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目的探讨白细胞介素6(interleukin6,IL6)基因启动子上游174G/C和634C/G基因多态性,在冠心病患者和正常人群中的分布及与冠心病的相关性。方法应用聚合酶链反应限制性片断长度多态性技术,对汉族199例冠心病患者及189名正常人群,白细胞介素6基因174G/C、634C/G位点进行研究,同时结合血脂、脂蛋白和载脂蛋白水平,探讨两者之间的关系。结果正常人群和冠心病患者的174G等位基因频率均为0.99。174C等位基因频率均为0.01。634C等位基因频率在正常人群和冠心病患者分别为0.82和0.76,G等位基因频率分别为0.18和0.24,两者差异有统计学意义(P<0.05)。冠心病患者634GG基因型频率(0.08)明显高于对照组(0.02)(P<0.05)。结论白细胞介素6基因174位点多态性与冠心病无关,而634位点多态性与冠心病有相关性。G等位基因可能是汉族人群冠心病的易感性标志。  相似文献   

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BACKGROUND: The aim of this pilot study was to evaluate the relationship between interleukin-6 promoter -174G/C (IL-6 -174G/C) polymorphism and insulin resistance (IR) in obese patients with coronary heart disease (CHD). METHODS: Twenty obese male patients with CHD were selected from a larger database of patients (n=606). IL-6 -174G/C genotype was previously analysed and only homozygotes with the CC genotype (n=10) or GG genotype (n=10) were selected. IR was measured using the homeostasis model assessment for IR (HOMA-IR) method. RESULTS: Differences in age, body mass index, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), hypertension, IL-6, C-reactive protein and HOMA-IR were not significant between the genotypes (p>0.05), but analysis of a homogeneity-of-slopes model showed that genotype had a significant influence on HOMA-IR (p=0.037), and the interaction between genotype and HDL-C had a pronounced tendency to affect HOMA-IR (p=0.058). Using multiple regression analysis, we found that HDL-C had a significant effect on HOMA-IR (p=0.023), and TG had a tendency to affect HOMA-IR (p=0.066) only in the CC genotype. CONCLUSIONS: Our data show that IL-6 -174G/C polymorphism may have a significant effect on IR. A comparison between the effects of various cardiovascular risk factors showed that HDL-C may have a significant effect on HOMA-IR in the CC genotype but not in the GG genotype. Further research is needed to test the preliminary results.  相似文献   

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本研究旨在通过对中国北方地区汉族人IL-6基因启动子区-572G/C,-597G/A多态性与体重指数(BMI)和炎症因子等生化指标的相关性的调查,探索基因多态性与冠心病(CHD)发生发展的关系。采用荧光杂交探针、以荧光共振能量转移原理和熔点曲线分析技术,测定了194例冠心病患者和123例健康对照者的IL-6基因型,同时测定BMI、超敏C反应蛋白(hsCRP)、血脂、载脂蛋白等指标,并通过建立逻辑回归(Logistic regression)模型分析CHD发生的危险因素。结果表明,在所有观察对象中发现中国北方汉族人IL-6基因启动子区-597位点有7例为GA型.其余均为GG型,尚未发现AA型,未发现其多态性与BMI和炎症因子等生化指标的相关性。冠心病(cor—onary heart disease,CHD)组与对照组-572G/C基因型频率和等位基因频率分布差异无统计学意义,但是CHD组和对照组携带G等位基因和非G等位基因频率相比差异有统计学意义(P=0,0425)。正常对照组中携带G等位基因者收缩压中位数水平明显高于非G等位基因者(P=0、02)。在所有研究对象中,与非G等位基因组相比,携带G等位基因组的体重指数、超敏C反应蛋白、收缩压中位数水平显著升高(P值分别为0、026、0.022、0、005)。经Logistic逐步回归分析显示,年龄、血清甘油三脂、性别、高血压、载脂蛋白C2、血清总胆固醇、脂蛋白a是冠心病发生的危险因子,而载脂蛋白A1是保护因子(P〈0.05),未见-572G/C的G等位基因是一独立的危险因素。结论:IL-6基因启动子区-597G/A多态性和CHD的易感性无关,而-572G/C多态性与CHD的易感性有关,其机制可能与-572G/C多态性可导致BMI、hsCRP和血压的变化有关。  相似文献   

