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
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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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