Abstract | BACKGROUND AND PURPOSE: Identification of single-nucleotide polymorphisms (SNPs) associated with increased risk of new intracranial hemorrhage (ICH) after brain arteriovenous malformation (BAVM) diagnosis would facilitate risk stratification and identify potential targets for therapeutic intervention. METHODS: Patients with BAVM were longitudinally followed. Primary outcome was new ICH after diagnosis; censoring events were last follow-up or any BAVM treatment. We genotyped 4 promoter SNPs in 2 inflammatory cytokine genes: interleukin-6 (IL-6-174G>C; IL-6-572G>C) and tumor necrosis factor-alpha ( TNF-alpha-238G>A; TNF-alpha-308G>A). Association of genotype with risk of new ICH was screened using chi2; SNPs associated with new ICH were further characterized using Cox proportional hazards. RESULTS: We genotyped 280 patients (50% female; 59% white, mean+/-SD age at diagnosis 37+/-17 years; 40% presenting with ICH). TNF-alpha-238G>A was associated with increased risk of new ICH after diagnosis (chi2; P=0.003). After adjusting for age, race/ethnicity, and clinical presentation, the risk of new ICH was increased for patients with TNF-alpha-238 AG genotype (hazard ratio, 4.01; P=0.015). No other SNP was found to be associated with new ICH. CONCLUSIONS: A TNF-alpha SNP was associated with increased risk of new ICH in the natural course of BAVMs. The role of inflammatory cytokines in the pathogenesis of BAVM hemorrhage merits further study.
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Authors | Achal S Achrol, Ludmila Pawlikowska, Charles E McCulloch, K Y Trudy Poon, Connie Ha, Jonathan G Zaroff, S Claiborne Johnston, Chanhung Lee, Michael T Lawton, Stephen Sidney, Douglas A Marchuk, Pui-Yan Kwok, William L Young, UCSF BAVM Study Project |
Journal | Stroke
(Stroke)
Vol. 37
Issue 1
Pg. 231-4
(Jan 2006)
ISSN: 1524-4628 [Electronic] United States |
PMID | 16322490
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
- Interleukin-6
- Tumor Necrosis Factor-alpha
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Topics |
- Adult
- Arteriovenous Malformations
(genetics, pathology)
- Brain
(pathology)
- Female
- Genotype
- Haplotypes
- Hemorrhage
(genetics)
- Humans
- Interleukin-6
(genetics)
- Male
- Middle Aged
- Models, Statistical
- Polymorphism, Single Nucleotide
- Promoter Regions, Genetic
- Proportional Hazards Models
- Risk
- Time Factors
- Tumor Necrosis Factor-alpha
(genetics)
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