上海地区非酒精性脂肪性肝炎患者肿瘤坏死因子-α的基因多态性研究

目的:了解非酒精性脂肪性肝炎(NASH)患者肿瘤坏死因子-α(Tumor necrosis factor-alpha,TNF-α)启动子基因多态性在上海人群中的分布及其与疾病的相关性。方法:用聚合酶链反应-限制性片段长度多态性技术检测400例NASH患者和50例健康对照者外周血的TNF-α基因启动子区域-308、-238位点基因多态性。结果:TNF-α基因-308位点在NASH组中变异的G/A基因型频率比健康对照组明显升高(P<0.01,OR=14.667,95%CI 4.436～48.497),而-238位点其基因变异频率两组差异无显著性意义(P>0.05)。结论:TNF-α基因-308位点G/A的突变与NASH易感性相关。     

肺结核患者肿瘤坏死因子-α基因多态性的研究

目的通过病例-对照研究,探讨肿瘤坏死因子-α(TNF-α)基因启动子区-238A/G、-308A/G位点单核苷酸多态性(SNP)与肺结核病的关系。方法采用序列特异性引物PCR(PCR-SSP)及测序技术检测深圳地区汉族人群肺结核患者200例及健康对照者197例TNF-α启动子区-238A/G、-308A/G位点基因多态性。采用直接计数法计算各组基因型频率及等位基因频率,并进行χ2检验;采用SHEsis软件进行单倍型分析。以P值0.05为具有统计学意义。结果2组人群TNF-α启动子区-238A/G、-308A/G位点基因型及等位基因分布频率差异无统计学意义(P0.05);两位点各种单倍型在2组间分布差异无统计学意义(P0.05)。结论TNF-α启动子区-238、-308位点基因多态性与中国汉族人群肺结核病易感性未见关联。     

肿瘤坏死因子基因多态性与多发性肌炎/皮肌炎的相关性分析

目的探讨我国汉族人群中多发性肌炎/皮肌炎(PM/DM)与肿瘤坏死因子(TNF)基因多态性之间的相关性。方法采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)分析方法对正常对照人群与PM/DM患者的TNF-α-308和TNF-β-252基因的等位基因多态性进行了检测。结果譹整体水平上,PM/DM患者TNF-α的等位基因TNF2频率与正常相比显著升高,差异有统计学意义[22.9%(16/70)vs9.5%(29/304),χ2=9.534,P<0.01],PM和DM患者分别与正常对照相比TNF2基因频率亦显著升高,差异有统计学意义[PM:23.1%(6/26),DM:22.7%(10/44),χ2=4.630,P<0.05和χ2=6.718,P=0.01];譺整体水平上,PM/DM患者的TNF-β-252的两个等位基因频率与正常人群相似[TNF-β*1的基因频率在PM/DM患者和正常对照间分别为48.6%(34/70)和40.5%(123/304),TNF-β*2分别为51.4%(36/70)和59.5%(181/304),差异均无统计学意义(P均>0.05)]。PM和DM患者分别与正常对照相比,TNF-β的两个基因频率与正常对照相比差异无统计学意义(P均>0.05)。结论TNF-α-308的等位基因多态性与中国汉族PM/DM的易感性相关,TNF-β-252的等位基因多态性与中国汉族PM/DM的易感性无关。     

