Title |
Cytokine polymorphisms associated with clinical features and treatment outcome in type 1 autoimmune hepatitis
|
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Published in |
Gastroenterology, September 1999
|
DOI | 10.1016/s0016-5085(99)70458-0 |
Pubmed ID | |
Authors |
Albert J. Czaja, Sharon Cookson, Patrizia K. Constantini, Michael Clare, James A. Underhill, Peter T. Donaldson |
Abstract |
Polymorphisms that control cytokine production can affect immunoregulation. The frequency and consequences of these polymorphisms in type 1 autoimmune hepatitis were determined. DNA samples from 155 patients and 102 ethnically similar normal individuals were assessed by polymerase chain reaction for polymorphisms of 4 different cytokine-producing genes. Only genotypes associated with the guanine to adenine substitution at position -308 of the tumor necrosis factor gene occurred more commonly in patients than in normal subjects (56% vs. 26%; P < 0.001). Patients with this polymorphism had the HLA DRB1*0301 allele (81% vs. 10%; P < 0.000001) and A1-B8-DRB1*0301 (66% vs. 0%; P < 0.000001) phenotype more frequently and HLA DRB1*04 alleles less often (24% vs. 67%; P < 0.000001). They also entered remission less commonly (56% vs. 78%; P = 0.01), had treatment failure more often (20% vs. 7%; P = 0.03), and developed cirrhosis more frequently (40% vs. 19%; P = 0.05). These latter differences, however, were not statistically significant by adjusted P value. A polymorphism of the tumor necrosis factor gene occurs more commonly in patients with type 1 autoimmune hepatitis than in normal subjects; it is associated with a poorer response to corticosteroids. The polymorphism may be inherited as part of the extended A1-B8-DRB1*0301 haplotype and may affect both disease expression and behavior. |
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Student > Master | 4 | 17% |
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Student > Ph. D. Student | 2 | 9% |
Unspecified | 1 | 4% |
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