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Shi J, He L, Tao R, Zheng H, Li W, Huang S, Li Y, Shang S. TLR4 polymorphisms as potential predictors of atopic dermatitis in Chinese Han children. J Clin Lab Anal 2022; 36:e24385. [PMID: 35349724 PMCID: PMC9102499 DOI: 10.1002/jcla.24385] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/09/2022] [Accepted: 03/21/2022] [Indexed: 12/20/2022] Open
Abstract
Background Toll‐like receptor 4 (TLR4) is considered to be involved in the pathogenesis and progression of atopic dermatitis (AD). In the present study, we evaluated the relationship between TLR4 gene polymorphisms and the susceptibility or severity of AD among Chinese Han children. Methods A total of 132 AD patients and 100 healthy controls were enrolled in this study. Four single‐nucleotide polymorphisms (rs19277914, rs11536891, rs7869402, and rs11536889) of the TLR4 gene were genotyped by multiplex PCR combined with next‐generation sequencing. Results Our results showed that a significantly reduced risk for AD was associated with C allele [p = 0.008; odds ratio (OR) = 0.41, C vs. T], TC genotype (p = 0.022; OR = 0.41, TC vs. TT), and TC + CC genotype (p = 0.010; OR = 0.39, TC + CC vs. TT) of TLR4 rs11536891. The frequency of the haplotype GCCG (rs1927914–rs11536891–rs7869402–rs11536889) in AD patients was lower than that in the controls (p = 0.010; OR = 0.38). Moreover, the results indicated that a higher risk of severe AD was related to the T allele (p = 0.019; OR = 2.97, T vs. C) and the TC genotype (p = 0.021; OR = 3.34, TC vs. CC) of TLR4 rs7869402. A risk haplotype of TLR4 (GTTG) was found in severe AD patients (p = 0.010; OR = 5.26). Conclusions Our data suggested that TLR4 rs11536891 polymorphism was associated with the susceptibility to AD in Chinese Han children. And TLR4 rs7869402 might confer the severity of pediatric AD patients.
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Affiliation(s)
- Jianrong Shi
- Department of Clinical LaboratoryThe Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center For Child HealthHangzhouChina
| | - Lin He
- Zhejiang University School of MedicineHangzhouChina
| | - Ran Tao
- Department of Clinical LaboratoryThe Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center For Child HealthHangzhouChina
| | - Huiwen Zheng
- Department of DermatologyThe Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center For Child HealthHangzhouChina
| | - Wei Li
- Department of Clinical LaboratoryThe Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center For Child HealthHangzhouChina
| | - Shuangshuang Huang
- Department of Clinical LaboratoryThe Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center For Child HealthHangzhouChina
| | - Yunling Li
- Department of DermatologyThe Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center For Child HealthHangzhouChina
| | - Shiqiang Shang
- Department of Clinical LaboratoryThe Children’s HospitalZhejiang University School of MedicineNational Clinical Research Center For Child HealthHangzhouChina
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Polymorphisms of TLR2, TLR4 and TOLLIP and tuberculosis in two independent studies. Biosci Rep 2021; 40:225758. [PMID: 32648572 PMCID: PMC7403954 DOI: 10.1042/bsr20193141] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 07/07/2020] [Accepted: 07/07/2020] [Indexed: 02/05/2023] Open
Abstract
Genetic polymorphisms for tuberculosis (TB) susceptibility have been researched by some studies, but few have studied multiple innate immunity genes associated with TB. Evidence suggests that the toll-like receptor 2, 4 (TLR2, TLR4) and toll interacting protein (TOLLIP) may be associated with TB susceptibility. In this self-validated study, we explored the association between common single nucleotide polymorphisms (SNPs) of TLR2, TLR4 and TOLLIP in the Chinese Han and Tibetan populations. A SNPscan™ method was used to genotype SNPs in the three genes. Multiple logistic regression adjusted by sex and age was used to detect the association between SNPs and TB. In TLR2, rs1898830 was associated with decreased risk against TB in the Chinese Han population, which was validated in the Tibetan population. In TLR4, rs11536889 was a protective factor for TB in the Tibetan population, but not in the Han population. Additionally, in the Tibetan population, we also found that the frequency of genotypes of TOLLIP rs11536889 differs significantly between TB patients and controls. We found rs1898830 in TLR2 was associated with TB susceptibility in both Chinese Han and Tibetan populations while rs11536889 in TLR4 and rs3750920 in TOLLIP were protective factors against TB in the Tibetan population.