肿瘤坏死因子基因多态性与溃疡性结肠炎相关性研究

目的 检测肿瘤坏死因子（TNF）α基因多态性是否与浙江地区汉族溃疡性结肠炎（UC）患者遗传易感相关.方法 血样来自浙江地区110例UC患者及292例健康对照者.通过特定引物的聚合酶链反应（PCR-SSP）方法直接检测野生型及TNF基因的6个多态性（TNF-1031T/C,-863C/A,-857C/T,-380G/A,-308G/A,-238G/A）.结果TNF-308A与汉族UC显著相关,等位基因频率在患者中为14.6%,在健康对照者中为8.9%,两者间差异有统计学意义（P=0.02）.TNF-857T的携带率在UC患者中为17.3%,健康对照者为12.2%,两者间差异无统计学意义（P=0.06）.单倍体分型显示,6种单倍体包括H5和H3,这两种单倍体都包含TNF-308A.H5单倍体频率在患者中为12.3%,在健康对照者为7.5%,两者间差异有统计学意义（P=0.03）.我们还发现了既往在白种人中较少见的单倍体H3.单倍体H4是由TNF基因启动子区域野生型等位基因组成,它的纯合子UC患者共有27例（24.5%）,在健康对照者中有102例（34.9%）,差异有统计学意义（P＜0.05）,说明野生型等位基因可能与疾病的发生无关.结论 TNF-308A可能与汉族UC患者遗传易感相关.进一步的功能研究有助于明确突变型TNFα在UC发病过程中的作用.     

肿瘤坏死因子-α基因多态性与非酒精性脂肪性肝病的关系

目的研究肿瘤坏死因子-α(TNF-α)基因-308位点及-238位点多态性在非酒精性脂肪性肝病(NAFLD)患者中的分布,及其在胰岛素抵抗(IR)和 NAFLD 发病中的地位。方法运用聚合酶链反应-限制性片段长度多态性检测117例 NAFLD 患者 TNF-α基因—308位点及—238位点多态性,其中伴肥胖者60例,非肥胖者57例,同时测定患者空腹血清胰岛素(FINS)及空腹血糖,通过体内平衡代谢指数(HOMA)评估 IR,并与120名健康者对照。结果 NAFLD 患者与正常对照组 TNF-α基因-238位点基因多态性分布差异有统计学意义(29.9%比15.8%,P<0.05),而—308位点差异无统计学意义(P>0.05)。NAFLD 患者血清 HOMA-IR、TNF-α明显高于对照者[2.50±0.68比1.16±0.68,(10.54±3.19)ng/L 比(4.54±3.10)ng/L,P<0.01]。FINS、HOMA-IR 在 TNF-α基因-238位点基因变异组明显高于正常基因型组(P<0.05),但在—308位点变异组差异无统计学意义(P>0.05)。NAFLD 患者中无论肥胖或非肥胖患者均较正常对照人群在 TNF-α基因-238位点多态性分布及HOMA-IR、TNF-α差异有统计学意义(P<0.05)。肥胖及非肥胖的 NAFLD 患者之间 HOMA-IR、TNF-α差异无统计学意义(P>0.05)。结论 NAFLD 患者 IR 与其体重关系不显著,非肥胖 NAFLD患者同样有 IR 发生。TNFα基因-238位点 G/A 变异与 IR、NAFLD 易感性相关,TNFα基因-308位点 G/A 的突变与 IR 易感性不相关。NAFLD 发病与 IR、TNF-α密切相关。     

环氧化酶2基因多态性与急性冠状动脉综合征的关联研究

目的探讨环氧化酶2(COX-2)基因-1195G>A和-765G>C位点与中国汉族人群急性冠状动脉综合征(ACS)的相关性。方法选择ACS患者250例(ACS组),同期选取健康体检者266例(对照组)。采用扩增阻碍突变系统结合TaqMan探针的实时荧光定量PCR方法对COX-2基因多态性位点(-1195G>A和-765G>C)进行基因分型。多因素logistic回归分析各多态性位点与ACS的相关性。结果在男性中,ACS组-1195G>A基因型及等位基因频率与对照组比较,差异有统计学意义(GG:23.4%vs 33.8%,GA:50.6%vs 49.4%,AA:25.5%vs 16.9%,P=0.049;G:48.7%vs 58.4%,A:51.3%vs 41.6%,P=0.014);与-1195G>A位点GG基因型比较,AA+GA基因型发生ACS的风险更高(P=0.042),行多因素分析校正相关危险因素后,差异有统计学意义(OR=1.971,95%CI:1.130³.438,P=0.017)。在女性中,ACS组-1195G>A位点基因型及等位基因频率与对照组比较,差异无统计学意义(P>0.05)。单体型分析提示,在男性中,ACS组A-1195-765-G频率显著高于对照组,差异有统计学意义(P=0.012),而在女性中,ACS组A-1195-765-G频率差异无统计学意义(P>0.05)。结论在中国汉族人群中,COX-2基因-1195G>A基因多态性以及单体型A-1195-765-G与男性ACS有关,与女性无关。     

