ANALYSIS OF TUMOR NECROSIS FACTOR G238A AND G308A GENE POLYMORPHISMS IN TUNISIAN PATIENTS WITH PRESSURE ULCER

Pressure ulcer (PU) is a complex and multifactor disease in which the cellular and molecular mechanisms contributing to risk of a delay in healing. An imbalance between pro-oxidant and antioxidant systems has been suggested to be implicated in the physiopathology of PU. Polymorphisms in TNF-α gene are emerging as key determinants of many diseases. The TNF-α (-238 and -308) G/A single-nucleotide polymorphisms (SNPs) are the most extensively studied. This study aimed to assess the value of serum pro-oxidant and antioxidant levels and to determine the role of a TNF-α gene SNPs in the pathogenesis of PU. 100 Tunisian subjects suffering of PU and 213 controls were admitted. Oxidant status was evaluated by the measure of homocysteine and thiobarbituric reactive oxygen substances. Antioxidant status was evaluated by the measure of total antioxidant status, serum catalase activity and trace elements. G308A and G238A variants of TNF-α gene were screened by AS-PCR and RFLP-PCR. Our results suggest that the unbalance between pro-oxidants and antioxidants seems to be more aggravated in patients suffering from PU in comparison with normal volunteers. Thus, for the first time in Africa, we sought to investigate whether polymorphisms in TNF-α gene were associated with the development of PU pathology in Tunisia. The TNF-α G308A may contribute to susceptibility to PU disease but our results do not support an association between PU and TNF-α G238A polymorphism. Our study drives the attention to implication of oxidative stress in PU. TNF-α G308 A polymorphism might be genetic risk factor for PU.