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[肿瘤坏死因子α及其基因多态性(rs1800629)对慢性肝炎和溃疡性结肠炎严重程度及进展的影响]

[THE INFLUENCE OF TUMOR NECROSIS FACTOR ALPHA AND POLYMORPHISM OF ITS GENE (RS1800629) ON THE SEVERITY AND PROGRESSION OF CHRONIC HEPATITIS AND ULCERATIVE COLITIS].

作者信息

Bulatova I A, Tretyakova Y I, Shchekotova A P, Shchekotov V V, Krivtsov A V, Nasibullina N I

出版信息

Eksp Klin Gastroenterol. 2016(3):9-14.

Abstract

AIM OF THE STUDY

To investigate the effect of generation of tumor necrosis factor-alpha (TNFα) and the importance of TNFα(rs1 800629) gene polymorphism in the progression of chronic hepatitis C (CHC) and ulcerative colitis (UC).

MATERIAL AND METHODS

The study involved 90 patients with chronic hepatitis C, 50 patients with UC and 50 healthy donors. The blood concentrations TNFα and TNFα gene polymorphism (rs1800629) were evaluated.

RESULTS

TNFα levels in the blood in patients with chronic hepatitis C were increased compared with the control group and correlated with the severity of Cytolysis and fibrosis (r = 0.34, p = 0.02). At slow speed the formation of liver fibrosis TNFα amounted to 1.5 (0.9-2.8) pg/mI, with a fast speed--2.3(1.4-8.2) pg/mI (p = 0.006). Patients with UC at 3-4 degrees endo- scopic activity production of TNFα reached 6.5 (7-9) pg/mI, which was significantly higher than the value obtained at 1-2 degrees endoscopic activity--0.25(0-0.8) pg/ml (p = 0.001). The allelic variations of TNFα in groups of patients with CHC at different rates forming LF statistically differences were not found. The allele, associated with severe progressive course of UC and increased production of TNFα--A risk allele and genotype GA TNFα, associated with a slow progression of UC- "protective" G allele and genotype GG TNFα gene were determined.

CONCLUSION

Determining the level of TNFα allows to evaluate the severity of liver disease, heaviness and progression of liver fibrosis speed in CHC, and the severity of inflammation in the intestinal mucosa in UC. The presence of the allele A of TNFo(rs1800629) is a predictor of severe and progression of UC. Determining genetic polymorphism TNFα in patients with UC may be an additional factor to assess the prognosis of the disease.

摘要

研究目的

探讨肿瘤坏死因子-α(TNFα)的产生及其基因多态性(TNFα(rs1800629))在慢性丙型肝炎(CHC)和溃疡性结肠炎(UC)进展中的作用。

材料与方法

本研究纳入90例慢性丙型肝炎患者、50例溃疡性结肠炎患者及50名健康献血者。检测血液中TNFα水平及TNFα基因多态性(rs1800629)。

结果

慢性丙型肝炎患者血液中TNFα水平高于对照组,且与细胞溶解和纤维化程度相关(r = 0.34,p = 0.02)。肝纤维化形成速度较慢时,TNFα水平为1.5(0.9 - 2.8)pg/ml,形成速度较快时为2.3(1.4 - 8.2)pg/ml(p = 0.006)。溃疡性结肠炎患者内镜活动度为3 - 4级时,TNFα产生量达6.5(7 - 9)pg/ml,显著高于内镜活动度为1 - 2级时的水平——0.25(0 - 0.8)pg/ml(p = 0.001)。不同肝纤维化形成速度的慢性丙型肝炎患者组中,TNFα的等位基因变异未发现统计学差异。确定了与溃疡性结肠炎严重进展及TNFα产生增加相关的A等位基因和基因型GA TNFα,以及与溃疡性结肠炎缓慢进展相关的“保护性”G等位基因和基因型GG TNFα。

结论

测定TNFα水平有助于评估慢性丙型肝炎患者肝病的严重程度、肝纤维化的严重程度及进展速度,以及溃疡性结肠炎患者肠黏膜炎症的严重程度。TNFα(rs1800629)的A等位基因是溃疡性结肠炎严重程度及进展的预测指标。测定溃疡性结肠炎患者的TNFα基因多态性可能是评估疾病预后的一个附加因素。

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