Association of tumor necrosis factor polymorphisms with Guillain-Barré syndrome.

It has been reported that the tumor necrosis factor (TNF)alpha promoter polymorphism is associated with autoimmune disease and inflammatory disease. It has also been claimed that this polymorphism may affect TNFalpha expression. We investigated the TNFalpha -308 polymorphism and TNFalpha levels in 79 unrelated Chinese patients with Guillain-Barré syndrome (GBS) and 78 healthy controls using PCR-RFLP and ELISA assay. Patients with GBS were divided into 2 subgroups, acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy (AMAN), based on electrophysiological information. We found that the TNFalpha2 allele was associated with increased risk of GBS (OR = 1.876, 95% CI = 1.144-3.075, p = 0.008), particularly for AMAN, the main subtype (OR = 2.914, 95% CI = 1.412-6.015, p = 0.004), but there was no association between TNFalpha polymorphism and AIDP. We also found that carriers of the TNFalpha2 allele had significantly higher TNFalpha2 levels than TNFalpha1 homozygotes (p < 0.05). These data indicate that TNFalpha promoter polymorphism is responsible for susceptibility to GBS, especially to AMAN. The TNFalpha2 allele is associated with higher levels of TNFalpha.