Abstract

BackgroundPromoter region SNPs in TNF-α have been studied in association with Recurrent Pregnancy Loss (RPL) occurrence in various populations. Among them, −238G > A, −308G > A and − 376G > A have been frequently investigated for their potential role in recurrent abortions. The aim of the present study is to evaluate the correlation among TNF-α 238, TNF-α 308 and TNF-α 376 polymorphisms and recurrent pregnancy loss risk in Greek women.MethodsThis study included 94 Caucasian women with at least two miscarriages of unexplained aetiology, before the 20th week of gestation. The control group consisted of 89 Caucasian women of proven fertility, with no history of pregnancy loss. DNA samples were subjected to PCR amplification using specific primers. Sanger sequencing was applied to investigate the presence of TNF-α 238, TNF-α 308, TNF-α 376 polymorphisms in all samples.ResultsThe TNF-α 238 and TNF-α 308 variants were both detected in RPL and control groups (7.45% vs 4.49 and 45.16% vs 36.73%, respectively), but with no statistically significant association (p-value 0.396 and 0.374, respectively). The TNF-α 376 variant was not detected at all in both control and RPL groups. When TNF-α 238 and TNF-α 308 genotypes were combined no association with RPL was detected (p-value = 0.694). In subgroup analysis by parity, RPL patients carrying the A allele reported less previous births.ConclusionsThis is the first study demonstrating TNF-α 238 and TNF-α 308 gene expression and the absence of TNF-α 376 variant in Greek women with RPL. However, no association emerged between each polymorphism studied and the occurrence of recurrent pregnancy loss. Accordingly, TNF-α -308G > A, −238G > A and -376G > A variants are not considered genetic markers for identifying women at increased risk of recurrent pregnancy loss in the Greek population.

Highlights

  • Recurrent pregnancy loss (RPL) is defined as three or more consecutive spontaneous abortions before the 20th week of gestation, as proposed by the European Society of Human Reproduction and Embryology, and occurs in approximately 1–2% of reproductively active couples [1,2,3]

  • Given the controversial data upon Tumor necrosis factor-alpha (TNF-α) variants and Recurrent Pregnancy Loss (RPL), the aim of the present study is to investigate the possible correlations between TNF-α 308, TNF-α 238, and TNF-α 376 polymorphisms and recurrent pregnancy loss risk separately and combined, revealing the genetic profile probably related to recurrent abortions occurrence in the Greek population

  • The TNF-α -238G > A variant was detected in heterozygosity in 7 out of the 94 patients (7.45%; 7/94), while it was found to be present in 4 women of the control group (4.49%; 4/89)

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Summary

Introduction

Recurrent pregnancy loss (RPL) is defined as three or more consecutive spontaneous abortions before the 20th week of gestation, as proposed by the European Society of Human Reproduction and Embryology, and occurs in approximately 1–2% of reproductively active couples [1,2,3]. Emerging evidence indicates that endometrial immune dysregulation could be responsible for several, if not many, cases of RPL of unknown origin. Cytokines seem to play a pivotal role in reproductive dysfunctions [8,9,10,11]. Tumor necrosis factoralpha (TNF-α) is a key pro-inflammatory cytokine and plays an important role in apoptotic cell death and initiating an immune response. The circulating levels of TNF-α are higher in case of miscarriage compared to those reported in a successful pregnancy indicating that abnormal TNF-α levels adversely affect the progression of pregnancy [9, 13,14,15]. Promoter region SNPs in TNF-α have been studied in association with Recurrent Pregnancy Loss (RPL) occurrence in various populations. The aim of the present study is to evaluate the correlation among TNF-α 238, TNF-α 308 and TNF-α 376 polymorphisms and recurrent pregnancy loss risk in Greek women

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