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3
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Grolmusz VK, Bozsik A, Papp J, Patócs A. Germline Genetic Variants of Viral Entry and Innate Immunity May Influence Susceptibility to SARS-CoV-2 Infection: Toward a Polygenic Risk Score for Risk Stratification. Front Immunol 2021; 12:653489. [PMID: 33763088 PMCID: PMC7982482 DOI: 10.3389/fimmu.2021.653489] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/16/2021] [Indexed: 12/15/2022] Open
Abstract
The ongoing COVID-19 pandemic caused by the novel coronavirus, SARS-CoV-2 has affected all aspects of human society with a special focus on healthcare. Although older patients with preexisting chronic illnesses are more prone to develop severe complications, younger, healthy individuals might also exhibit serious manifestations. Previous studies directed to detect genetic susceptibility factors for earlier epidemics have provided evidence of certain protective variations. Following SARS-CoV-2 exposure, viral entry into cells followed by recognition and response by the innate immunity are key determinants of COVID-19 development. In the present review our aim was to conduct a thorough review of the literature on the role of single nucleotide polymorphisms (SNPs) as key agents affecting the viral entry of SARS-CoV-2 and innate immunity. Several SNPs within the scope of our approach were found to alter susceptibility to various bacterial and viral infections. Additionally, a multitude of studies confirmed genetic associations between the analyzed genes and autoimmune diseases, underlining the versatile immune consequences of these variants. Based on confirmed associations it is highly plausible that the SNPs affecting viral entry and innate immunity might confer altered susceptibility to SARS-CoV-2 infection and its complex clinical consequences. Anticipating several COVID-19 genomic susceptibility loci based on the ongoing genome wide association studies, our review also proposes that a well-established polygenic risk score would be able to clinically leverage the acquired knowledge.
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Affiliation(s)
- Vince Kornél Grolmusz
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary.,Hereditary Tumors Research Group, Eötvös Loránd Research Network-Semmelweis University, Budapest, Hungary
| | - Anikó Bozsik
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary.,Hereditary Tumors Research Group, Eötvös Loránd Research Network-Semmelweis University, Budapest, Hungary
| | - János Papp
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary.,Hereditary Tumors Research Group, Eötvös Loránd Research Network-Semmelweis University, Budapest, Hungary
| | - Attila Patócs
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary.,Hereditary Tumors Research Group, Eötvös Loránd Research Network-Semmelweis University, Budapest, Hungary.,Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
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4
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Yang Z, Liu W, Wan X, Liu R, Zhang Y. Association of Toll-like Receptor 4 Rs7873784 G/C Polymorphism with Rheumatoid Arthritis Risk in a Chinese Population. Immunol Invest 2020; 51:660-669. [PMID: 33356682 DOI: 10.1080/08820139.2020.1864397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: The purposes of this study were to explore whether the Toll-like receptor 4 (TLR4) gene rs7873784 G/C polymorphism was related to the risk of rheumatoid arthritis (RA) and to the clinical features of the disease in Chinese subjects.Materials and Methods: We examined the TLR4 rs7873784 G/C polymorphism in 805 Chinese RA patients and 1095 healthy controls. Genotype was determined with a custom-by-design 48-Plex single nucleotide polymorphism scan™ Kit. Blood plasma levels of TLR4 in 170 RA patients and 170 matched controls were measured by ELISA.Results: The TLR4 gene rs7873784 G/C polymorphism was related to a reduced risk for RA. By stratified analysis, we found a dramatically reduced risk for RA in patients who were female, CRP-positive, RF-positive, DAS28 ≥ 3.20, or ESR ≥ 25. Compared with the controls, the average level of TLR4 protein in plasma of RA patients was increased. In addition, RA patients exhibited higher levels of TLR4 mRNA than controls (P < .05).Conclusion: These results demonstrate the TLR4 rs7873784 G/C polymorphism to relate to a decreased risk for RA in a Chinese population.
