title: Toll-like receptor 4 and inducible nitric oxide synthase gene polymorphisms are associated with Type 2 diabetes.
abstract: BACKGROUND
  The toll-like receptor 4 (TLR4) and inducible nitric oxide synthase are proteins from the innate immune system that, when activated, can induce insulin resistance. Polymorphisms in these genes, TLR4 and NOS2, respectively, could affect the immune response, as well as the prevalence of Type 2 diabetes (T2DM).
  
  
  OBJECTIVE
  The aim of the present study was to investigate the contribution of four polymorphisms (two from TLR4 and two from NOS2) to susceptibility to T2DM in a southeast Brazilian population.
  
  
  METHODS
  A total of 211 patients with T2DM and 200 unrelated controls were genotyped for the Asp299Gly and Thr399Ile polymorphisms of the TLR4 gene and for the insertion (I)/deletion (D) AAAT and (CCTTT)n polymorphisms of the NOS2 promoter gene.
  
  
  RESULTS
  With regard to the NOS2 promoter region, the data showed that the I allele of the I/D AAAT polymorphism was more prevalent in the T2DM group and that the L/L genotype of the (CCTTT)n polymorphism was also more frequent in the same group. In contrast, the 299Gly allele and the 399Ile allele from the Asp299Gly and Thr399Ile TLR4 gene polymorphisms, respectively, were associated with protection of T2DM. It is believed that the persistence of these genetic variations in human populations may be indicative of a selective advantage in the face of different environmental pressures.
  
  
  CONCLUSIONS
  Genetic variations in the NOS2 gene promoter and TLR4 coding sequence may lead to deleterious and protective effects, respectively, arising from altered function of the innate immune system in patients with T2DM.
authors.affiliation: Department of Internal Medicine, State University of Campinas, Campinas, São Paulo, Brazil.
authors.forename: Renata A
authors.initials: RA
authors.lastname: Bagarolli
authors.forename: Mario José A
authors.initials: MJ
authors.lastname: Saad
authors.forename: Sara Teresinha O
authors.initials: ST
authors.lastname: Saad
mesh_terms: D001786:Blood Glucose / Q000235:genetics; D001938:Brazil / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000235:genetics*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016254:Mutagenesis, Insertional; D052247:Nitric Oxide Synthase Type II / Q000235:genetics*; D011110:Polymorphism, Genetic; D015995:Prevalence; D011401:Promoter Regions, Genetic; D017384:Sequence Deletion; D051197:Toll-Like Receptor 4 / Q000235:genetics*
chemical_list: D001786:Blood Glucose; D051197:Toll-Like Receptor 4; C496319:NOS2 protein, human; D052247:Nitric Oxide Synthase Type II