TNF-[alpha] and IL-1 [beta] Cytokine Gene Polymorphism in Patients with Nasal Polyposis.
Objective: Nasal Polyp (NP) is a benign mass of the paranasal sinuses that protrudes into the nasal cavity. The exact underlying pathogenesis is not known. In this study we aimed to determine the genetic susceptibility of NP formation in relation to TNF-[alpha]-308 and IL-1[beta]-511 promoter region gene polymorphisms.
Methods: A total of 71 patients with NP with asthma (n=21) or without asthma (n=50) were taken as the study group, and 91 healthy volunteers were taken as the control group. Blood was gathered into EDTA-containing tubes, and patient DNA was extracted. The polymorphisms of the IL-[beta] and TNF-[alpha] cytokine genes were analyzed using real time polymerase chain reaction.
Results: The GG genotype in the TNF-[alpha]-308 region and the CC genotype in the IL-1[beta]-511 region were found to be risk factors for NP formation (OR: 9.2, p=0.007 and OR 33.3, p=0.001, respectively). Regarding allelic frequencies, the G allele at the TNF-[alpha]-308 promoter region was a risk factor for NP formation (OR 6.06, p<0.001).
Conclusion: TNF-[alpha] GG genotype in the -308 promoter region and the IL-1[beta] CC genotype in the -511 region are genetic risk factors for NP formation.
Keywords: Nasal polyp, cytokine, polymorphism, genetic, TNF-[alpha], IL-1[beta]
Chronic rhinosinusitis with nasal polyps (NP) is a disease of the paranasal sinuses and the nasal cavity and is distinguished by extracellular edema and abundant inflammatory cells. It might cause a certain degree of morbidity such as nasal obstruction, rhinorrhea, and anosmia (1). Although the underlying pathogenesis has been presumed to be infections, allergies, or immunological diseases, the exact pathogenesis has not been fully elucidated (1). Not all patients with chronic rhinosinusitis or allergic rhinitis have NPs; therefore, genetic predisposition such as glutathione-S-transferase genetic polymorphism, increased gene expression of chemokines, metalloproteinases, growth factors, and increased expression of leukotriene receptor genes are thought be the underlying cause of NP pathogenesis along with accompanying environmental factors (1-3).
The histopathological examination of NP demonstrates epithelial proliferation, glandular hyperplasia, basal membrane thickening, edema, fibrosis, and cellular infiltration (4). The mediators secreted from inflammatory cells stimulate a cascade of reactions that result in ongoing inflammation, mucosal edema, and subsequent NP development. When compared to antrochoanal polyps, the nasal polyps have many more submucous glands and much more eosinophilic infiltration (5, 6).
Many cytokines and inflammatory mediators show increased concentrations in NP tissue. Tumor necrosis factor (TNF)-[alpha] and Interleukin-1 (IL-1) are pro-inflammatory cytokines that take part in the signaling cascades that are involved in the pathogenesis of NP They have synergistic effects such as recruitment of eosinophils by upregulating adhesion molecules during NP formation. Single nucleotide polymorphisms (SNPs) in these pro-inflammatory mediators have been studied for genetic susceptibility to NP development, but the literature findings regarding the dominant genotype or allele causing NP formation are conflicting. Some authors claim that the TNF-[alpha] GA polymorphism in the -308 promoter region is a risk factor for NP development, whereas others have found that the A allele frequency is a risk factor (7-9). Some authors have found no relationship between the TNF-[alpha] GA polymorphism and NP development (4, 10).
Because the number of previous studies is limited, and due to the conflicting results, we aimed to investigate the polymorphisms of the IL1-[beta] and TNF-[alpha] genes in NP patients in a Turkish population.
Local ethics committee approval was acquired for the study, and signed informed consent was obtained from all NP patients and control group participants. The study group consisted of 71 patients with NP with asthma (n=21) or without asthma (n=50) who were undergoing functional endoscopic sinus surgery in our tertiary center Otorhinolaryngology department. The diagnosis of NP was made according to the 2012 European position paper on rhinosinusitis and nasal polyps (11). Allergic rhinitis comorbidity in the NP patients was assessed with a skin prick test and by measuring serum-specific Ig-E levels. All patients had negative allergy findings. Control group patients had no illnesses or nasal symptoms. All of them underwent endoscopic nasal examination to rule out asymptomatic nasal polyps.