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目的 探讨白细胞介素6(interleukin-6,IL-6)基因启动子区域-572C>G和-174G>C基因多态性与宿迁汉族人群冠心病(coronary heart disease,CHD)的关系。方法 参考2010卫生部CHD诊断标准(WS319-2010),选择2017年1~12月在宿迁市第一人民医院心内科确诊的CHD患者,应用聚合酶链-限制性片段长度多态性(Polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)方法检测266例CHD患者和192例体检健康人群(对照组),分析其IL-6-572C>G和IL-6-174G>C基因多态性,并进行Hardy-Weinberg平衡检验,检测血糖、血脂等生化指标。结果 IL-6-572C>G基因型和等位基因频率在两组间分布差异有统计学意义(χ2=11.1,19.5,22.4,P<0.05),CHD组GG型和CG型OR值分别是CC型的4.88倍(95%CI:2.31~10.31)和1.96倍(95% CI:1.32~2.91); -174G>C基因型和等位基因频率在两组间分布差异无统计学意义(χ2=0.024,0.027,P>0.05)。结论 IL-6-572G等位基因可能是宿迁汉族CHD的易感基因,IL-6-174G>C基因多态性可能与宿迁汉族人群CHD没有相关性。  相似文献   

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【目的】探讨白介素-6(IL-6)基因-572C/G多态性对2型糖尿病患者血清IL-6水平的影响。【方法】应用聚合酶链反应-限制性片段长度多态性方法检测358例初发2型糖尿病患者IL-6基因-572C/G多态性,用ELISA方法检测不同基因型患者的IL-6水平【结果】2型糖尿病患者IL-6基因-572CC,CG,GG基因型人数分别为212,129,17;血清IL-6水平分别为(61.32±16.98)pg/mL,(64.98±15.19)pg/mL和(92.18±25.36)pg/mL,血清IL-6水平在CC,CG基因型间差异无显著性,两种基因型与GG基因型相比,血清IL-6水平差异均有显著性(P〈0.05)。【结论]IL-6基因572C/G多态性可能具有功能性,572GG基因型分泌IL-6能力可能较CC及CG基因型强,IL-6基因572GG基因型可能是2型糖尿病的危险因素之一。  相似文献   

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目的 研究单采献血者白细胞介素-28b(IL-28b)基因多态性与隐匿性乙型肝炎病毒(HBV)感染(OBI)相关性。方法 选择2016年1月~2019年12月山东省血液中心成功捐献血小板HbsAg(-)、核酸检测(NAT)无反应的献血者1 158例为研究对象,提取献血者血液DNA,采用直接测序法进行IL-28b基因分型,cobas HBV定量核酸检测试剂盒检测血液HBV-DNA载量,Logistic回归分析IL-28b基因rs8099917位点、rs12979860位点多态性与OBI的关系。结果 与非OBI比较,OBI献血者IL-28b基因rs8099917位点G等位基因频率、TG+GG基因型频率显著降低,T等位基因频率、TT基因型频率显著增加(χ2=22.137,22.163,均P<0.01);rs12979860位点T等位基因频率、CT+TT基因型频率显著降低,C等位基因频率、CC基因型频率显著增加(χ2=16.378,19.091,均P<0.01)。OBI献血者rs8099917位点,与TT基因型比较,TG+GG基因型患者HBV-DNA载量显著降低(t=5.257,P<0.01);rs12979860位点,与CC基因型比较,CT+TT基因患者HBV-DNA载量显著降低(t=17.398,P<0.01),以上比较差异均有统计学意义。Logistic回归分析结果显示,rs8099917位点,与TT基因型比较,TG+GG基因型可显著降低OBI发生风险(95% CI:0.288~0.843,P<0.05) ;rs12979860位点,与CC基因型比较,CT+TT基因型可显著降低OBI发生风险(95% CI :0.207~0.761,P<0.05)。结论 单采献血者OBI可能与IL-28b基因rs8099917位点、rs12979860位点多态性有关。  相似文献   

