Abstract
The objective of this study was to investigate the influence of TNF-α promoter alleles on clinical response to etanercept therapy in JIA. TNF-α promoter polymorphisms at positions −163, −238, −244, −308, −376 were determined in 137 JIA patients treated with etanercept for at least 3 months. A PCR fragment of about 500 bp of the TNF gene promoter was amplified. Polymorphisms were detected by a single sequencing procedure. Patients with the genotype −308GG achieved an ACR-JRA 30 response at month 6 more frequently than patients with the genotype −308GA or AA. This was already notable at month 3 of therapy. This difference in the total patient group is attributable to the JIA subgroup with rheumatoid factor negative polyarthritis. In this subgroup, patients with the −308GG genotype achieved an ACR-JRA 30 response more frequently than those with the −308GA or AA genotype (84 vs. 33% at months three, P < 0.01, 93 vs. 67% at months six, P < 0.05). There was no influence of the −238 TNF-α promoter alleles on clinical response. The rare alleles at position −376 or at positions −163 and −244 were too infrequent. There is an association between TNF gene promoter polymorphisms and response to etanercept in rheumatoid factor negative polyarticular JIA.
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Acknowledgments
The authors thank the following contributors for including their patients to the study: R. Berner, M. Borte, I. Feddersen, I. Földvari, D. Föll, H. Girschick, G. Heubner, C. Huemer, S. Kastner, M. Kirschstein, H. Kössel, H. Michels, D. Möbius, S. Müller, T. Niehues, A. Nimtz-Talaska, J. Quietsch, J. Roth, A. Thon, R. Trauzeddel, A. Urban, and E. Weissbarth-Riedel.
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Schmeling, H., Horneff, G. Tumour necrosis factor alpha promoter polymorphisms and etanercept therapy in juvenile idiopathic arthritis. Rheumatol Int 27, 383–386 (2007). https://doi.org/10.1007/s00296-006-0208-2
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DOI: https://doi.org/10.1007/s00296-006-0208-2