Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.
Department of Biology and Human Genetics, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.
J Endod. 2021 Jul;47(7):1061-1069. doi: 10.1016/j.joen.2021.03.007. Epub 2021 Mar 26.
This study aimed to perform a more precise estimation of the association between tumor necrosis factor alpha (TNF-α) -308 G/A single-nucleotide polymorphism (SNP) and the risk of development of apical periodontitis (AP) and its phenotypes based on all available published studies.
The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and is registered in PROSPERO (CRD42020176190). The literature search was conducted via Clarivate Analytics Web of Science, Scopus, PubMed, Cochrane Central Register of Controlled Trials, and China National Knowledge Infrastructure databases from inception to December 2020 with no language restrictions. Two reviewers were involved independently in the study selection, data extraction, and appraising the studies that were included. The quality of the included studies was evaluated using the Strengthening the Reporting of Genetic Association and the Grading of Recommendations Assessment, Development and Evaluation system. The frequencies of the genotypes and alleles of the TNF-α (G>A 308, rs1800629) gene with 95% odds ratio were used.
Four studies met the inclusion criteria with moderate risk of bias. This study revealed no significant association between TNF-α -308 G/A SNP and AP and the risk of AP development. Moreover, there was no significant association between genotype or allele frequency distribution and clinical manifestations (acute vs chronic) of AP. The certainty of evidence per the Grading of Recommendations Assessment, Development and Evaluation system was very low.
Because of very low certainty of evidence, whether there is an association between TNF-α -308 G/A SNP and AP warrants further well-designed multicentric studies to adjudicate a better understanding of the role of genetic factors in the etiopathogenesis of AP.
本研究旨在基于所有已发表的研究，更精确地评估肿瘤坏死因子-α（TNF-α）-308 G/A 单核苷酸多态性（SNP）与根尖周炎（AP）发病风险及其表型之间的关联。
本研究按照系统评价和荟萃分析的首选报告项目进行，并在 PROSPERO（CRD42020176190）中进行了注册。文献检索通过 Clarivate Analytics Web of Science、Scopus、PubMed、Cochrane 中央对照试验注册中心和中国国家知识基础设施数据库进行，从创建到 2020 年 12 月，没有语言限制。两名审查员独立参与了研究选择、数据提取和评估纳入研究的工作。使用遗传关联和推荐评估、发展和评估系统的强化报告来评估纳入研究的质量。使用 95%的优势比来评估 TNF-α（G>A 308，rs1800629）基因的基因型和等位基因频率。
四项研究符合纳入标准，存在中度偏倚风险。本研究表明 TNF-α-308 G/A SNP 与 AP 及 AP 发病风险之间无显著关联。此外，基因型或等位基因频率分布与 AP 的临床表现（急性与慢性）之间也无显著关联。根据推荐评估、发展和评估系统的分级，证据的确定性非常低。
由于证据的确定性非常低，TNF-α-308 G/A SNP 是否与 AP 相关还需要进一步设计良好的多中心研究来确定，以更好地了解遗传因素在 AP 发病机制中的作用。