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背景存在启动子区的多态性可以改变基因的表达水平,可能关系人类对疾病的易感性.白细胞介素6启动子基因多态性和民族以及很多疾病有关,不同民族其基因多态性表现特点也常常不同.目的观察白细胞介素6启动子-597和-572位点在西藏藏族人群的分布,为藏族群体遗传学和高原人群免疫背景提供基础资料.设计随机抽查.单位锦州医学院人类学研究所.对象于2003-10和2004-07分别对西藏自治区拉萨市和那曲牧区进行样本采集.选择108名藏族青少年为研究对象,其中男60名,女48名,年龄14~21 岁.纳入标准父母均为藏族并经过严格体格检查确定健康.纳入对象均对检测项目知情同意并签署知情同意书.方法抽取108名藏族青少年的外周静脉血5 mL,采用盐析法提取人的白细胞DNA.应用聚合酶链式反应扩增IL-6启动子包含-597和-572片断,对扩增片断进行限制酶切后取不同条带进行克隆后测序.主要观察指标西藏自治区藏族人启动子多态性分布情况,以及和中国汉族和其他民族比较结果.结果纳入的108名藏族青少年数据全部进入结果分析.①不同性别人群IL-6启动子-572C/G位点多态性分布-597位点108个样本中都没有发现GA和AA基因型,仅发现GG基因型.-572位点存在CC,CG,GG3种基因型,频率依次为0.63,0.35,0.02;基因型分布符合Hardy-Weinberg平衡,具有群体代表性;等位基因频率分别为0.81,0.19;基因型和等位基因频率均无性别差异(P>0.05).②不同种族间IL-6基因-597G/A与-572C/G多态性分布英法白种人群中-597位点存在GG,GA,AA3种基因型,G,A等位基因频率分别为0.60和0.40,明显不同于本实验中西藏藏族人群位点多态性分布;而日本人群中-597位点也不存在多态性,与我国汉族人群接近(P>0.05).③不同条带基因分型,DNA序列测定结果-597位点仅发现有GG基因型(不含酶切位点,酶切后为1条片段,长度仍为PCR扩增产物),未见GA和AA基因型.-572位点存在CC,CG,GG3种基因型,频率依次为0.64,0.35,0.01;基因型分布符合Hardy-Weinberg平衡(P>0.05),具有群体代表性;C,G等位基因频率分布为0.81,0.19;基因型和等位基因分布频率均无性别差异.不同种族人群间IL-6基因频率及等位基因携带频率分布的比较,西藏藏族和我国汉族人接近,而与欧美西方白种人比较,差异明显.结论IL-6基因-597和-572多态性存在种族差异,西藏藏族人群可能不存在-597多态性;其-572位点有着自己的民族特点,存在CC、CG、GG3种基因型,G等位基因为少见基因,与欧美白种人相比-572位点基因型等位基因频率分布存在显著差异,而与我国汉族和日本人接近,这种差异可能是与高原人特有的遗传基因有关.  相似文献   

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目的研究白细胞介素-6(IL-6)基因-572G/C多态性对急性冠状动脉综合征患者血浆高敏C反应蛋白(hs-CRP)浓度的影响。方法采用聚合酶链反应结合限制性内切酶片段长度多态分析方法(PCR-RFLP)检测228例急性冠状动脉综合征患者的IL-6基因-572G/C多态性,用免疫比浊法测定hs-CRP浓度。结果①ST段抬高急性心肌梗死(STEMI)组hs—CRP水平明显高于非ST段抬高急性冠脉综合征(NSTEACS)组,差异有统计学意义(P〈0.05)。②IL-6基因-572G/C多态性的基因型频率:CC42.54%、GC46.92%、GG10.52%;等住基因频率:C66.01%、T33.99%。③在STEMI组中,基因型CC组hs-CRP浓度较基因型GG+GC组高,差异有统计学意义(P〈0.05)。多因素线性回归分析结果仍显示基因型CC携带者的血浆hs-CRP水平较携带G等住基因者高(P〈0.05)。在NSTEACS组及总人群中,不同基因型组hs—CRP比较差异无统计学意义(P〉0.05)。结论IL-6基因-572G/C多态性对急性冠状动脉综合征患者血浆hs-CRP水平无影响。在STEMI患者中,基因型CC携带者的血浆hs-CRP水平较携带G等住基因者高,提示IL-6基因-572G/C多态性在较高的炎症反应状态下,会对hs-CRP的表达产生影响。  相似文献   

