Association of polymorphisms in promoter region of TNF- α -238 and -308 with clinical outcomes in patients with immune-mediated inflammatory diseases on anti-TNF therapy

AbstractThe hypothesis of the study was that polymorphisms in promoter regions -238 and -308 ofTNF- α could be associated with different clinical outcomes in inflammatory bowel diseases (IBD) and immune-mediated rheumatic diseases (IMRD). The aim was to examine the possible association of both polymorphisms with concentration of C-reactive protein (CRP) and fecal calprotectin (fCAL), onset of the remission and development of the ADA in patients on therapy with anti-TNF inhibitors. The prospective study was done in patients with IBD and IMRD on infliximab (IFX) or adalimumab (ADM). Patients were genotyped forTNF- α -238 and -308 polymorphisms. The concentration of CRP, fCAL, IFX or ADM and antibodies to drugs were measured according to manufacturer’s instructions and followed-up for 6 or 12 months. Out of all patients (N = 112), number of patients in remission did not differ according to genotypes (for IBD patientsP = 0.509 vs 0.223; for IMRD patientsP = 0.541 vs 0.132 forTNF- α -238 and -308, respectively). Initial CRP concentration was higher in IBD patients withTNF- α -308 GG than GA/AA genotypes in patients who failed to achieve remission [11.8 (4.4 –39.6) vs 3.1 (1.5–6.5),P = 0.033]. In IBD patients with remission, fCAL concentration after at least 6 months of therapy was higher inTNF- α-308 GG than in GA genotype [52 (25 –552) vs 20 (20–20) µg/g,P = 0.041]. Our results showed the association ofTNF- α -308 GG genotype with a highe...
Source: Rheumatology International - Category: Rheumatology Source Type: research