Association between hepatocellular carcinoma and tumor necrosis factor alpha polymorphisms in South Korea

AIM: To investigate associations between the tumor necrosis factor alpha(TNF-α)-1031 TC,-863 CA,-857 CT,-308 GA,and-238 GA polymorphisms and HCC in Korea.METHODS: Hepatocellular carcinoma(HCC) cases were diagnosed at CHA Bundang Medical Center from June 1996 to August 2008. The association between TNF-α polymorphisms and HCC was analyzed in 157HCC patients and 201 controls using a polymerase chain reaction-restriction fragment length polymorphism assay. We investigated five TNF-α polymorphisms,which are TNF-α-1031 TC,-863 CA,-857 CT,-308 GA,and-238 GA. The TNF-α genotype frequencies,genotype combinations and haplotypes were analyzed to disclose the association with HCC.RESULTS: None of the TNF-α polymorphisms was significantly associated with HCC. However,nine genotype combinations had associations with increased likelihood of HCC. Among them,TNF-α-1031/-857/-238 TT/CC/GA(AOR = 18.849,95%CI: 2.203-161.246,P = 0.007),TNF-α-1031/-308/-238 TT/GG/GA(AOR = 26.956,95%CI: 3.071-236.584,P = 0.003),and TNF-α-1031/-238 TT/GA(AOR = 21.576,95%CI: 2.581-180.394,P = 0.005) showed marked association with HCC. There were five haplotypes of TNF-α polymorphisms which were significantly associated with HCC. They are TNF-α-1031/-863/-857/-308/-238 T-C-C-G-A(OR = 25.824,95%CI: 1.491-447.223,P = 0.0005),TNF-α-1031/-857/-308/-238 T-C-G-A(OR = 12.059,95%CI: 2.747-52.950,P 0.0001),TNF-α-1031/-857/-238 T-C-A(OR = 10.696,95%CI: 2.428-47.110,P = 0.0001),TNF-α-1031/-308/-238 T-G-A(OR = 7.556,95%CI: 2.173-26.280,P = 0.0002) and TNF-α-1031/-238 T-A(OR = 10.865,95%CI: 2.473-47.740,P = 0.0001). Moreover,HCC Okuda stage Ⅲ cases with the TNF-α-1031 CC genotype had better survival than those with the TT genotype(AOR = 5.795,95%CI: 1.145-29.323). CONCLUSION: Although no single TNF-α polymorphism is associated with HCC in this study,some TNF-α genotype combinations and haplotypes are associated with HCC. In addition,HCC Okuda stage Ⅲ cases with the TNF-α-1031 TT genotype may have a better prognosis than those with the CC genotype.     

内脏脂肪素基因多态性与宁夏回、汉族2型糖尿病患者的相关性研究

目的 探讨内脏脂肪素基因启动子区-1535 C/T基因多态性与宁夏回、汉族T2DM的相关性. 方法 用PCR-RFLP方法检测210例宁夏回、汉族T2DM患者(T2DM组)及207名健康对照者(NC组)内脏脂肪素启动子区-1535 C/T位点多态性. 结果 两组间及两组内回、汉族内脏脂肪素基因启动子区-1535 C/T基因多态性位点CC、CT、TT3种基因型和等位基因频率差异均无统计学意义(P＞0.05).回族T2DM组TT基因型HDL-C低于CT、CC基因型(P=0.007),汉族T2DM组TT基因型TG较CC、CT基因型高(P=0.026). 结论 内脏脂肪素基因启动子区-1535 C/T位点存在多态性,两组间回、汉族差异无统计学意义;TT基因型可能与T2DM患者血脂异常有关.     

白三烯A4水解酶基因多态性与结核性脑膜炎易感性的研究

目的 探讨中国汉族人群中白三烯A4水解酶（LTA4H）基因多态性与结核性脑膜炎的相关性。 方法 应用SNaPshot技术检测48例结核性脑膜炎患者和70名健康对照者LTA4H基因中rs1978331,rs2247570,rs2660898,rs2660845多态位点的等位基因、基因型和单体型分布频率,采用SHEsis软件进行相关统计学分析。 结果 对照组与患者组rs1978331多态性位点C等位基因例数分别为83和40、频率分别为59.3%和41.7%,T等位基因例数分别为57和56、频率分别为40.7%和58.3%,差异有统计学意义（χ²=7.080,P=0.008）;rs1978331位点CC、CT和TT基因型在对照组例和患者组中的例数分别为12、33、25和20、16、12,分布频率分别为17.1%、47.1%、35.7%和41.7%、33.3%、25.0%,差异有统计学意义（χ²=8.670,P=0.013）;rs2660898位点AA、AC和CC基因型在对照组和患者组中的数分别为28、32、10和20、12、16,分布频率分别为40.0%、45.7%、14.3%和41.7%、25.0%、33.3%,差异有统计学意义（χ²=7.980,P=0.019）;对照组与患者组单体型CACT频率分别为26.3%和45.8%,差异有统计学意义（χ²=7.349,P=0.007）。 结论 LTA4H基因中rs1978331基因多态性位点等位基因、rs1978331和rs2660898基因多态性位点基因型、单倍体型CACT与中国汉族人群结核性脑膜炎的易感性存在相关性。     

I型自身免疫性肝炎患者细胞因子基因多态性研究

目的评价肿瘤坏死因子-α(TNF-α)和白细胞介素-10(IL-10)启动子基因的多态性在I型自身免疫性肝炎(AIH)易感背景中的作用.方法采用聚合酶链反应扩增后寡核苷酸探针杂交法,在I型AIH(32例)和健康对照者(48例)中,对2个TNF-α启动子多态性位点(-238和-308)和3个IL-10启动子多态性位点(-1082、-819和-592)进行分析.结果 I型AIH患者中TNF-α启动子-308位点鸟嘌呤(G)被替换为腺嘌呤(A)的频率显著高于健康对照组(53.1%对27.1%,RR=3.05,P＜0.05).TNF-238位点和IL-10启动子3个位点的多态性差异无显著性.结论TNF-308位点G被替换为A(TNF-308A)可能是I型AIH的发病机制之一.     

Tumour necrosis factor-alpha single nucleotide polymorphisms are not independent of HLA class I in UK Caucasians with adult onset idiopathic inflammatory myopathies

OBJECTIVE: To investigate haplotype tagging single nucleotide polymorphisms (SNPs) in the tumour necrosis factor alpha (TNF-alpha) gene, in UK Caucasian idiopathic inflammatory myopathy (IIM) patients. METHODS: A cross-sectional, case-control study of four TNF-alpha SNPs was undertaken, comparing cases of polymyositis (PM) (n = 121), dermatomyositis (DM) (n = 109) and myositis overlapping with other connective tissue diseases (CTD-overlap) (n = 73) with normal subjects (n = 177). Subgroup analyses were undertaken after stratifying for myositis specific/associated antibodies. RESULTS: The TNF-308A allele demonstrated a strong association with each myositis disease subgroup vs controls [PM, odds ratio (OR) 2.8, 95% confidence interval 1.9-4.3; DM, OR 2.5, 1.6-3.8; CTD-overlap, OR 3.3, 2.1-5.1]. The TNF-308GA/AA genotype frequency was significantly increased vs controls (PM, OR 3.7, 2.1-6.3; DM, OR 3.2, 1.8-5.5; CTD-overlap, OR 5.0, 2.6-9.6) suggesting a dominant model. The association was strongest in patients possessing anti-aminoacyl transfer RNA synthetase (anti-synthetase) (OR 5.1, 3.3-8.0) or -PM-Scl (OR 5.0, 2.7-8.9) antibodies. The -1031T allele was also a significant risk factor in DM (OR 2.2, 1.4-3.6), anti-synthetase (OR 2.9, 1.6-5.3) and -PM-Scl (OR 5.6, 1.9-6.4) antibody positive patients. The TNF-308A association was lost after adjusting for HLA-B*08, but remained independent of HLA-DQB1*02 (both are alleles forming part of the common ancestral haplotype). The HLA-B*08/TNF-308A/DRB1*03/DQA1*05/DQB1*02 haplotype was a risk factor in all myositis subgroups vs controls (OR 3.0, 1.8-5.3). CONCLUSIONS: TNF-308A and -1031T alleles are significant risk factors in the IIMs. In the IIMs, the TNF-308A allele is part of the common ancestral haplotype, but is not independent of HLA-B*08.     

Tumor necrosis factor gene polymorphisms and clearance or progression of hepatitis B virus infection.

OBJECTIVES: We evaluated the influence of tumor necrosis factor-alpha (TNF-alpha) promoter gene polymorphisms on clearance of hepatitis B virus (HBV) and outcome of HBV chronic hepatitis. METHODS: Four TNF-alpha promoter polymorphisms (T-1031C, C-863A, G-308A, and G-238A) were evaluated by direct sequencing in 184 chronic HBV carriers hepatitis B surface antigen (HBsAg) positive and 96 controls with documented sero-clearance (HBsAg negativity, positivity for anti-HBs and anti-HBc IgG). Frequencies of single-nucleotide polymorphisms (SNPs) and haplotypes in the control group were compared with those of the chronic carrier group and with clinically defined subgroups of the latter: asymptomatic carriers, patients with compensated hepatitis, decompensated cirrhotics, and patients with hepatocellular carcinoma. Furthermore, subgroups of chronic carriers were compared among them. Results: In the chronic carrier group, the -308 G allele was more frequent in those with a family history of HBV infection (96% vs 88% of those with non-familial transmission). The G/G genotype at position -308 was found in all chronic carriers with decompensated cirrhosis but in only 78% of controls (P=0.01) and was more frequent in decompensated cirrhotics than in the other subgroups. The distribution of TNF-alpha gene polymorphisms in the carrier group was not significantly different from that in the sero-clearance control group. TNF-alpha SNPs at positions -1031/-863 and -863/-238 were in linkage disequilibrium. The TCGG haplotype (-T1031, -C863, -G308, -G238) was significantly associated with end-stage liver disease. CONCLUSION: The TNF-alpha promoter polymorphisms do not appear to be determinant of HBV sero-clearance in southern Italians. The genotype -308G/G and haplotype TCGG are associated with an unfavorable prognosis in patients with chronic HBV infection.     

HBeAg阳性慢性乙型肝炎患者肿瘤坏死因子α基因启动子区-238和-308位点基因多态性分析

目的探讨HBeAg阳性慢性乙型肝炎(CHB)患者肿瘤坏死因子α(TNF-α)基因启动子区-238和-308位点基因多态性及其与血清TNF-α水平的关系。方法对203例HBeAg阳性CHB患者,采用聚合酶链反应-限制性片段长度多态性分析法检测TNF-α-238和-308位点基因多态性;采用ELISA法测定血清TNF-α水平。结果 TNF-α-238G/G、G/A基因型频率分别为84.7%和15.3%,-308G/G、G/A、A/A基因型频率分别为76.8%、22.7%和0.5%;TNF-α-238G/A基因型患者血清TNF-α水平低于G/G基因型(201.2±36.3pg/ml对215.7±34.7pg/ml,x2=4.355,P=0.037),-308G/A基因型TNF-α水平高于G/G基因型(234.6±37.5pg/ml对207.4±32.3pg/ml,x2=14.653,P0.001)。结论 TNF-α-238G/G或-308G/A基因型患者血清TNF-α水平相对较高。     

Association of TNF-alpha promoter polymorphisms with the outcomes of hepatitis B virus infection in Chinese Han population

Host genetic factors and environment factors including hepatitis B virus (HBV) genotypes are widely studied for the different outcomes of HBV infection. Recent studies suggest that tumour necrosis factor-alpha (TNF-alpha) plays a pivotal role in the viral clearance and host immune response to HBV, and the capacity for TNF-alpha production in individuals is influenced by a major genetic component. In this study, we aimed to explore whether the single-nucleotide polymorphisms (SNPs) of TNF-alpha promoter are associated with the outcomes of HBV infection in the Chinese Han population. One hundred and forty-three spontaneously recovered HBV subjects and 196 chronic hepatitis B patients were recruited in this case-control study in the Beijing area of China. Polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP) and sequence-specific primer-PCR (SSP-PCR) were used to detect the SNPs of five sites in the TNF-alpha promoter (-238G/A, -308G/A, -857C/T, -863C/A, -1031T/C). The frequency distributions of genotypes and haplotypes in two groups were analysed by EPI and EH programs. The presence of the -238GG genotype was significantly correlated with persistence of HBV infection (OR = 4.08, P = 0.02), and -857TT genotype appeared in relation to the spontaneous clearance of HBV (OR = 0.47, P = 0.03). Frequency of haplotype GGCCT (-238/-308/-857/-863/-1031) in the chronic HB group was significantly lower than that in spontaneously recovered group (P = 0.03), and frequencies of haplotypes GGCAT and GGTAT in the chronic HB group were significantly higher than those in the spontaneously recovered group (P = 0.0001, P = 0.0004). In conclusion, TNF-alpha promoter polymorphisms are independently associated with different outcomes of HBV infection.     

IL-10 and TNF-α promoter haplotypes are associated with childhood Crohn's disease location

AIM: To determine the distribution and frequencies of the genotypes and haplotypes of the genes encoding for the glucocorticoid receptor (GR), the tumor necrosis factor (TNF)-α and the interleukin (IL)-10 in childhood Crohn's disease (CD) and to assess the impact of the corresponding DNA variants on clinical and disease phenotypes. METHODS: Ten variants in GR, TNF-α and IL-10 were genotyped in 113 childhood CD cases and 95 healthy subjects, both of French-Canadian origin. RESULTS: For the GR polymorphisms (R23K and N363S) and IL-10 variants in the 5'flanking region (-1082 G > A, -819 T > C and -592 A > C), no difference was observed in allele and genotype frequencies between CD patients and controls. At the haplotype level, we found three IL-10 haplotypes previously described in Caucasians (GCC, ACC and ATA) and three novel haplotypes only present in IBD patients. When we analyzed the haplotype distribution with the anatomical location of the disease, the GCC haplotype was associated with the colonic and the ACC haplotype with the terminal ileum location, respectively. The genotyping of five polymorphisms in the promoter region of the TNF-α gene (-1031 T > C, -863 A > C, -857 T > C, -308 A > G and -238 A > G) revealed a significant overrepresentation of homozygous -1031 CC among CD patients (OR = 9.9) and an association with the colonic location. For TNF-α, eleven haplotypes were inferred, including two frequent ones, TCCGG and CACGG, which were significantly observed more frequently in controls and cases, respectively. CONCLUSION: This is one of the first studies investigating the association between haplotype structure and disease location in a CD pediatric cohort. Our results will help to increase our understanding of the genetic determinants of childhood CD.     

