[Significance of tumor necrosis factor-alpha gene polymorphism in patients with acute severe pancreatitis].
OBJECTIVE
To investigate the relation of the frequency of TNF2 allele, a TNF-alpha promoter polymorphism, and plasma concentrations of TNF-alpha and soluble tumor necrosis receptor (sTNF-R) to acute severe pancreatitis (ASP) and its severe complication--sepsis.


METHODS
The DNA samples of peripheral white blood cells of 72 ASP patients, 16 of them being complicated by severe sepsis and the other 46 cases being without sepsis, and 89 healthy volunteers were extracted. PCR, NcoI digestion, and electrophoresis were used to examine the polymorphism of the TNF-alpha gene promoter region -308. Plasma concentrations of TNF-alpha, sTNF-R I and sTNF-R II were measured by EASIA.


RESULTS
The TNF2 allele frequency of ASP patients was 29.2% (21/72), not significantly different from that of healthy volunteers (25.7%, 25/89) (P > 0.05). The prevalence rate of TNF2 was 46.2% in patients with severe sepsis, significantly higher than that of the patients without asepsis (19.6%, P < 0.05). The plasma levels of TNF-alpha, sTNF-R I, and sTNF-R II were 36 +/- 30 ng/L, 5.4 +/- 3.5 micro g/L, and 11.2 +/- 7.9 micro g/L respectively in patients with ASP, not significantly different from those in the healthy controls (30 +/- 25 ng/L, 4.6 +/- 3.8 micro g/L, and 8.8 +/- 6.6 micro g/L respectively, P > 0.05). There was no significant difference in baseline TNF-alpha levels between the TNF2 group and TNF1 group (37 +/- 31 ng/L vs. 31 +/- 25 ng/L, P > 0.05).


CONCLUSIONS
TNF-2 is not related to the pathogenesis of ASP, and is associated with the susceptibility to severe sepsis complicating ASP. The baseline TNF-alpha and sTNF-R levels have little value in predicting the development of severe sepsis.
Zhang
Dianliang
D
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China.
Li
Jieshou
J
Jiang
Zhiwei
Z
Yu
Baojun
B
Tang
Xingming
X
D000208:Acute Disease; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000097:blood; D004247:DNA / Q000235:genetics / Q000378:metabolism; D015252:Deoxyribonucleases, Type II Site-Specific / Q000378:metabolism; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000235:genetics / Q000473:pathology*; D011110:Polymorphism, Genetic; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics* / Q000378:metabolism
D015703:Antigens, CD; D018124:Receptors, Tumor Necrosis Factor; D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha; D004247:DNA; C052380:endodeoxyribonuclease NcoI; D015252:Deoxyribonucleases, Type II Site-Specific