TNF-α Polymorphisms in Juvenile Idiopathic Arthritis : Which Potential Clinical Implications?

الملخص EN

Whether tumor necrosis factor alpha (TNF-α) gene polymorphisms (SNPs) influence disease susceptibility and treatment of patients with juvenile idiopathic arthritis (JIA) is presently uncertain.

TNF-α is one of the most important cytokine involved in JIA pathogenesis.

Several single nucleotide polymorphisms (SNPs) have been identified within the region of the TNF-α gene but only a very small minority have proven functional consequences and have been associated with susceptibility to JIA.

An association between some TNF-α SNPs and adult rheumatoid arthritis (RA) susceptibility, severity and clinical response to anti-TNF-α treatment has been reported.

The most frenquetly studied TNF-α SNP is located at −308 position, where a substitution of the G allele with the rare A allele has been found.

The presence of the allele −308A is associated to JIA and to a poor prognosis.

Besides, the −308G genotype has been associated with a better response to anti-TNF-α therapy in JIA patients, confirming adult data.

Psoriatic and oligoarticular arthritis are significantly associated to the −238 SNP only in some works.

Studies considering other SNPs are conflicting and inconclusive.

Large scale studies are required to define the contribution of TNF-α gene products to disease pathogenesis and anti-TNF-α therapeutic efficacy in JIA.