ASSOCIATION BETWEEN OBSESSIVE COMPULSIVE DISORDER AND TUMOR NECROSIS FACTOR-α GENE 308 (G>A) AND 850 (C>T) POLYMORPHISMS IN TURKISH CHILDREN
Lüleyap HU1, Onatoğlu D1, Tahiroğlu AY2, Alptekin D1,*, Yılmaz MB1, Çetiner S3, Pazarbaşı A1, Ünal İ4, Avcı A2
*Corresponding Author: Professor Dr. Davut Alptekin, Department of Medical Biology and Genetics, Medical Faculty, Çukurova University, 01330 Adana, Turkey; Tel.: +90-322-3386060/3498; Fax: +90-322-3386572; E-mail: alptekin@cu.edu.tr
page: 61

DISCUSSION

In our country, GABHS infections in childhood are much more common when compared to the other countries. In addition, some patients cause delays in treatment because they do not seek immediate medical attention or do not pay attention to the disease once diagnosed. Taking these conditions into consideration, we decided to conduct our study. We know that GABHS infections are associated with OCD symptoms and GABHS preceded 31.0% of exacerbations of OCD [21]. We studied two polymor-phisms of the TNF-α gene and ASO titers of patients. According to our statistical results, we have demonstrated a positive association between OCD and the TNF-α gene 308 polymorphism. In different parts of the world, studies are conducted for different OCD patients. The study by Hounie et al. [27] is consistent with our results about the 308 polymorphism. According to their report, the 308 polymorphism is strongly associated with OCD [27]. On the other hand, the study conducted by Zai et al. [25] indicates that the TNF-α gene 308 polymorphism is not associated with OCD in Canadian patients. In particular, we saw the remarkable effects of the 308 polymorphism on phenotype-genotype relationship because of the increased frequency of mutant genotypes in OCD patients. We did not find a positive correlation between ASO titers and the 308 polymorphism, but there is statistically relevant difference between ASO titers and the 850 polymorphism. In other words, ASO is a determinant for the 850 polymorphism in OCD. The result of another study revealed a positive correlation between ASO titers and the severity of tic disorder for 150 consecutive children presenting with tics [28]. Also, an additional study supporting our results was conducted on 105 patients diagnosed with chronic tic disorder (CTD), OCD or ADHD and ASO titers. They found that ASO titers of ADHD patients were increased significantly [29]. According to the study conducted by Gause et al. [5] there is no relationship between ASO titers in children with OCD only, OCD+PANDAS, OCD+ chronic tic disorder patients and the control group. It was verified that boys were affected much more when compared to girls by Lewin et al. (3:2 ratio) [9]. We did not find any association between OCD and gender. With this new comprehension, we can say that epigenetic mechanism plays a role for inactivation of some genes, despite the fact that some of the patients had a polymorphism; thus, we have to broaden our perspective of the disease. In a lot of multifactorial and single gene neurodegenerative disorders, the symptoms are similar, but also these are the common characteristics of polygenic traits. In addition, there are symptoms that differ from patient to patient. For that reason, simultaneous expression profiles of immune system genes should be researched as well. The factors or susceptibilities and taking blood from patients on different dates may cause a certain extent of differentiation to our results. In light of our findings, we propose that the mutant AA genotype for the 308 polymorphism and the mutant CT genotype for the 850 polymorphism may be used as molecular indicators of OCD, with verification from future research.



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