DNA samples of the 71 NP patients and 91 healthy controls were obtained from blood samples that were collected at the Biochemistry department of our tertiary center university hospital where the genotyping was performed.
Genotyping methodology: For determining the relationship between IL-1[beta] and TNF-[alpha] gene polymorphisms with NP, the purifed DNA of 71 patients and 91 controls was analyzed by using a High Pure PCR Themplate Preparation Kit (Roche Diagnostics; GmbH, Mannheim, Germany). Polymorphism analysis was performed by using the same primers (IL-1[beta]-511 common, T, and C primers and TNF-[alpha]-308 common, A, and G primers), control primers (HGH, HGH II), and PCR conditions that were previously reported by McCarron et al. (12). SNPs were genotyped by PCR using one reaction per allele for each SNP All PCR reactions were performed in 10 [micro]l reaction volumes, and the final reagent concentrations were 10x reaction bufer (MBI Fermentas, Vilnius, Lithuania), 200 [micro]M each deoxynucleotide triphosphate (MBI Fermentas), 12% (w/v) sucrose (Merck Darmstadt, Germany), 200 [micro]M cresol red (Aldrich, Steinheim, Germany), 1 [micro]M each specific/common primer (Metabion Int. AG, Martinsried, Germany), 0.2 [micro]M each internal control primer (Metabion Int. AG), 0.25 units of Taq DNA polymerase (MBI Fermentas), and 50-100 ng/[micro]l DNA. MgCl[O.sub.2] (Roche Diagnostics; GmbH, Manheim, Germany) concentrations were optimized for each SNP as 2.75 mM per reaction for IL-1[beta] and 1.65 mM per reaction for TNF-[alpha]. PCR reactions were performed using a thermocycler (Uvigene, Biolab, UK) with the following conditions: 1 min at 96[degrees]C; 10 cycles of 96[degrees]C for 15 s, 65[degrees]C for 50 s, and 72[degrees]C for 40 s; 20 cycles of 96[degrees]C for 10 s and 60[degrees]C for 50 s; and 40 s at 72[degrees]C. PCR products were loaded directly onto 2% agarose gels (containing 0.5% mg/ml ethidium bromide), electrophoresed at 90 V for 40 minutes (Elite 300, Wealtec, Taiwan), and visualized by photography under UV transillumination (UVI PhotoV.99, Uvitec Ltd, UK). Genotypes were designated as CC, CT, and TT for IL-1[beta] and as AA, AG, and GG for TNF-[alpha].
Genotype distribution was compatible with Hardy-Weinberg equilibrium. The Statistical Package for the Social Sciences for Windows (SPSS Inc.; version 11.5, IBM, Chicago, USA) statistical was used for statistical analysis. The chi-square test was used for patient and control comparisons, and significance was assumed as p<0.05. Logistic regression analysis was performed and the odds ratio (OR) was calculated when a genotype demonstrated a significantly different frequency than the others.
The mean age of NP patients at presentation (50 males and 21 females) was 41[+ or -]10 years (range 28-66 years). The mean age of the control group patients (73 males and 18 females) was 38[+ or -]10 years (range 20-64 years). There was no statistically significant difference regarding age (p=0.097) or sex (p=0.206) between the study and control groups.
For TNF-[alpha] genotypes, four cases could not be determined for this polymorphism in the control group. It was likely that their DNA base sequences had differences at this point, and DNA sequencing analysis would be appropriate in these cases. The GG genotype in the TNF-[alpha]-308 region was a risk factor for NP development (OR:9.2, p=0.007). There was no statistically significant difference between the TNF-[alpha] AA or GA genotypes regarding NP development (p=0.792). Regarding allelic frequencies, the G allele was a risk factor for NP development in the TNF-[alpha]-308 promoter region (OR: 6.06, p<0.001) (Table 1).
There was a statistically significant relationship between asthma in NP patients and TNF-[alpha] genotype in the -308 region (p=0.029). Patients with asthma more commonly had the GG genotype in the TNF-[alpha]-308 region compared to non-asthmatic NP patients (p=0.000) (Table 2). There was no statistically significant relationship between asthma and allelic frequencies in the TNF-[alpha]-308 promoter region (p=0.253). Regarding IL-1[beta]-511 promoter region genotypes, the CC genotype was a risk factor for NP development (OR:33.3, p=0.001). There was no statistically significant difference between TT and CT genotypes in the IL-1[beta]-511 promoter region regarding NP development (p=0.519). There was no statistically significant diference between the allelic frequencies of T or C and NP development (p=0.166) (Table 3).