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Affiliation(s)
- Zhicheng Yang
- Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou China
| | - Weixi Liu
- Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou China
| | - Xiaoxian Wan
- Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou China
| | - Ruiping Liu
- Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou China
| | - Yunkun Zhang
- Department of Orthopedics, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou China
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5
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Yan S, Chen H, Wang Z, Zhao L. Association of two polymorphisms Asp299Gly and Thr399Ile in Toll-like receptor 4 with rheumatoid arthritis: A meta-analysis. Int J Rheum Dis 2020; 23:1117-1125. [PMID: 32558389 DOI: 10.1111/1756-185x.13890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/04/2020] [Accepted: 05/27/2020] [Indexed: 11/28/2022]
Abstract
Our meta-analysis aims to evaluate the association of Asp299Gly and Thr399Ile with rheumatoid arthritis (RA) susceptibility and severity. By manually searching 3 electronic databases (PubMed, Embase and Web of Science), relevant articles were collected. After checking eligibility for every study, this meta-analysis on eligible studies was performed under 5 genetic models: (1) allelic contrast; (2) heterozygous model; (3) homozygous model; (4) dominant model; (5) recessive model. In Spanish populations, a significantly decreased RA risk was identified in allelic comparison (odds ratio [OR] = 0.73, 95% CI 0.55 ~ 0.96) and dominant model (OR = 0.74, 95% CI 0.56 ~ 0.99) of Asp299Gly polymorphism. A trend of reduced risk was also observed under the heterozygous model (OR = 0.77, 95% CI 0.58 ~ 1.03). As for Thr399Ile, it might also have a protective effect on Spanish populations in allelic comparison (OR = 0.71, 95% CI 0.44 ~ 1.15). In contrast, for both Asp299Gly and Thr399Ile, a higher risk of RA was detected in Chinese Han populations. The frequency of both Asp299Gly and Thr399Ile increased in rheumatoid factor (RF)-positive subjects in Chinese patients (Asp299Gly, RF+:RF- = 0.165:0.145; Thr399Ile, RF+:RF- = 0.170:0.161) and decreased in Spanish patients (Asp299Gly, RF+:RF- = 0.060:0.073; Thr399Ile, RF+:RF- = 0.046:0.056), but not to a statistically significant extent. Our meta-analysis suggested that both Asp299Gly and Thr399Ile might have a protective effect on Spanish populations, but the 2 polymorphisms could act as a susceptible factor in Chinese Han populations. To confirm our results, further investigation concerning the functional impacts of Asp299Gly and Thr399Ile are still needed.
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Affiliation(s)
- Shunchao Yan
- Clinical Medical College of Henan University, Kaifeng, China
| | - Haobo Chen
- Basic Medical College of Henan University, Kaifeng, China
| | - Zixian Wang
- First Affiliated Hospital of Henan University, Kaifeng, China
| | - Linshan Zhao
- Clinical Medical College of Henan University, Kaifeng, China
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Garcia MM, Goicoechea C, Molina-Álvarez M, Pascual D. Toll-like receptor 4: A promising crossroads in the diagnosis and treatment of several pathologies. Eur J Pharmacol 2020; 874:172975. [PMID: 32017939 DOI: 10.1016/j.ejphar.2020.172975] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 12/20/2019] [Accepted: 01/29/2020] [Indexed: 12/26/2022]
Abstract
Toll-like receptor 4 (TLR4) is expressed in a wide variety of cells and is the central component of the mammalian innate immune system. Since its discovery in 1997, TLR4 has been assigned an ever-increasing number of functions that extend from pathogen recognition to tissue damage identification and promotion of the intrinsic "damage repair response" in pain, intestinal, respiratory and vascular disorders. Precisely, the finding of conserved sequence homology among species along with the molecular and functional characterisation of the TLR4 gene enabled researchers to envisage a common operating system in the activation of innate immunity and the initiation of plastic changes at the onset of chronic pain. Malfunctioning in other conditions was conceived in parallel. In this respect, "pivot" proteins and pathway redundancy are not just evolutionary leftovers but essential for normal functioning or cell survival. Indeed, at present, TLR4 single nucleotide polymorphisms (SNP) and their association with certain dysfunctions and diseases are being confirmed in different pools of patients. However, despite its ability to trigger pathogen infection or alternatively tissue injury communications to immune system, TLR4 targeting might not be considered a panacea. This review article represents a compilation of what we know about TLR4 from clinics and basic research on the 20th anniversary of its discovery. Understanding how to fine-tune the interaction between TLR4 and its specific ligands may lead in the next decades to the development of promising new treatments, reducing polypharmacy and probably having an impact on drug use in numerous pathologies.
