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Tumor necrosis factor-alpha genetic predisposing factors can influence clinical severity in nephropathia epidemica.

Abstract
Severe human infection with Hantavirus is characterized by high fever, cold chills, thrombocytopenia, arterial hypotension, acute renal failure, and/or adult respiratory distress syndrome (ARDS)-like pulmonary involvement, but the clinical course varies greatly between individuals. We investigated whether genetically determined differences in tumor necrosis factor (TNF)-alpha production can influence the severity of Hantavirus disease. We studied a TNF-alpha single-nucleotide promoter polymorphism (SNP) at position -238 (a guanine [G]-to-adenine [A] transition) and ex vivo TNF-alpha production in a recall study of 36 Belgian patients who had a serologically proven form of Puumala virus-induced Hantavirus infection with the kidney as main target organ. In our study, the highest creatinine levels were found in patients with the lowest ex vivo TNF-alpha production. Creatinine levels correlated inversely with TNF-alpha production (R = -0.35, p < 0.05). The number of thrombocytes was significantly lower in patients with the GA-238 genotype (low TNF-alpha producers) compared with patients with the GG-238 genotype. In our study, genetically determined low production of TNF-alpha was associated with some parameters indicating a more severe clinical course of Puumala Hantavirus infection in humans, possibly by impaired activation of TNF-alpha-dependent antiviral mechanisms, which could in turn result in decreased clearance of Hantavirus.
AuthorsPiet Maes, Jan Clement, Paul H P Groeneveld, Paul Colson, Tom W J Huizinga, Marc Van Ranst
JournalViral immunology (Viral Immunol) Vol. 19 Issue 3 Pg. 558-64 ( 2006) ISSN: 0882-8245 [Print] United States
PMID16987073 (Publication Type: Journal Article)
Chemical References
  • Tumor Necrosis Factor-alpha
Topics
  • Genetic Predisposition to Disease
  • Hemorrhagic Fever with Renal Syndrome (genetics, immunology, physiopathology, virology)
  • Humans
  • Polymorphism, Single Nucleotide
  • Promoter Regions, Genetic (genetics)
  • Puumala virus
  • Severity of Illness Index
  • Tumor Necrosis Factor-alpha (genetics, metabolism)

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