There was a statistically significant relationship between the IL-1[beta]-511 promoter region genotypes and asthma in NP patients (p=0.021). The CT genotype was more common in NP patients having asthma compared to those without asthma (p=0.03) (Table 4). There was no statistically significant difference between allelic frequencies in the IL-1[beta]-511 promoter region and asthma in the NP patients (p=0.641).
In this study, we found that there was a statistically significant increase in the expression of the TNF-[alpha]-308 GG and IL-1[beta]-511 CC genotypes in the patients with NP. Comparison of allele frequencies showed that the G allele of the TNF-ct-308 gene was higher in NP patients and in asthmatic patients with NP with a statistical significance. There was no statistically significant difference for having the T or the C allele of the IL-1[beta]-511 gene polymorphism in NP patients and asthmatic patients with NP. In asthmatic patients with NP, there was a higher expression of the TNF-ct-308 GG and IL-1(3-511 CT genotypes.
Chronic rhinosinusitis with nasal polyps is an inflammatory disease of the paranasal sinuses and nasal mucosa that is diagnosed by bilateral endoscopically visualized polyps in the middle meatus with additional physical and/or radiological findings and symptoms presenting for longer than 12 weeks (11). It is seen more commonly in men and it has been associated with various medical conditions such as atopy, asthma, aspirin sensitivity, cystic fibrosis, and ciliary dyskinesia (1, 9). Although NP is a widespread disease with a 1%-4% incidence, the exact underlying pathogenesis is not known (1). Mucosal inflammation with eosinophil predominance is presumably the most significant factor in its pathogenesis. The NP stroma contains various important molecules such as cytokines, chemokines, growth factors, and adhesion molecules that all take part in the cascade of reactions that take place during NP development (2). Although T1 cytokines are also shown to be increased in the NP stroma, NP is characterized by a T2-dominant cytokine profile. The increased eosinophil infiltration is related to T2-triggered cytokines, including IL-4 and IL-5 (13).
TNF-[alpha] and IL-1[beta] are pro-inflammatory cytokines that are generated by several types of cells such as eosinophils, epithelial cells, and macrophages. They have synergistic effects in chronic inflammation in the presence of either Th1 or Th2 cytokines (13). Increased levels of TNF-[alpha] mRNA are observed in the NP tissue compared to the inferior turbinate, and there are also increases in the secretion of monocyte chemo-attractants from NP fibroblasts (14). Tus there is a vicious cycle between eosinophils and TNF-[alpha] production in the NP tissue. The major source of TNF-[alpha] in NP tissue is eosinophils (15). TNF-a upregulates vascular cell adhesion molecule-1 (VCAM-1) expression in fibroblasts, and this in turn increases the trans-migration of eosinophils to the inflammation site and leads to even more TNF-[alpha] production (16). Saji et al. (17) showed that the pro-inflammatory cytokines TNF-[alpha] and IL-1[beta] increased the secretion of RANTES from nasal polyp fibroblasts. RANTES is a chemo-attractant for monocytes, eosinophils, and memory T-cells, and it takes part in the cascade of reactions leading to the recruitment and trans-endothelial migration of cells into the inflammation site. Furthermore, when endothelial cells are exposed to these pro-inflammatory cytokines, they increase their expression of intercellular adhesion molecules and VCAM-1, which act as ligands for eosinophil integrins (18).