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Affiliation(s)
- Miguel M Garcia
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Avda, Atenas S/n, 28922, Alcorcón, Spain
| | - Carlos Goicoechea
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Avda, Atenas S/n, 28922, Alcorcón, Spain
| | - Miguel Molina-Álvarez
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Avda, Atenas S/n, 28922, Alcorcón, Spain
| | - David Pascual
- Area of Pharmacology, Nutrition and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Avda, Atenas S/n, 28922, Alcorcón, Spain.
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7
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Korneev KV, Sviriaeva EN, Mitkin NA, Gorbacheva AM, Uvarova AN, Ustiugova AS, Polanovsky OL, Kulakovskiy IV, Afanasyeva MA, Schwartz AM, Kuprash DV. Minor C allele of the SNP rs7873784 associated with rheumatoid arthritis and type-2 diabetes mellitus binds PU.1 and enhances TLR4 expression. Biochim Biophys Acta Mol Basis Dis 2019; 1866:165626. [PMID: 31785408 DOI: 10.1016/j.bbadis.2019.165626] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 11/08/2019] [Accepted: 11/26/2019] [Indexed: 12/19/2022]
Abstract
Toll-like receptor 4 (TLR4) is an innate immunity receptor predominantly expressed on myeloid cells and involved in the development of various diseases, many of them with complex genetics. Here we present data on functionality of single nucleotide polymorphism rs7873784 located in the 3'-untranslated region (3'-UTR) of TLR4 gene and associated with various pathologies involving chronic inflammation. We demonstrate that TLR4 3'-UTR strongly enhanced the activity of TLR4 promoter in U937 human monocytic cell line while minor rs7873784(C) allele created a binding site for transcription factor PU.1 (encoded by SPI1 gene), a known regulator of TLR4 expression. Increased binding of PU.1 further augmented the TLR4 transcription while PU.1 knockdown or complete disruption of the PU.1 binding site abrogated the effect. We hypothesize that additional functional PU.1 site may increase TLR4 expression in individuals carrying minor C variant of rs7873784 and modulate the development of certain pathologies, such as rheumatoid arthritis and type-2 diabetes mellitus.
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Affiliation(s)
- Kirill V Korneev
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Ekaterina N Sviriaeva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Nikita A Mitkin
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Alisa M Gorbacheva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; Biological Faculty, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - Aksinya N Uvarova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; Biological Faculty, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - Alina S Ustiugova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; Biological Faculty, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - Oleg L Polanovsky
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Ivan V Kulakovskiy
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; Vavilov Institute of General Genetics, Russian Academy of Sciences, 119991 Moscow, Russia; Institute of Mathematical Problems of Biology, Keldysh Institute of Applied Mathematics, Russian Academy of Sciences, 142290 Pushchino, Russia
| | - Marina A Afanasyeva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Anton M Schwartz
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Dmitry V Kuprash
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; Biological Faculty, Lomonosov Moscow State University, 119234 Moscow, Russia.
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8
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Leite FRM, Enevold C, Bendtzen K, Baelum V, López R. Pattern recognition receptor polymorphisms in early periodontitis. J Periodontol 2018; 90:647-654. [DOI: 10.1002/jper.18-0547] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/06/2018] [Accepted: 11/30/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Fábio R. M. Leite
- Section of PeriodontologyDepartment of Dentistry and Oral HealthFaculty of Health SciencesAarhus University Aarhus Denmark
| | - Christian Enevold
- Institute for Inflammation ResearchCenter for Rheumatology and Spine DiseasesCopenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - Klaus Bendtzen
- Institute for Inflammation ResearchCenter for Rheumatology and Spine DiseasesCopenhagen University Hospital Rigshospitalet Copenhagen Denmark
| | - Vibeke Baelum
- Section of Epidemiology and Public HealthDepartment of Dentistry and Oral Health, Faculty of Health SciencesAarhus University Aarhus Denmark
| | - Rodrigo López
- Section of PeriodontologyDepartment of Dentistry and Oral HealthFaculty of Health SciencesAarhus University Aarhus Denmark
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9
