Tumor necrosis factor-α -863 C/A promoter polymorphism affects the inflammatory response after cardiac surgery
| Autor: | Johannes Boehm, Siegmund Braun, Stefan Wagenpfeil, Katharina Hauner, J Grammer, Robert Bauernschmitt, Rüdiger Lange, Wulf Dietrich |
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| Rok vydání: | 2010 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Genotype Single-nucleotide polymorphism Gastroenterology Polymorphism Single Nucleotide Perioperative Care law.invention Coronary artery bypass surgery law Internal medicine medicine Cardiopulmonary bypass Humans Genetic Predisposition to Disease Prospective Studies Coronary Artery Bypass Promoter Regions Genetic Aged Aged 80 and over Inflammation Cardiopulmonary Bypass business.industry Tumor Necrosis Factor-alpha Heterozygote advantage General Medicine Perioperative Middle Aged Cardiac surgery medicine.anatomical_structure Treatment Outcome Ventricle Anesthesia Surgery Inflammation Mediators Cardiology and Cardiovascular Medicine business |
| Zdroj: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 40(1) |
| ISSN: | 1873-734X |
| Popis: | Objective:Cardiacsurgeryusingcardiopulmonarybypass(CPB)initiatesaninflammatoryresponsethatshowsawideinter-individualrangeand determines postoperative morbidity. Previous research suggests that genetic diversity contributes to individual susceptibility to perioperative trauma and stress. Nevertheless, the genetic triggering of the tumor necrosis factor-alpha (TNF-a) release remains unclear. We tested two geneticsingle-nucleotide polymorphisms (SNPs) from the promoterregion of the TNF-agenefor associationswith perioperative TNF-alevel after CPB.Methods:Weprospectivelyincluded122patients,whounderwentelectivecoronaryarterybypassgrafting(CABG).Patientsweregenotyped for TNF-a —863 C/A (rs1800630) and TNF-a —308 G/A (rs1800629). Plasma level of TNF-a was obtained preoperatively, at the end of CPB, 6 h postoperatively, and on the first postoperative day (POD). Results: Demographic characteristics and operative data revealed no significant differences between the different genotypes. Multiple linear regression analyses revealed significant associations for the TNF-a 863 C/A polymorphism: the major —863 CC variant was associated with higher TNF-a level preoperatively (p = 0.003), after CPB (p = 0.005), and 6 h postoperatively (p = 0.010), independently from CPB time, left ventricle (LV) function and age. Contrarily, the AA allele had lower TNF-a level preoperatively (p = 0.008), after surgery (p = 0.024) and 6 h postoperatively (p = 0.001). For the TNF-a 308 G/A polymorphism, only few significant associations could be observed: —308 GG carriers were associated with lower TNF-a level immediately after CPB (p = 0.020), whereas 308 AA carriers were significantly associated with elevated TNF-a level preoperatively (p = 0.032) and immediately after CPB (p = 0.05). No heterozygote variant of both SNPs revealed any significant associations with perioperative TNF-a level. Conclusions: The current study suggests that the major —863 CC variant determines elevated TNF-a level preoperatively and throughout the postoperative course after CPB. # 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved. |
| Databáze: | OpenAIRE |
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