The TNFA gene locus is found in the highly polymorphic major histocompatibility III region on chromosome 6 (6p21.3). SNPs within the -308 promoter region of the TNF-[alpha] gene result in two allelic forms. The common form is called TNFA-1, and this has a G at this position. If G is substituted by A, the rare TNFA-2 allele appears (19). The results of previous studies investigating the allelic frequencies of TNF-[alpha] in the -308 promoter region on NP development are incompatible with each other. According to the results of Erbek et al. (7), AA polymorphism in the TNF-a-308 promoter region was higher in the control group. Bernstein et al. (9) found that the TNF-[alpha] A allele at position -308 increased the formation of NP almost two-fold compared to the control groups, whereas Erbek et al. (7), Mfuna Endam et al. (4), and Fajardo-Dolci et al. (10) found no statistically significant difference between TNF-[alpha] genotypes or allelic frequencies and NP development. Szabo et al. (20) found the A allele to be a risk factor for NP development only when acetylsalicylic acid sensitivity was present. In our results, the G allele frequency and the GG genotype were statistically significantly higher in NP patients compared to the control group. These different results in the studies can be explained by genetic variations and the different ethnicities of the study populations. TNF-[alpha] promoter region allele frequencies can even change in study groups from the same region in the same disease (19). In the North America region, Randolph et al. (21) found that TNF-[alpha] gene promoter region allele frequency did not affect asthma formation, whereas Witte et al. (22) found the A allele to be a risk factor. The different results in the Turkish population (7, 8, and our study) can be explained by genetic variations in different regions of the country, patient selection criteria, and differences in study design. Moreover, the effect of allelic frequencies and genotypes of the TNF-[alpha] gene promoter region on the transcription of TNF-[alpha] is not clear. Greater production of TNF-[alpha] in the case of the GA genotype compared to the GG genotype has been reported in in-vitro studies, while other studies have found no correlation between genotype and transcription (23-27). In some gene reporter assays, the authors claim that the A allele influences TNF-[alpha] gene transcription, whereas others have found no such relationship (23, 28). There has been no published article investigating the role of allele frequency or genotype on TNF-[alpha] transcription in NP patients. The other important factor is that TNF-[alpha] expression is not only controlled by the TNFA gene locus, and the TNFB gene is another important molecular determinant of TNF-[alpha] levels (7). The extended linkage group around the TNFA locus might also be a causative factor for the genetic susceptibility for NP development (20).
Interleukin-1 is a crucial mediator in the pathogenesis of NP by activating T-cells and monocytes, inducing the expression of other cytokines, upregulating cellular adhesion molecules, taking part in the recruitment of eosinophils, and amplifying the reaction cascades of the inflammatory response (18, 29). IL-1 is found in two forms in humans IL-l[alpha] and IL-1[beta] (both on chromosome 2) and they bind to the same receptor with different affinities (4, 29). The IL-1 [beta] gene is located in the long arm of chromosome 2q14 (18). Besides its inflammatory effects in NP pathogenesis, IL-1[beta] is also responsible for glucocorticoid resistance in the NP tissue, making the treatment more complex (30). Like TNF-[alpha], the results of the studies concerning the role of IL-1 [beta] gene polymorphisms at the -511 promoter region in NP pathogenesis are also conflicting. Some authors have found no correlation between the IL-1[beta] genotype and NP development (4, 31), whereas the TT genotype (18) and the CC genotype (7) have been reported to be risk factors. Our results were similar to those of Erbek et al. (7), and we also found a higher CC genotype in NP patients and no relationship between allelic frequency (T or C) and NP formation. The IL-1a GG genotype at the +4548 region has been demonstrated to be a genetic risk factor for NP development in asthmatic patients (29). According to our results, the CT genotype of the IL-1 [beta] -511 region was a risk factor for asthma comorbidity in NP patients. The difference between previous published articles can also be attributed to different study design and ethnicity between study populations. In addition to IL-1[alpha] and IL-1 [beta] , the genes in the IL-1 complex code for a third protein called Interleukin-1 receptor antagonist (IL-1RA). This peptide is a confirmed competitive inhibitor of IL-1 [beta] by binding to the IL-1 cell surface receptors, and it can down-regulate the pro-inflammatory responses elicited by IL-1 [beta] . Linkage disequilibrium between the IL-1RA and IL-1 [beta] genes might be the cause of NP development rather than IL-1 [beta] alone (31).
The TNF-a GG genotype in the -308 position of the promoter region and the IL-1[beta] CC genotype in the -511 region might be genetic risk factors for NP development in the Turkish population. The effect of gene polymorphisms on the transcriptional expression of these pro-inflammatory cytokines should be investigated in further studies of NP patients.
Ethics Committee Approval: Ethics committee approval was received for this study from ethics committee of Mersin University (08/10/2015-2015/314).
Informed Consent: Written informed consent was obtained from patients who participated in this study.
Peer-review: Externally peer-reviewed.
Author Contributions: Concept - O.I., C.O., G.P., S.K., K.G., T.P.; Design - O.I., C.O., G.P., S.K., K.G., T.P.; Supervision - O.I., C.O., G.P., S.K., K.G., T.P.; Resource - O.I., C.O., G.P., S.K., K.G., T.P.; Materials O.I., C.O., G.P., S.K., K.G., T.P.; Data Collection and/or Processing - O.I., C.O., G.P., S.K., K.G., T.P.; Analysis and/or Interpretation - O.I., .O., G.P., S.K., K.G., T.P.; Literature Search - O.I., C.O., G.P., S.K., K.G., T.P.; Writing - O.I., C.O., G.P., S.K., K.G., T.P.; Critical Reviews - O.I., C.O., G.P., S.K., K.G., T. P.