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Kim SH, Bang J, Son CN, Baek WK, Kim JM. Grape seed proanthocyanidin extract ameliorates murine autoimmune arthritis through regulation of TLR4/MyD88/NF-κB signaling pathway. Korean J Intern Med 2018; 33:612-621. [PMID: 27271273 PMCID: PMC5943648 DOI: 10.3904/kjim.2016.053] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/08/2016] [Accepted: 04/27/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/AIMS Grape seed proanthocyanidin extract (GSPE) has been reported to have a beneficial effect on regulating inf lammation. However, the anti-inflammatory mechanism of GSPE remains unclear. The aim of this study was to verify the influence of GSPE on the Toll-like receptor 4 (TLR4)-mediated signaling pathway in the regulation of murine autoimmune arthritis. METHODS Collagen-induced arthritis (CIA) was induced in dilute brown non-agouti (DBA)/1J mice. The mice were treated with GSPE (0 or 100 mg/kg) intraperitoneally. The severity of arthritis was assessed clinically, biochemically, and histologically. Immunostaining for TLR4 was performed. The expressions of TLR4 and downstream signaling molecules were analyzed by Western blot. The effect of GSPE on lipopolysaccharide (LPS)-induced TLR4 activation was also evaluated using RAW264.7 cells and fibroblast-like synoviocytes (FLSs) from patients with rheumatoid arthritis and from those with osteoarthritis. RESULTS GSPE attenuated the clinical severity of arthritis and decreased histological damage. GSPE treatment reduced the number of TLR4-stained cells in the synovium of mice with CIA. GSPE also downregulated the expression of TLR4, myeloid differentiation factor 88 (MyD88) and phosphorylated IκBα synovial protein in CIA mice. Concurrently, GSPE inhibited the nuclear translocation of nuclear factor-κB (NF-κB) subunits (p65 and p50). LPS-induced TLR4 activation was suppressed by GSPE in human FLS as well as in murine macrophages in vitro. CONCLUSIONS Our results demonstrated that GSPE ameliorated CIA by regulating the TLR4-MyD88-NF-κB signaling pathway.
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Affiliation(s)
- Sang-Hyon Kim
- Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Jihye Bang
- Keimyung University School of Medicine, Daegu, Korea
| | - Chang-Nam Son
- Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Won-Ki Baek
- Department of Microbiology, Keimyung University School of Medicine, Daegu, Korea
| | - Ji-Min Kim
- Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
- Correspondence to Ji-Min Kim, M.D. Division of Rheumatology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, 56 Dalseong-ro, Jung-gu, Daegu 41931, Korea Tel: +82-53-250-7410 Fax: +82-53-250-7434 E-mail:
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10
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Wang Y, Chen L, Li F, Bao M, Zeng J, Xiang J, Luo H, Li J, Tang L. TLR4 rs41426344 increases susceptibility of rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) in a central south Chinese Han population. Pediatr Rheumatol Online J 2017; 15:12. [PMID: 28222760 PMCID: PMC5320652 DOI: 10.1186/s12969-017-0137-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the study was to determine whether polymorphisms in toll-like receptor 4 (TLR4) confer susceptibility to rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) in a central south Chinese Han population. METHODS Genotyping for six well studied polymorphisms (rs4986790, rs4986791, rs10759932, rs41426344, rs11536889 and rs7873784) in TLR4 gene were conducted in 1074 unrelated patients with RA and 1692 healthy control subjects, as well as in 217 unrelated patients with JIA and 378 healthy control subjects using direct sequencing technique. Comparisons between cases and controls in alleles, genotypes and haplotypes were carried out using Fisher's exact test. RESULTS Significant genetic associations were detected between the 3'UTR rs41426344C and RA (p < 0.001, p adj < 0.001, OR = 2.24) and JIA (p < 0.001, p adj < 0.001, OR = 2.05). In addition, rs4986790G was found to be significantly associated with the susceptibility for RA (p = 0.005, p adj = 0.03, OR = 3.43), but not for JIA (p = 0.06, p adj = 0.36, OR = 2.65). Furthermore, significant increasing in the distributions of haplotypes H4 and H10 in RA (H4: p = 0.001, OR = 1.13; H10: p = 0.001, OR = 1.15) and JIA (H4: p = 0.04, OR = 2.06; H10: p = 0.02, OR = 2.47) were also found. Moreover, the frequency of rs41426344C significantly increased in RF-positive and anti-CCP positive subjects both in RA (RF+: p <0.0001, OR = 2.33; anti-CCP+: p =0.008, OR = 2.79) and JIA (RF+: p =0.02, OR = 2.91; anti-CCP+: p = 0.02, OR = 2.78). CONCLUSIONS Our study suggested that rs41426344 and rs4986790 of TLR4 might contribute to RA, and rs41426344 might contribute to JIA pathogenesis in central south Chinese Han population.
