Korean Journal of Nephrology 2001;20(4):576-583.
논평 : Tumor Necrosis Factor α 유전자 다형성이 사구체 신염의 병변에 미치는 영향 (Editorial : Tumor Necrosis Factor a Gene Polymorphism in Patients with Glomerulonephritis)
이은영(Eun Young Lee),홍세용(Sae Yong Hong),최종순(Jong Tae Cho),양동호(Dong Ho Yang),조종태(Jong Tae Cho),윤성철(Sung Chul Yoon)
Abstract
Tumor necrosis factor(TNF) α is a potent cytokine which is involved in the pathogenesis of glo- merulonephritis. Recently, it was known that TNF α gene polymorphism influenced the concentrations of TNF β in plasma and renal tissue and also the susceptibility of renal injury. To elucidate the contribution of TNF α gene polymorphism to the development and progression of glomerulonephritis, we typed the alleles of the TNF α gene by polymorphism chain reaction and digestion with restriction enzyme Ncol in 190 patients with glomerulonephritis confirmed by renal biopsy and 249 normal controls. Underlying diseases were minimal change disease (31 patients), focal segmental glomerulosclerosis(33 patients), membranous glomerulonephritis(18 patients), membranoproliferative glomerulonephritis(16 patients), and IgA nephropathy(92 patients). TNF a genotypes in the patients with glomerulonephritis were 64.2% TNFA1/TNFA1 genotype, 31.6% TNFA1/TNFA2 genotype, 4.2% TNFA2/TNFA2 genotype. The frequencies of genotype in patients with glomerulonephritis were not significantly different from those of normal controls. The severity of clinical data such as proteinuria, serum creatinine, systolic and diastolic blood pressure, hematocrit, cholesterol were not cor- related with the TNF α genotypes. The mean follow-up duration of 113 patients with glomerulonephritis was 79.3±39.8 months. Patients who started dialysis treatment or whose serum creatinine was double or more during over 3 years of follow-up period were designated as progress, the remainder were designated as stable. In patients with IgA nephropathy, the TNFAZ/TNFA2 genotype was more prevalent(p<0.05) in the progress group than in the stable group. In conclusion, we could not find any association between the TNFα gene polymorphism and the development of glomerulonephritis. However, we suggest that TNF a gene polymorphism may affect the disease progression in IgA nephropathy.
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