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Glucose-6-phosphate dehydrogenase (G6PD) deficiency, a condition associated with malaria resistance, is a common genetic polymorphism. Decreased interleukin (IL)-10 production was demonstrated in vivo and in vitro in the African and Mediterranean forms of G6PD deficiencies. We hypothesized that low-producing IL-10 alleles are more abundant in the G6PD-deficient than nondeficient population. One hundred eleven men with African American ancestry were tested for G6PD deficiency (Type A-202/376) and for the cytokine gene promoter polymorphisms of IL-10 (-1082 G/A, -819 T/C, and -592 A/C), tumor necrosis factor (TNF)-alpha (-308 G/A), transforming growth factor (TGF)-beta1 (C/T codon 10 and C/G codon 25), IL-6 (-174 G/C), and interferon (IFN)-gamma (+874 A/T). There were no differences in the allele frequencies for TNF-alpha, IL-6, or TGF-beta1 between the G6PD-deficient and nondeficient population. In contrast, the low-producing IL-10 alleles (-592A) and low-producing IFN-gamma (+874A) allele frequencies were greater in G6PD-deficient than nondeficient samples (P = 0.035 and 0.009). Seventy-one percent of G6PD-deficient and 50% of nondeficient samples carried the high-producing IL-6(G) allele with low-producing IL-10(A) allele (P = 0.03). Furthermore, 95% of deficient and 81% of nondeficient samples carried the IL-6(G) allele together with low-producing IFN-gamma(A) allele (P = 0.017). These investigations indicate a predominant presence of high-producing IL-6 alleles together with low-producing IL-10 and IFN-gamma alleles in individuals with ancestry from malaria-endemic regions. The frequency of low-producing IL-10 genotypes is greater in the G6PD-deficient compared with nondeficient patients. The fact that these genetic differences are preserved in the current African American G6PD-deficient population indicates their potential role in pathophysiological processes in the absence of the selective pressure caused by tropical diseases.  相似文献   

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AIMS: Atherosclerosis is a chronic inflammatory condition, manifest in its early stages by endothelial dysfunction. Interleukin-6 (IL6) plays a key role in driving this process through stimulation of acute phase protein synthesis. We have examined the effect of the IL6 gene -174G > C promoter polymorphism on endothelial function in a group of healthy subjects. METHODS: 248 adults aged 20-28 years participated. Polymerase chain reaction was performed for the -174G > C polymorphism. Brachial artery diameter was measured at rest and after forearm cuff occlusion by high-resolution ultrasound. Responses were represented as absolute flow mediated dilatation (FMDA). RESULTS: Overall there was a trend towards greater FMDA for genotype CC, P = 0.14. No effect was seen in women; however, in men, following multivariate analysis, there was a significant association between genotype and FMDA, P = 0.04. In addition, a significant detrimental effect of smoking on FMDA was only seen in males of genotype CC (P < 0.05) when compared to nonsmokers of the same genotype. CONCLUSION: IL6-174G > C promoter polymorphism influences endothelial function in healthy male subjects. The detrimental effect of smoking on endothelial function is most clearly seen in men of genotype -174 CC, suggesting a genotype-specific interaction with smoking.  相似文献   

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目的 探讨炎症细胞因子基因多态性与癌因性疲乏(CRF)的关联,为研究遗传易感性在CRF发生发展中所起的作用提供研究基础。方法 肺癌患者242例,其中癌因性疲乏组162例,非癌因性疲乏组80例。通过PCR RFLP进行基因分型,分析基因型及等位基因频率在疲乏组与非疲乏组的分布情况及炎症细胞因子基因多态性与癌因性疲乏的关联性。结果 TNFα 308G/A、IL 1β 511C/T基因型分布在两组间差异有统计学意义(P均<0.05)。多元logistic回归校正了年龄和性别等混杂因素后显示,相对于TNFα 308GG基因型患者,携带GA/AA基因型患者发生CRF的风险降低了74%(15%~92%);相对于IL 6 174GG基因型患者,携带GC/CC基因型患者发生CRF的风险降低了78%(0%~95%);在IL 1β 511C/T基因位点中,携带CC基因型的患者发生CRF的风险是TT基因型患者的3.96倍(95%CI 1.02 15.45)。结论 携带TNFα 308GG、IL 6 174GG、IL 1β 511CC基因型的肺癌患者发生癌因性疲乏的风险明显增加。  相似文献   

