Clinical significance of serum TNFα and -308 G/A promoter polymorphism in rheumatoid arthritis

Aim of the work: To evaluate the clinical significance of serum levels of tumor necrosis factor alpha (TNFa) and -308 G/A promoter polymorphism in rheumatoid arthritis (RA) patients. Patients and methods: We studied 43 RA patients and 30 controls. Demographic, clinical and serological data were prospectively evaluated. Disease activity score (DAS28) and the Health Assessment Questionnaire (HAQ) were assessed. Serum TNF-alpha level was measured and promoter (-308 G/A) genotyped. Results: Serum TNF-alpha level was significantly higher in the RA patients compared to controls (p = 0.036) and was significantly higher in those with AA promoter polymorphism who had a significantly younger age at disease onset. In the multivariate analysis, disease duration would predict the TNFa level (p = 0.006) while age at disease onset, DAS28 and HAQ would predict the TNF alpha polymorphism (p = 0.004, p = 0.04 and p = 0.03 respectively). A significant negative correlation was present between TNF alpha level with age (p = 0.001) and age at disease onset (p < 0.0001) while in those with GA genotype a significant negative correlation was present with DAS28 (r = -0.66, p = 0.038). Conclusion: Serum TNFa levels and -308 G/A promoter polymorphism were higher in RA patients than in controls and could be predicted by disease activity and HAQ. (C) 2014 Production and hosting by Elsevier B.V. on behalf of Egyptian Society of Rheumatic Diseases.