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Affiliation(s)
- Yan Wang
- 0000 0004 1765 8757grid.464229.fDepartment of Human Anatomy, Histology and Embryology, Institute of Neuroscience, Changsha Medical University, No. 1501 Lei Feng Road,, Wangcheng District, Changsha City, Hunan Province 410219 People’s Republic of China ,0000 0004 1765 8757grid.464229.fSchool of Basic Medical Science, Changsha Medical University, Changsha, People’s Republic of China ,0000 0004 1765 8757grid.464229.fExperiment center for Function, Changsha Medical University, Changsha, People’s Republic of China
| | - Lianghui Chen
- 0000 0004 1765 8757grid.464229.fDepartment of Human Anatomy, Histology and Embryology, Institute of Neuroscience, Changsha Medical University, No. 1501 Lei Feng Road,, Wangcheng District, Changsha City, Hunan Province 410219 People’s Republic of China ,0000 0004 1765 8757grid.464229.fSchool of Basic Medical Science, Changsha Medical University, Changsha, People’s Republic of China ,0000 0004 1765 8757grid.464229.fExperiment center for Function, Changsha Medical University, Changsha, People’s Republic of China
| | - Fang Li
- 0000 0004 1765 8757grid.464229.fDepartment of Human Anatomy, Histology and Embryology, Institute of Neuroscience, Changsha Medical University, No. 1501 Lei Feng Road,, Wangcheng District, Changsha City, Hunan Province 410219 People’s Republic of China ,0000 0004 1765 8757grid.464229.fSchool of Basic Medical Science, Changsha Medical University, Changsha, People’s Republic of China
| | - Meihua Bao
- 0000 0004 1765 8757grid.464229.fDepartment of Human Anatomy, Histology and Embryology, Institute of Neuroscience, Changsha Medical University, No. 1501 Lei Feng Road,, Wangcheng District, Changsha City, Hunan Province 410219 People’s Republic of China ,0000 0004 1765 8757grid.464229.fSchool of Basic Medical Science, Changsha Medical University, Changsha, People’s Republic of China
| | - Jie Zeng
- 0000 0004 1765 8757grid.464229.fDepartment of Human Anatomy, Histology and Embryology, Institute of Neuroscience, Changsha Medical University, No. 1501 Lei Feng Road,, Wangcheng District, Changsha City, Hunan Province 410219 People’s Republic of China ,0000 0004 1765 8757grid.464229.fSchool of Basic Medical Science, Changsha Medical University, Changsha, People’s Republic of China
| | - Ju Xiang
- 0000 0004 1765 8757grid.464229.fDepartment of Human Anatomy, Histology and Embryology, Institute of Neuroscience, Changsha Medical University, No. 1501 Lei Feng Road,, Wangcheng District, Changsha City, Hunan Province 410219 People’s Republic of China ,0000 0004 1765 8757grid.464229.fSchool of Basic Medical Science, Changsha Medical University, Changsha, People’s Republic of China
| | - Huaiqing Luo
- 0000 0004 1765 8757grid.464229.fDepartment of Human Anatomy, Histology and Embryology, Institute of Neuroscience, Changsha Medical University, No. 1501 Lei Feng Road,, Wangcheng District, Changsha City, Hunan Province 410219 People’s Republic of China ,0000 0004 1765 8757grid.464229.fSchool of Basic Medical Science, Changsha Medical University, Changsha, People’s Republic of China ,0000 0004 1765 8757grid.464229.fExperiment center for Function, Changsha Medical University, Changsha, People’s Republic of China
| | - Jianming Li
- 0000 0004 1765 8757grid.464229.fDepartment of Human Anatomy, Histology and Embryology, Institute of Neuroscience, Changsha Medical University, No. 1501 Lei Feng Road,, Wangcheng District, Changsha City, Hunan Province 410219 People’s Republic of China ,0000 0001 0379 7164grid.216417.7Department of Neurology, Xiang-ya Hospital, Central South University, Changsha City, Hunan Province China
| | - Liang Tang
- Department of Human Anatomy, Histology and Embryology, Institute of Neuroscience, Changsha Medical University, No. 1501 Lei Feng Road,, Wangcheng District, Changsha City, Hunan Province, 410219, People's Republic of China. .,School of Basic Medical Science, Changsha Medical University, Changsha, People's Republic of China.
