Yilmaz Meral, Elaldi Nazif, Bagci Binnur, Sari Ismail, Gümüs Erkan, Yelkovan Izzet
Department of Research Centre, Cumhuriyet University, Faculty of Medicine, Sivas, Turkey.
J Vector Borne Dis. 2015 Mar;52(1):30-5.
In this case-control study, we investigated whether IL-6 (-174G/C) and TNF-α (-308G/A) gene polymorphisms affect the clinical course and outcome of CCHF.
Total 150 patients with CCHF and 170 controls were examined in this study. Genotyping of these polymorphisms were performed by PCR-RFLP methods.
We found no statistically significant differences in genotype and allele frequencies of these polymorphisms between patients and controls [(χ2 = 1.31, p = 0.51 for TNF-α) and (χ2 = 2.61, p = 0.27 for IL-6)]. Either TNF-α AA or IL-6 CC genotypes in dead cases were not observed in this study. Frequency of heterozygous genotypes in both IL-6 (GC) and TNF-α (GA) was higher in dead patients than living patients. However, the difference was not statistically significant. A significant difference was found in AST levels and INR when compared to patients with CCHF who died and who survived [OR = 13.9 (95% CI = 1.79-107) for INR, p = 0.01] and [OR = 23.3 (95% CI = 3.62-149) for AST, p = 0.001], respectively.
We did not find a significant association of IL-6 -174G/C and TNF-α -308G/A polymorphisms on the prognosis of CCHF and mortality in this study. We suggest that AST and INR may be important biomarkers for determining the risk of severity and death as a result of infection with Crimean-Congo hemorrhagic fever virus (CCHFV).
在本病例对照研究中，我们调查了白细胞介素-6（IL-6，-174G/C）和肿瘤坏死因子-α（TNF-α，-308G/A）基因多态性是否会影响克里米亚-刚果出血热（CCHF）的临床病程及预后。
本研究共检测了150例CCHF患者和170例对照。采用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法对这些多态性进行基因分型。
我们发现患者与对照之间这些多态性的基因型和等位基因频率无统计学显著差异[TNF-α的χ2 = 1.31，p = 0.51；IL-6的χ2 = 2.61，p = 0.27]。本研究未观察到死亡病例中有TNF-α AA或IL-6 CC基因型。死亡患者中IL-6（GC）和TNF-α（GA）杂合基因型的频率均高于存活患者。然而，差异无统计学意义。与死亡和存活的CCHF患者相比，天门冬氨酸氨基转移酶（AST）水平和国际标准化比值（INR）存在显著差异[INR的比值比（OR）= 13.9（95%置信区间[CI] = 1.79 - 107），p = 0.01]，以及[AST的OR = 23.3（95% CI = 3.62 - 149），p = 0.001]。
在本研究中，我们未发现IL-6 -174G/C和TNF-α -308G/A多态性与CCHF预后及死亡率之间存在显著关联。我们认为AST和INR可能是用于确定克里米亚-刚果出血热病毒（CCHFV）感染导致的严重程度和死亡风险的重要生物标志物。
