Abstract
BackgroundPulmonary tuberculosis, the most common clinical form of mycobacterial diseases, is a granulomatous disease of the lungs caused by Mycobaterium tuberculosis. A number of genes have been identified in studies of diverse origins to be important in tuberculosis. Of these, both tumor necrosis factor α (TNF-α) and lymphotoxin α (LT-α) play important immunoregulatory roles.MethodsTo investigate the association of TNF polymorphisms with tuberculosis in the Asian Indians, we genotyped five potentially functional promoter polymorphisms in the TNFA gene and a LTA_NcoI polymorphism (+252 position) of the LTA gene in a clinically well-defined cohort of North-Indian patients with tuberculosis (N = 185) and their regional controls (N = 155). Serum TNF-α (sTNF-α) levels were measured and correlated with genotypes and haplotypes.ResultsThe comparison of the allele frequencies for the various loci investigated revealed no significant differences between the tuberculosis patients and controls. Also, when the patients were sub-grouped into minimal, moderately advanced and far advanced disease on the basis of chest radiographs, TST and the presence/absence of cavitary lesions, none of the polymorphisms showed a significant association with any of the patient sub-groups. Although a significant difference was observed in the serum TNF-α levels in the patients and the controls, none of the investigated polymorphisms were found to affect the sTNF-α levels. Interestingly, it was observed that patients with minimal severity were associated with lower log sTNF-α levels when compared to the patients with moderately advanced and far advanced severity. However, none of these differences were found to be statistically significant. Furthermore, when haplotypes were analyzed, no significant difference was observed.ConclusionsThus, our findings exclude the TNF genes as major risk factor for tuberculosis in the North Indians.
Highlights
IntroductionThe most common clinical form of mycobacterial diseases, is a granulomatous disease of the lungs caused by Mycobaterium tuberculosis
Pulmonary tuberculosis, the most common clinical form of mycobacterial diseases, is a granulomatous disease of the lungs caused by Mycobaterium tuberculosis
Tumor necrosis factor (TNF)-α contributes to the pathogenesis of tuberculosis due to its role in the formation and maintenance of granulomas [10]
Summary
The most common clinical form of mycobacterial diseases, is a granulomatous disease of the lungs caused by Mycobaterium tuberculosis. A number of genes have been identified in studies of diverse origins to be important in tuberculosis Of these, both tumor necrosis factor α (TNF-α) and lymphotoxin α (LT-α) play important immunoregulatory roles. The genes for tumor necrosis factor-α (TNF-α; TNFA) and lymphotoxin-α (LT-α; LTA), located within the MHC III region of chromosome 6, shows close linkage to the HLA class I (HLA-B) and class II (HLA-DR) genes [8] Both TNF-α, produced mainly by monocytes and activated macrophages; and LT-α, produced mainly by activated T-cells, play important immunoregulatory roles [9]. TNF-α contributes to the pathogenesis of tuberculosis due to its role in the formation and maintenance of granulomas [10] It plays a major role in host defense to M. tuberculosis by its synergistic action with interferon-γ (IFN-γ) to activate macrophages and thereby impacts on disease perpetuation [11,12]. Elevated serum TNF-α (sTNF-α) levels have been reported in advanced tuberculosis patients when compared to those with mild tuberculosis and healthy individuals [13]
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