Conflict of Interest: No conflict of interest was declared by the authors.
Financial Disclosure: The authors declared that this study has received no financial support.
(1.) Ozcan C, Tamer L, Ates NA, Gorur K. The glutathione-s-transferase gene polymorphisms (Gstt1, Gstm1, and Gstp1) in patients with non-allergic nasal polyposis. Eur Arch Otorhinolaryngol 2010; 267: 227-32. [CrossRef]
(2.) Figueiredo CR, Silva IDC, Weckx LLM. Infammatory genes in nasal polyposis. Curr Opin Otolaryngol Head Neck Surg 2008; 16: 18-21. [CrossRef ]
(3.) Bolger WE, Joshi AS, Spear S, Nelson M, Govindaraj K. Gene expression analysis in sinonasal polyposis before and after corticosteroids: a preliminary investigation. Otolaryngol Head Neck Surg 2007; 137: 27-33. [CrossRef]
(4.) Mfuna Endam L, Cormier C, Bosse Y, Filali-Mouhim A, Desrosiers M. Association of IL1A, IL1B, and TNF gene polymorphisms with chronic rhinosinusitis with and without nasal polyposis: A replication study. Arch Otolaryngol Head Neck Surg 2010; 136: 187-92. [CrossRef]
(5.) Ozcan C, Apa DD, Pata YS, Gorur K, Akbas Y. Expression of in-ducible nitric oxide synthase in antrochoanal polyps. Int J Pediatr Otorhinolaryngol 2003; 67: 383-8. [CrossRef]
(6.) Ozcan C, Zeren H, Talas DU, Kucukoglu M, Gorur K. Antrochoanal polyp: a transmission electron and light microscopic study. Eur Arch Otorhinolaryngol 2005; 262: 55-60. [CrossRef]
(7.) Erbek SS, Yurtcu E, Erbek S, Atac FB, Sahin FI, Cakmak O. Proinflammatory cytokine single nucleotide polymorphisms in nasal polyposis. Arch Otolaryngol Head Neck Surg 2007; 133: 705-9. [CrossRef]
(8.) Batikhan H, Gokcan MK, Beder E, Akar N, Ozturk A, Gerceker M. Association of the tumor necrosis factor-alpha -308 G/A polymorphism with nasal polyposis. Eur Arch Otorhinolaryngol 2010; 267: 903-8. [CrossRef]
(9.) Bernstein JM, Anon JB, Rontal M, Conroy J, Wang C, Sucheston L. Genetic polymorphisms with chronic hyperplastic sinusitis with nasal polyposis. Laryngoscope 2009; 119: 1258-64. [CrossRef ]
(10.) Fajardo-Dolci G, Solorio-Abreu J, Romero-Alvarez JC, Zavaleta-Villa B, Cerezo-Camacho O, Jimenez-Lucio R, et al. DQA1 and DQB1 association and nasal polyposis. Otolaryngol Head Neck Surg 2006: 135: 243-7. [CrossRef]
(11.) Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012; 50: 1-12.
(12.) McCarron SL, Edwards S, Evans PR, Gibbs R, Dearneley DP, Dowe A, et al. Influence of cytokine gene polymorphisms on the development of prostate cancer. Cancer Research 2002; 62: 3369-72.
