Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, PR China; Department of Orthopedic, Beijing Beiya Orthopedics Hospital, Beijing 102445, PR China.
Hum Immunol. 2013 Oct;74(10):1357-62. doi: 10.1016/j.humimm.2013.06.037. Epub 2013 Jul 2.
Studies investigating the association between tumor necrosis factor (TNF)-alpha promoter polymorphisms and ankylosing spondylitis have reported conflicting results. We here performed a meta-analysis based on the evidence currently available from the literature to make a more precise estimation of this relationship.
We performed a systematic search of the National Library of Medline and Embase databases before January 2013. This meta-analysis included 14 case-control studies, which included 1607 ankylosing spondylitis cases and 1910 controls.
The combined results based on all studies showed that ankylosing spondylitis cases had a significantly lower frequency of -308GA [OR (codominant model)=0.81, 95% CI=0.66, 0.99, P=0.04], -857CT [OR (codominant model)=0.55, 95% CI=0.32, 0.94, P=0.03], -863AA [OR (codominant model)=0.11, 95% CI=0.01, 0.94, P=0.04], -863CA [OR (codominant model)=0.32, 95% CI=0.18, 0.58, P<0.001], and -1031TC [OR (codominant model)=0.44, 95% CI=0.25, 0.77, P=0.004] genotype. However, ankylosing spondylitis cases had a significantly higher frequency of -238AA [OR (recessive model)=7.43, 95% CI=3.66, 15.05, P<0.001] and -850TT [OR (recessive model)=2.49, 95% CI=1.16, 5.34, P=0.02; OR (codominant model)=2.83, 95% CI=1.28, 6.25, P=0.01] genotype. In the subgroup analysis by race, we found that ankylosing spondylitis cases had a significantly higher frequency of -238AA [OR (recessive model)=7.43, 95% CI=3.66, 15.05, P<0.001] genotype in Caucasians and lower frequency of -857CT [OR (codominant model)=0.53, 95% CI=0.30, 0.94, P=0.03] in Asians.
Our meta-analysis suggests that TNF-alpha promoter polymorphisms at positions -238, -308, -850, -857, -863 and -1031 could have a small influence on ankylosing spondylitis susceptibility. But there is a lack of association of the TNF-alpha-376G/A and -646G/A polymorphisms with ankylosing spondylitis.
研究肿瘤坏死因子（TNF）-α启动子多态性与强直性脊柱炎之间的关系的研究结果相互矛盾。我们在此进行了一项荟萃分析，根据目前文献中的证据，更精确地评估这种关系。
我们对 2013 年 1 月之前的国家医学图书馆 Medline 和 Embase 数据库进行了系统搜索。这项荟萃分析包括 14 项病例对照研究，包括 1607 例强直性脊柱炎病例和 1910 例对照。
基于所有研究的综合结果表明，强直性脊柱炎病例的-308GA[OR（共显性模型）=0.81，95%CI=0.66，0.99，P=0.04]、-857CT[OR（共显性模型）=0.55，95%CI=0.32，0.94，P=0.03]、-863AA[OR（共显性模型）=0.11，95%CI=0.01，0.94，P=0.04]、-863CA[OR（共显性模型）=0.32，95%CI=0.18，0.58，P<0.001]和-1031TC[OR（共显性模型）=0.44，95%CI=0.25，0.77，P=0.004]基因型的频率明显较低。然而，强直性脊柱炎病例的-238AA[OR（隐性模型）=7.43，95%CI=3.66，15.05，P<0.001]和-850TT[OR（隐性模型）=2.49，95%CI=1.16，5.34，P=0.02；OR（共显性模型）=2.83，95%CI=1.28，6.25，P=0.01]基因型的频率明显较高。在按种族进行的亚组分析中，我们发现强直性脊柱炎病例的-238AA[OR（隐性模型）=7.43，95%CI=3.66，15.05，P<0.001]基因型在白种人中的频率明显较高，而-857CT[OR（共显性模型）=0.53，95%CI=0.30，0.94，P=0.03]基因型在亚洲人中的频率较低。
我们的荟萃分析表明，TNF-α启动子的-238、-308、-850、-857、-863 和-1031 位置的多态性可能对强直性脊柱炎的易感性有一定影响。但是 TNF-α-376G/A 和-646G/A 多态性与强直性脊柱炎无关联。