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BACKGROUND: Serum C-reactive protein (CRP) levels, closely associated with cardiovascular disease (CVD) risk are influenced by CRP or interleukin-6 (IL-6) single nucleotide polymorphism (SNPs). However, it is still controversial. Therefore, we investigated the association of IL-6/CRP SNPs and serum CRP levels or other CVD risk factors in healthy adult Korean men. METHODS: In healthy adult men (age>or=20 years, n=677), we genotyped IL-6-572C>G and CRP SNPs (-717G>A, 1444C>T, 2147A>G) and measured anthropometric parameters, lipid profile, serum levels of CRP and IL-6 and insulin resistance. RESULTS: At IL-6-572C>G (n=677), subjects with G/G genotype (n=42) showed higher concentrations of CRP (P=0.027) and IL-6 (P=0.028) as compared with C allele carriers after age-adjustment (C/C: n=371, C/G: n=264). Fasting insulin and homeostatis model assessment insulin resistance (HOMA-IR) were also higher in G/G genotype. However, there were no significant differences in other metabolic biomarkers. Among 677 study subjects, 676 were genotyped at CRP-717G>A (G/G: n=513, G/A: n=150, A/A: n=13), 672 at CRP+1444C>T (C/C: n=580, C/T: n=85, T/T: n=7), and 668 at CRP+2147A>G (A/A: n=273, A/G: n=296, G/G: n=99). There were no significant differences in CRP concentrations and other markers related to CVD risk according to each CRP SNP genotype. However, we could find the additive gene-gene interaction between IL-6-572C>G and CRP SNPs on CRP concentration; subjects with the 'G/G' at IL-6-572 showed the highest CRP levels when they have variant allele at CRP SNPs after adjusted for age, body mass index, cigarette smoking and alcohol drinking (-717G>A: F=7.806, P=0.005; CRP+1444C>T: F=8.398, P=0.004; and CRP+2147A>G: F=7.564, P=0.006, respectively) Particularly, G allele carriers at CRP+2147A>G in subjects with IL-6-572G/G showed highest HOMA-IR (F=9.092, P=0.003). CONCLUSION: The present data showed that serum CRP levels and other CVD risk factors appeared more influenced by IL-6-572C>G rather than CRP SNPs (-717G>A, 1444C>T, and 2147A>G), however CRP levels and insulin resistance may be additively affected by IL-6-572 and CRP SNP, particularly when subjects with G/G genotype at IL-6-572 have allele variant at CRP SNPs.  相似文献   

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BACKGROUND: A single-nucleotide polymorphism (SNP) in the promoter region of the interleukin-6 (IL-6) gene at position -174 (G>C) has been reported to be associated with a variety of major diseases, such as Alzheimer disease, atherosclerosis, and cardiovascular disease, cancer, non-insulin-dependent diabetes mellitus, osteoporosis, sepsis, and systemic-onset juvenile chronic arthritis. However, authors of previous in vitro and in vivo studies have reported conflicting results regarding the functionality of this polymorphism. We therefore aimed to clarify the role of the -174 SNP for the induction of IL-6 in vivo. METHODS: We vaccinated 20 and 18 healthy individuals homozygous for the -174 C and G alleles, respectively, with 1 mL of Salmonella typhii vaccine. IL-1beta, IL-6, and tumor necrosis factor-alpha (TNF-alpha) were measured in the blood at baseline and up to 24 h after vaccination. RESULTS: Individuals with the G genotype had significantly higher plasma IL-6 values at 6, 8, and 10 h after vaccination than did individuals with the C genotype (P <0.005). There were no differences between the two genotypes regarding serum concentrations of IL-1beta and TNF-alpha before or after vaccination. CONCLUSIONS: The -174 G>C SNP in the promoter region of the IL-6 gene is functional in vivo with an increased inflammatory response associated with the G allele. Considering the central role of IL-6 in a variety of major diseases, the present finding might be of major relevance.  相似文献   