(13.) Otto BA, Wenzel SE. The role of cytokines in chronic rhinosinusitis with nasal polyps. Curr Opin Otolaryngol Head Neck Surg 2008; 16: 270-4. [CrossRef]
(14.) Lin SK, Kok SH, Shun CT, Hong CY, Wang CC, Hsu MC, et al. Tumor necrosis factor-alpha stimulates the expression of C-C chemokine ligand 2 gene in fibroblasts from the human nasal polyp through the pathways of mitogen-activated protein kinase. Am J Rhinol 2007; 21: 251-5. [CrossRef]
(15.) Kramer MF, Rasp G. Nasal polyposis: eosinophils and Interleukin-5. Allergy 1999; 55: 669-80. [CrossRef]
(16.) Ohori J, Ushikai M, Sun D, Nishimoto K, Sagara Y, Fukuiwa T, et al. TNF-a upregulates VCAM-1 and NF-KB in fibroblasts from nasal polyps. Auris Nasus Larynx 2007; 34: 177-83. [CrossRef]
(17.) Saji F, Nonaka M, Pawankar R. Expression of RANTES by IL-1 [beta] and TNF- [alpha] stimulated nasal polyp fibroblasts. Auris Nasus Larynx 2000; 27: 247-52. [CrossRef]
(18.) Mrowicka M, Zielinska-Blizniewska H, Milonski J, Majsterek I, Olszewski J. Association of IL1 [beta] and IL4 gene polymorphisms with nasal polyps in a Polish population. Mol Biol Rep 2014; 41: 4653-8. [CrossRef]
(19.) Elahi MM, Asotra K, Matata BM, Mastana SS. Tumor necrosis factor alpha-308 gene locus promoter polymorphism: An analysis of association with health and disease. Biochim Biophys Acta 2009; 1792: 163-72. [CrossRef]
(20.) Szabo K, Kiricsi A, Revesz M, Vona I, Szabo Z, Bella Z, et al. The -308 G>A SNP of TNFA is a factor predisposing to chronic sinusitis associated with nasal polyposis in aspirin-sensitive Hungarian individuals: conclusions of a genetic study with multiple stratifications. Int Immunol 2013; 25: 383-8. [CrossRef]
(21.) Randolph AG, Lange C, Silverman EK, Lazarus R, Weiss ST. Extended haplotype in the tumor necrosis factor gene cluster is associated with asthma and asthma-related phenotypes. Am J Resp Crit Care Med 2005; 172: 687-92. [CrossRef]
(22.) Witte JS, Palmer LJ, O'Connor RD, Hopkins PJ, Hall JM. Relation between tumour necrosis factor polymorphism TNF-a 308 and risk of asthma. Eur J Hum Genet 2002; 10: 82-5. [CrossRef]
(23.) Hajeer AH, Hutchinson IV. Influence of TNF[alpha] gene polymorphisms on TNFa production and disease. Hum Immunol 2001; 62: 1191-99. [CrossRef]
(24.) Bouma G, Xia B, Crusius JB, Bioque G, Koutroubakis I, von Blomberg BM, et al.. Distribution of four polymorphisms in the tumour necrosis factor (TNF) genes in patients with inflammatory bowel disease (IBD). Clin Exp Immunol 1996; 103: 391-6. [CrossRef]
(25.) Louis E, Franchimont D, Piron A, Gevaert Y, Schaaf-Lafontaine N, Roland S, et al. Tumour necrosis factor (TNF) gene polymorphism influences TNF-alpha production in lipopolysaccharide (LPS)-stimulated whole blood cell culture in healthy humans. Clin Exp Immunol 1998; 113: 401-6. [CrossRef]
(26.) Pocoit F, Briant L, Jongeneel CV, Molvig J, Worsaae H, Abbal M, et al. Association of tumor necrosis factor (TNF) and class II major histocompatibility complex alleles with the secretion of TNF-alpha and TNF-beta by human mononuclear cells: A possible link to insulin-dependent diabetes mellitus. Eur J Immunol 1993; 23: 224-31. [CrossRef]
(27.) Danis VA, Millington M, Hyland V, Lawford R, Huang Q, Grennan D. Increased frequency of the uncommon allele of a tumour necrosis factor alpha gene polymorphism in rheumatoid arthritis and systemic lupus erythematosus. Dis Markers 1995; 12: 127-33. [CrossRef]
(28.) Kroeger KM, Carville KS, Abraham LJ. The -308 Tumor necrosis factor-[alpha] promoter polymorphism effects transcription. Mol Immunol 1997; 34: 391-99. [CrossRef]
(29.) Karjalainen J, Joki-Erkkila V-P, Hulkkonen J, Pessi T, Nieminen MM, Aromaa A, et al. The IL1A genotype is associated with nasal polyposis in asthmatic adults. Allergy 2003; 58: 393-6. [CrossRef ]
(30.) Wang Z, Li P, Zhang Q, Lv H, Liu J, Si J. Interleukin-1[beta] regulates the expression of glucocorticoid receptor isoforms in nasal polyps in vitro via p38 MAPK and JNK signal transduction pathways. J Infamm (Lond) 2015; 12: 3. [CrossRef]
(31.) Cheng YK, Lin CD, Chang WC, Hwang GY, Tsai SW, Wan L, et al. Increased prevalence of interleukin 1 receptor antagonist gene polymorphism in patient with chronic rhinosinusitis. Arch Otolaryngol Head Neck Surg 2006; 132; 285-90. [CrossRef]
Onur Ismi (1), Cengiz Ozcan (1), Gurbuz Polat (2), Seval Kul (3), Kemal Gorur (1), Tugce Puturgeli (1)
(1) Department of Otorhinolaryngology Mersin University School of Medicine, Mersin, Turkey
(2) Department of Biochemistry Mersin University School of Medicine, Mersin, Turkey
(3) Department of Biostatistics, Mersin University School of Medicine, Mersin, Turkey
This study was presented at the 12th Turkish National Rhinology Congress 21-24 April 2015, Antalya, Turkey.
