Gene polymorphism of tumor necrosis factor-?affecting severity of myocardial damage during cardiopulmonary bypass / 中华创伤杂志

ABSTRACT

Objective To investigate the effect of polymorphism of TNF-?gene G308A on sever- ity of myocardial damage during cardiopulmonary bypass(CPB).Methods Sixty-three congenital ca- ses with ventrieualr septal defect(VSD)were divided into groups TNF1 and TNF2 after TNF-?gene pol- ymorphism was identified by polymerase chain reaction-restriction fragment length polymorphism(PCR- RFLP)before surgery.When the right atrium was opened and closed,specimens of myocardium were ob- tained to study the ultrastructural changes by electron microscope and determine expression of TNF-?mR- NA.Concentration of TNF-?in plasma was measured by radio-immunity after anesthetic induction(T1), 20 minutes of CPB(T2),at the end of CPB(T3) and six hours after CPB(T4)in all cases,respective- ly.Results (1)TNF-?level and the expression of TNF-?mRNA in myocardium were significantly increased during CPB(P＜0.05)in both groups.(2)TNF-?mRNA level of group TNF2 was significant- ly higher than that of group TNF1(P＜0.05).The myocardial CK-MB in group TNF2 was significantly higher than that in group TNF1 at 24 hours postoperatively(P＜0.01).The electron microscope showed more severe ultrastructural changes of myocardium in TNF2 group compared with that in group TNF1(P＜0.05).(3)The concentration of TNF-?in blood plasma in group TNF2 was significantly higher than that in group TNF1 at time points of T2-T4(P＜0.05).Conclusion Polymorphism of TNF-?gene G308A may influence the transcription and production of TNF-?in vivo and hence affect severity of myo- cardial damage.