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目的 探讨白细胞介素6(IL-6) 基因启动子区基因-572位点和-634位点多态性与冠心病的关系,及其对血脂、脂蛋白、载脂蛋白水平的影响.方法 采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法,检测165例冠心病(冠心病组)患者和170名健康人(对照组) 的IL-6基因型;按常规方法测定血脂、脂蛋白、载脂蛋白水平.结果 冠心病组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均明显高于对照组(P均〈0.05);IL-6基因-634位点多态性在冠心病组和对照组的分布差异无显著性(P〉0.05),而IL-6基因-572位点多态性在两组人群中的分布差异存在显著性(P〈0.05);等位基因频率的相对风险分析发现,G等位基因携带者患冠心病的风险是C等位基因的1.652倍[相对比值比(OR)=1.652,95%可信区间(CI):1.137~2.401],携带G等位基因的冠心病个体血清TC水平显著高于不携带者(P〈0.05).结论 IL-6基因-572位点多态性与冠心病的发病具有相关性,其中G等位基因是冠心病重要的遗传标记;IL-6基因-572位点多态性可能通过影响血脂水平而影响冠心病的发生.  相似文献   

18.
刘永超  段宗明  张明娟 《临床荟萃》2011,26(14):1200-1203
目的 探讨白细胞介素6(interleukin 6,IL-6)基因启动子区-174G/C、-572C/G和-634C/G多态性对冠状动脉疾病(coronary heart disease,CHD)的发病易感性.方法 严格按照诊断标准,选取无亲缘关系的CHD患者126例(CHD组)及健康对照组150例提取基因组DNA,应用聚合酶链反应-限制性片段长度多态性(PCR-polymorphism,Restriction Fragment,PCR-RFLP)技术检测-174 G/C、-572 C/G和-634 C/G 3个多态性位点的基因型;采用HaploView4.0及SPSS11.5软件分析各位点基因型、等位基因频率及组间差异.结果 -572C/G位点及-634C/G位点的基因型频率分布在CHD组与正常对照组差异均有统计学意义(P<0.05),CHD组-572C/G位点的等位基因G频率显著高于正常对照组(P<0.05),-634C/G位点的等位基因G频率显著高于正常对照组(P<0.05).连锁不平衡检验结果显示,IL-6基因这3个位点处于不连锁状态,D'<0.5.结论 IL-6基因-174G/C和-572C/G多态性可能与CHD有关,携带有-572C/G和-634C/G多态性位点G等位基因的个体可能更容易患CHD.  相似文献   

19.
目的:了解白细胞介素-6(interleukin-6,IL-6)基因启动子区域单核苷酸多态位点-634C/G与青岛地区汉族人群过敏性哮喘的相关性.方法:采用聚合酶链反应-限制性片段长度多态性分析方法对青岛地区479例健康个体和481例过敏性哮喘患者IL-6基因启动子-634C/G多态性进行观察.结果:过敏性哮喘组与健康对照组CC、CG和GG基因型以及C和G等位基因频率分布均无统计学差异,携带GG、CG、CC基因型个体哮喘患病风险依次递增.结论:IL-6基因启动子-634C/G位点多态性与青岛地区人群过敏性哮喘发生无相关性,但携带CC等位基因型的个体过敏性哮喘的发病风险可能增加.  相似文献   

20.
BACKGROUND: Interleukin 6 (IL-6) is a pleiotropic cytokine that plays an essential role in the pathogenesis of acute and chronic infections. As the role of the IL-6 G(-174)C polymorphism in determining serum concentrations of IL-6 is controversial, we studied the genotype-specific IL-6 response in a well-standardized model of systemic inflammation. METHODS: A total of 76 healthy young males (age range, 19-35 years) received a single bolus of 2 ng/kg endotoxin [lipopolysaccharide (LPS)] intravenously. Plasma IL-6 was measured by enzyme immunoassay at 0, 2, 6, and 24 h after LPS infusion, and the IL-6 promoter genotype was analyzed by a mutagenic separated PCR assay. RESULTS: IL-6 increased 300-fold 2 h after LPS challenge and returned almost to normal within 24 h. Neither basal IL-6 nor the IL-6 response to LPS was significantly affected by the IL-6 promoter genotype. CONCLUSIONS: The IL-6 G(-174)C promoter polymorphism does not significantly influence basal concentrations of IL-6 or peak IL-6 in human endotoxemia.  相似文献   

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