释放的遗传连锁。然而,使用多元方法,我们在 11p15 染色体区域检测到一个主要的多效性位点(P < 10(-5)),称为 TNF 基因座 1(TNF1),该基因座控制单独刺激 BCG 和 BCG 加 IFN-γ后 TNF 的产生。
TNF1 基因座在 TST1 基因座附近被定位,该基因座先前在相同的家族样本中被识别,该基因座控制结核菌素皮肤试验(TST)本身的阴性,即对结核分枝杆菌感染的 T 细胞非依赖性抵抗。这表明 TST 本身的阴性与 TNF 产生之间存在联系。