title: [The influence of -238 and -308 TNF alpha polymorphisms on the pathogenesis and response to treatment in rheumatoid arthritis].
abstract: Rheumatoid arthritis (RA) is a systemic autoimmune disease that affects 0.8% of the world population, it affects the synovial membrane of joints and the clinical presentation encompasses a wide spectrum, ranging from a mild to a severe and erosive disease that causes joint and cartilage destruction which finally provokes irreversible structural damage and patient disability. In the last years, there have been important advances in the pathogenesis of this disease, the efforts have been concentrated on pro-inflammatory cytokines such as tumor necrosis factor alpha (TNFalpha). This protein guides numerous events in the synovial and systemic inflammatory process and is encoded in the Major Histocompatibility Complex (MHC), one of the most polymorphic of the genome. Polymorphisms affecting the TNFalpha gene and its regulatory regions are associated with RA prevalence and course. There is a possible association between these polymorphisms and the clinical response to the use of monoclonal antibodies anti-TNFalpha. The possibility that the determination of genotypes -238 and -308 may have prognostic and therapeutic consequences is debated nowadays.
authors.affiliation: Departamento de Medicina, Hospital Clínico, Universidad de Chile.
authors.forename: Carolina
authors.initials: C
authors.lastname: Llanos
authors.forename: Lilian
authors.initials: L
authors.lastname: Soto
authors.forename: Francisca
authors.initials: F
authors.lastname: Sabugo
authors.forename: M José
authors.initials: MJ
authors.lastname: Bastías
authors.forename: Lorena
authors.initials: L
authors.lastname: Salazar
authors.forename: Juan C
authors.initials: JC
authors.lastname: Aguillón
authors.forename: Miguel
authors.initials: M
authors.lastname: Cuchacovich
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000235:genetics; D005838:Genotype; D006801:Humans; D011110:Polymorphism, Genetic; D011401:Promoter Regions, Genetic / Q000235:genetics; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics*
chemical_list: D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha