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a Asthma Genetics
Group, Nuffield Department of Clinical Medicine, John Radcliffe
Hospital, Headington, Oxford OX3 9DU, UK, b Department of Respiratory Medicine
& Busselton Research Foundation, Sir Charles Gairdner Hospital, Perth,
Western Australia 6009
Correspondence to: Dr M F Moffatt.
Received 8 January 1999; Returned to authors 10 March 1999; Revised version received 26 April 1999; Accepted for publication 20 May 1999
BACKGROUND
Tumour
necrosis factor (TNF) is a potent pro-inflammatory cytokine which is
prominent in asthmatic airways. TNF shows genetic variations in
secretion which are linked to polymorphisms in the TNF gene complex and
the surrounding major histocompatibility (MHC) locus. These
polymorphisms do not seem to be themselves functionally important. In
these circumstances, the identification of disease associated
haplotypes (combination of alleles on individual chromosomes) may
narrow the search for polymorphisms which alter gene function.
METHODS
TNF-308, LT
NcoI, and HLA-DRB1 polymorphisms were
investigated for association with asthma, bronchial responsiveness, and medication use in 1004 subjects in 230 families from a general population sample.
RESULTS
The common
LT
NcoI*1/TNF-308*2/HLA-DRB1*03
haplotype, which was present in 11% of unrelated individuals, was
weakly associated with asthma (OR = 1.38, p = 0.016, corrected for
familial correlation). The rarer LT
NcoI*1/TNF-308*2/HLA-DRB1*02 haplotype,
which was found in 0.6% of unrelated subjects, was more strongly
associated with asthma (OR = 6.68, p = 0.002). This haplotype also
showed association with bronchial hyperresponsiveness (OR = 21.9, p = 0.0000) and the use of inhaled or oral steroids (OR 8.0, p = 0.04).
CONCLUSIONS
The
results of this study show only two extended TNF/HLA-DR haplotypes to
be associated with asthma. The search for functional alleles
responsible for an increased risk of asthma should concentrate on
the LT
NcoI*1/TNF-308*2/HLA-DRB1*02 haplotype.
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