Address for Correspondence: Onur Ismi
Received Date: 15.02.2017
Accepted Date: 23.04.2017
Table 1. TNF-[alpha]-308 promoter region genotypes and allelic frequencies seen in patients with nasal polyps 95.0% CI Patient Control Odds (n=71) (n=87) Ratio Lower Upper GG 60 (84.5%) 35 (40.2%) p 9.236 1.853 46.03 Genotypes AG 9 (12.7%) 38 (43.7%) 0.007 (*) 1.263 0.223 7.150 AA 2 (2.8%) 14 (16.1%) 0.792 1 Allelic G 129 (90.8%) 108 (62.1%) 6.064 3.174 1.585 frequencies A 13 (9.2%) 66 (37.9%) 0.000 (*) 1 (*) Statistically significant p-values CI: confidence interval; G: guanine; A: adenosine Table 2. Relationship between TNF-[alpha]-308 genotype and asthma in patients with nasal polyps Asthma Absent Present Total p Genotype GG Count 40 20 60 0.029 % within TNF-[alpha] 66.7% 33.3% 100.0% % within Asthma 80.0% 95.2% 84.5% AG Count 9 0 9 % within TNF-[alpha] 100.0% .0% 100.0% % within Asthma 18.0% .0% 12.7% AA Count 1 1 2 % within TNF-[alpha] 50.0% 50.0% 100.0% % within Asthma 2.0% 4.8% 2.8% Total Count 50 21 71 % within TNF-[alpha] 70.4% 29.6% 100.0% % within Asthma 100.0% 100.0% 100.0% TNF: tumor necrosis factor; A: adenosine; G: guanine Table 3. IL-1[beta] -511 promoter region genotypes and allelic frequencies seen in patients with nasal polyps Patient (n=71) Control (n=91) p Odds Ratio TT 5 (7%) 1 (1.1%) 0.519 0.375 Genotypes CT 50 (70.4%) 89 (97.8%) 0.001 (*) 0.030 CC 16 (22.5 %) 1 (1.1%) 1 Allelic T 60 (42.3%) 91 (%50) 0.166 0.732 frequencies C 82 (57.7%) 91 (%50) 1 95.0% CI Lower Upper 0.019 7.412 Genotypes 0.004 0.241 Allelic 0.470 1.138 frequencies (*) Statistically significant p-values CI: confidence interval; C: cytosine; T: thymine; IL: Interleukin Table 4. Relationship between IL-1[beta]-511 genotype and asthma in patients with nasal polyps Asthma Absent Present Total p Genotype CC Count 14 2 16 0.021 % within IL-1[beta] 87.5% 12.5% 100.0% % within Asthma 28.0% 9.5% 22.5% CT Count 31 19 50 % within IL-1[beta] 62.0% 38.0% 100.0% % within Asthma 62.0% 90.5% 70.4% TT Count 5 0 5 % within IL-1[beta] 100.0% .0% 100.0% % within Asthma 10.0% .0% 7.0% Total Count 50 21 71 % within IL-1[beta] 70.4% 29.6% 100.0% % within Asthma 100.0% 100.0% 100.0% IL: Interleukin; C: cytosine; T: thymine
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|Title Annotation:||Original Investigation; Tumor necrosis factor; Interleukin-1|
|Author:||Ismi, Onur; Ozcan, Cengiz; Polat, Gurbuz; Kul, Seval; Gorur, Kemal; Puturgeli, Tugce|
|Publication:||Turkish Archives of Otorhinolaryngology|
|Date:||Jun 1, 2017|
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