title: Tumour necrosis factor gene polymorphism: a predictive factor for the development of post-transplant lymphoproliferative disease.
abstract: BACKGROUND
  Epstein-Barr virus-positive post-transplant lymphoproliferative disease (PTLD) is a potentially lethal complication of iatrogenic immunosupression after transplantation. Predicting the development of PTLD allowing early and effective intervention is therefore of importance. Polymorphisms within cytokine genes are implicated in susceptibility to, and progression of, disease however the published data are often conflicting. We undertook investigation of polymorphic alleles within cytokine genes in PTLD and non-PTLD transplant cohorts to determine risk factors for disease.
  
  
  METHODS
  SSP-PCR was used to analyse single nucleotide polymorphism within tumour necrosis factor (TNF)-alpha, interleukin- 1, -6, -10 and lymphotoxin-alpha genes. The TNF-alpha levels were measured by standard enzyme-linked immuno-absorbant assay.
  
  
  RESULTS
  We show an association between variant alleles within the TNF-alpha promoter (-1031C (P=0.005)); -863A (P=0.0001) and TNF receptor I promoter regions (-201T (P=0.02)); -1135C (P=0.03) with the development of PTLD. We also show an association with TNF-alpha promoter haplotypes with haplotype-3 significantly increased (P=0.0001) and haplotype-1 decreased (P=0.02) in PTLD patients compared to transplant controls. Furthermore, we show a significant increase (P=0.02) in the level of TNF-alpha in PTLD patient plasma (range 0-97.97 pg ml(-1)) compared to transplant controls (0-8.147 pg ml(-1)), with the highest levels found in individuals carrying the variant alleles.
  
  
  CONCLUSIONS
  We suggest that genetic variation within TNF-alpha loci and the level of plasma cytokine could be used as a predictive risk factor for the development of PTLD.
authors.affiliation: Clinical and Basic Virology Laboratory, School of Biomedical Sciences, University of Edinburgh, Summerhall, Edinburgh EH9 1QH, UK. kmcaulay@ed.ac.uk
authors.forename: K A
authors.initials: KA
authors.lastname: McAulay
authors.forename: T
authors.initials: T
authors.lastname: Haque
authors.forename: D H
authors.initials: DH
authors.lastname: Crawford
mesh_terms: D006239:Haplotypes; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000209:etiology / Q000235:genetics* / Q000821:virology; D016377:Organ Transplantation / Q000009:adverse effects*; D020641:Polymorphism, Single Nucleotide; D011401:Promoter Regions, Genetic; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000235:genetics; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000235:genetics; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000235:genetics*
chemical_list: D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D014409:Tumor Necrosis Factor-alpha