IL-10 and TNF-α promoter haplotypes are associated with childhood Crohn＇s disease location

AIM： To determine the distribution and frequencies of the genotypes and haplotypes of the genes encoding for the glucocorticoid receptor （GR）, the tumor necrosis factor （TNF）-α and the interleukin （IL）-10 in childhood Crohn＇s disease （CD） and to assess the impact of the corresponding DNA variants on clinical and disease phenotypes.
METHODS： Ten variants in GR, TNF-a and IL-10 were genotyped in 113 childhood CD cases and 95 healthy subjects, both of French-Canadian origin.
RESULTS： For the GR polymorphisms （R23K and N363S） and IL-10 variants in the 5＇flanking region （-1082 G 〉 A, -819 T 〉 C and -592 A 〉 C）, no difference was observed in allele and genotype frequencies between CD patients and controls. At the haplotype level, we found three IL-10 haplotypes previously described in Caucasians （GCC, ACC and ATA） and three novel haplotypes only present in IBD patients. When we analyzed the haplotype distribution with the anatomical location of the disease, the GCC haplotype was associated with the colonic and the ACC haplotype with the terminal ileum location, respectively. The genotyping of five polymorphisms in the promoter region of the TNF-α gene （-1031 T 〉 C, -863 A 〉 C, -857 T 〉 C, -308 A 〉 G and -238 A 〉 G） revealed a significant overrepresentation of homozygous -1031 CC among CD patients （OR = 9.9） and an association with the colonic location. For TNF-α, eleven haplotypes were inferred, including two frequent ones, TCCGG and CACGG, which were significantly observed more frequently in controls and cases, respectively.
CONCLUSION： This is one of the first studies investigating the association between haplotype structure and disease location in a CD pediatric cohort. Our results will help to increase our understanding of the genetic determinants of childhood CD.     

A polymorphism of the 5' flanking region of tumour necrosis factor alpha gene is associated with thyroid-associated ophthalmopathy in Japanese

OBJECTIVE: We have studied the polymorphism of the 5' flanking region of the tumour necrosis factor (TNF)-alpha gene in order to better understand the genetic background of autoimmune thyroid disorders and thyroid-associated ophthalmopathy. PATIENTS AND METHODS: We studied the polymorphism of the 5' flanking region of the TNF-alpha gene at positions - 1031 (T to C change, termed as - 1031C), - 863 (C to A, - 863 A), - 857 (C to T, - 857T), - 308 (G to A, - 308 A) and - 238 (G to A, - 238 A) in Japanese patients with Graves' disease [n = 173, 62 of whom had associated ophthalmopathy (American Thyroid Association (ATA) class III or greater)] and healthy control subjects (n = 575), using a polymerase chain reaction sequence-specific oligonucleotide probe method. RESULTS: The allele frequency of - 857T in the Graves' disease patients (22. 5% vs. 17.7%, OR = 1.35, P = 0.045, corrected P = 0.23) was slightly greater than in the Japanese healthy subjects, respectively. However, the difference was not statistically significant. In Graves' disease patients with evident ophthalmopathy (ATA class III or greater), the allele frequencies of - 1031C and - 863 A were significantly greater than those with no or mild ophthalmopathy (ATA class 0-II) (31.5% vs. 13.5%, OR =2.94, P < 0.0001, corrected P < 0. 0005; 23.4% vs. 11.7%, OR =2.30, P = 0.0044, corrected P = 0.022, respectively) and in control subjects. The strength of the association of the polymorphism - 1031C increased with the severity of ophthalmopathy, with odds ratios of 2.36 for ATA class III, and 5. 43 for ATA class IV-VI, respectively, compared with Graves' disease with no or mild ophthalmopathy (ATA class 0-II). Although the phenotype frequency of DRB1*0901 was not different among Graves' disease patients with or without ophthalmopathy and control subjects, the phenotype frequency of DRB1*0901(-)/-1031C(+) was significantly increased in Graves' disease patients with ophthalmopathy compared to those with no or mild ophthalmopathy (OR = 4.91, P = 0.0005) or control subjects (OR = 4.59, P < 0.0001). CONCLUSIONS: These results suggest that the - 1031C or - 863 A alleles, or a gene in linkage disequilibrium with the TNF-alpha gene, predispose to the development of ophthalmopathy in Japanese patients with Graves' disease.