Role of Gene Polymorphism in TNF Alpha Expression and Outcome in Surgical Patients

Introduction: An acute phase response to tissue injury leads to release of pro inflammatory and anti inflammatory cytokines. TNF alpha is an early pro inflammatory cytokine that released in SIRS and largely responsible for clinical manifestation of sepsis. The release of TNF alpha is influenced by messenger RNA transcription of TNF alpha gene. In patients with severe sepsis genomic polymorphism with in the TNF locus found to be associated with TNF alpha production and outcome.

Objectives: To evaluate genetic polymorphism of TNF alpha gene at c 850 t locus, influence on TNF alpha expression and on outcome.

Materials and Methods: A prospective cohort study conducted at our institute between June 2007 to 2009 in 100 cases. Serum TNF alpha levels measured by using ELISA .TNF alpha polymorphism done at c850t locus in 100 patients and were compared with 70 controls who were normal subjects. By using MEDCALC software mean and standard deviations were calculated, continuous variables were compared using t-test. ROC curves were used to determine the predictive capability of the variables.

Results: The most common polymorphism observed was CT in 51 patients. The significant different TNF alpha level expression between the three groups were observed. Significant Tallele was observed in cases (100) when compared with controls (70), p= 0.0002.

Conclusion: Genetic polymorphism of TNF alpha gene may play critical role in stress response and outcome of the patient but it needs to be validated in large number of population.