title: TNFA-308G>A polymorphism influences the TNF-alpha response to altered vaginal flora.
abstract: OBJECTIVE
  To investigate the association between a tumor necrosis factor-alpha (TNF-alpha) gene polymorphism, vaginal TNF-alpha level, and microbial flora in pregnant women.
  
  
  METHODS
  Vaginal samples from 203 women at 18-22 weeks' gestation were analyzed for microflora. TNFA-308G>A polymorphism was analyzed by polymerase chain reaction and restriction endonuclease analysis and TNF-alpha concentration was determined by ELISA. Outcome data were subsequently obtained.
  
  
  RESULTS
  The vaginal TNF-alpha concentration was elevated in TNFA-308A carriers only in the presence of abnormal vaginal flora. A median TNF-alpha level of 10.94 pg/ml in TNFA-308A carriers with bacterial vaginosis (BV) was significantly higher than that of 1.77 pg/ml in TNFA-308A carriers without BV (P=.02), and 1.72 pg/ml in TNF-308G homozygotes with BV (P=.01).
  
  
  CONCLUSIONS
  The TNFA-308G>A polymorphism influences the local TNF-alpha response to altered vaginal microflora. This suggests that the nature of the host response to microbial invasion in the lower female genital is genetically determined.
authors.affiliation: Brigham & Women's Hospital, Harvard Medical School, Department of Obstetrics and Gynecology, Boston, MA 02446, USA. mgenc@partners.org
authors.forename: Mehmet R
authors.initials: MR
authors.lastname: Genç
authors.forename: Santosh
authors.initials: S
authors.lastname: Vardhana
authors.forename: Mary L
authors.initials: ML
authors.lastname: Delaney
authors.forename: Steven S
authors.initials: SS
authors.lastname: Witkin
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Onderdonk
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D006801:Humans; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D011247:Pregnancy; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics* / Q000378:metabolism; D014621:Vagina / Q000276:immunology / Q000378:metabolism* / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000235:genetics / Q000276:immunology*
chemical_list: D014409:Tumor Necrosis Factor-alpha