Association between tumor necrosis factor alpha 308G/A polymorphism and increased proinflammatory cytokine release after cardiac surgery with cardiopulmonary bypass in the Korean population.
OBJECTIVE
The G-308A polymorphism of the tumor necrosis factor alpha (TNF-alpha) gene has been suggested to be linked to high TNF promoter activity in in vitro studies. However, there have been some controversies in in vivo studies. This study investigated whether A allele at TNF-308 site is associated with (1) the changes in plasma cytokine levels during and after cardiopulmonary bypass (CPB) and (2) an increased incidence of pulmonary morbidity after CPB.


METHODS
Prospective and observational investigation.


METHODS
A university hospital, single institution.


METHODS
Patients scheduled for cardiac surgery with CPB.


METHODS
TNF genotype was determined by the real-time polymerase chain reaction method. IL-6 and TNF-alpha levels were measured by enzyme-linked immunosorbent assay at the following time points: T1, before initiation of CPB; T2, 30 minutes of CPB; T3, 30 minutes after CPB; T4, 2 hours after CPB; and T5, 24 hours after CPB. The oxygen index, serum creatinine level, 24-hour blood loss, intubation time, and length of intensive care unit (ICU) stay were examined.


RESULTS
The levels of TNF-alpha in group A (TNF-308GA/AA, n = 25) were higher at T3, T4, and T5 than group G (TNF-308GG, n = 225). The levels of IL-6 showed no statistical difference. The oxygenation index, serum creatinine level, 24-hour blood loss, intubation time, and length of ICU stay showed no statistical difference.


CONCLUSIONS
TNF G-308A polymorphism may be associated with excess TNF-alpha secretion in this study and may not be associated with excess IL-6 secretion and postoperative morbidity after CPB.
Yoon
Seung Zhoo
SZ
Department of Anesthesiology and Pain Medicine, Korea University, Seoul, Korea.
Jang
In-Jin
IJ
Choi
Yoon Ji
YJ
Kang
Mae Hwa
MH
Lim
Hye Ja
HJ
Lim
Young Jin
YJ
Lee
Hye Won
HW
Chang
Seong Ho
SH
Yoon
Suk Min
SM
D000328:Adult; D044466:Asian People / Q000235:genetics*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007723:Korea; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics*; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000235:genetics*; D015854:Up-Regulation / Q000235:genetics
D018836:Inflammation Mediators; D014409:Tumor Necrosis Factor-alpha