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Guo XH, Shao L, Li J, Mao YJ, Zhang LL, Song Q. Association of TLR-4 regulatory variants (rs41426344 and rs7873784) with rheumatoid arthritis in a Chinese population. EUR J INFLAMM 2016. [DOI: 10.1177/1721727x16660559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Toll-like receptors (TLRs) play a key role in both innate and adaptive immunity. The role of TLR-4 in various autoimmune disorders has been well documented. Variations in the TLR-4 gene have been linked with susceptibility to rheumatoid arthritis (RA). In the present report, we conducted a hospital-based case-control study to investigate whether common polymorphisms in the TLR-4 gene are associated with susceptibility/resistance to development of RA in a Chinese population. A total of six single nucleotide polymorphisms (Asp299Gly, Thr399Ile, rs10759932, rs41426344, rs11536889, and rs7873784) were genotyped by PCR-RFLP in 250 RA patients and 248 healthy controls. Distribution of genotypes and alleles in RA and controls were compared by Fisher’s exact test. The prevalence of minor allele, heterozygous and homozygous mutants for rs41426344 polymorphism were more frequent in RA patients compared to healthy controls (C: P <0.0001, OR = 5.51 [3.37–8.99]; GC: P <0.0001, OR = 7.38 [4.10–13.29]; CC: P = 0.01, OR = 4.73 [1.28–17.47]). Similarly, the frequencies of CC genotype and C allele of rs7873784 polymorphism were significantly higher in RA than healthy controls ([GC: P = 0.008, OR = 1.77 [1.16–2.70]; C: P = 0.01, OR = 1.61 (1.11–2.34]). However, genotypes and alleles distribution of rs10759932 and rs11536889 were comparable in both clinical categories. Similar to earlier observations, all participants were wild type for TLR-4 codon polymorphisms (Asp299Gly and Thr399Ile). In conclusion, TLR-4 (rs41426344 and rs7873784) variants are associated with susceptibility to development of RA in a Chinese population.
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Affiliation(s)
- Xiang-hua Guo
- Department of Rheumatology and Immunology, The Affiliated Hospital of Jining Medical College, Shandong Province 272000, PR China
| | - Li Shao
- Department of Rheumatology and Immunology, The Affiliated Hospital of Jining Medical College, Shandong Province 272000, PR China
| | - Jian Li
- Department of Rheumatology and Immunology, The Affiliated Hospital of Jining Medical College, Shandong Province 272000, PR China
| | - Yu-jing Mao
- Department of Rheumatology and Immunology, The Affiliated Hospital of Jining Medical College, Shandong Province 272000, PR China
| | - Li-li Zhang
- Department of Rheumatology and Immunology, The Affiliated Hospital of Jining Medical College, Shandong Province 272000, PR China
| | - Qin Song
- Department of Rheumatology and Immunology, The Affiliated Hospital of Jining Medical College, Shandong Province 272000, PR China
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Zhang J, Yang J, Xu X, Liang L, Sun H, Liu G, Zhang L, Su Y. The influence of genetic polymorphisms in TLR4 and TIRAP, and their expression levels in peripheral blood, on susceptibility to sepsis. Exp Ther Med 2015; 11:131-139. [PMID: 26889229 PMCID: PMC4726872 DOI: 10.3892/etm.2015.2884] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 10/06/2015] [Indexed: 12/28/2022] Open
Abstract
The present study aimed to investigate whether genetic polymorphisms in the Toll-like receptor (TLR)-4 and Toll/interleukin-1 receptor (TIR)-associated protein (TIRAP) genes, and/or their expression levels, influence the susceptibility of a patient to sepsis. A total of 106 patients with sepsis were divided into two groups on the basis of their acute physiology and chronic health evaluation (APACHE) II scores: i) Sepsis group A (APACHE II <20) and ii) Sepsis group B (APACHE II >20). In addition, 100 healthy volunteers were enrolled into the control group. Polymerase chain reaction-restriction fragment length polymorphism assay was used to detect the following genetic polymorphisms: The Ser180Leu allele of the TIRAP gene and the Asp299Gly and Thr399I1e alleles of the TLR4 gene. Furthermore, the protein expression levels of TLR4 and TIRAP were analyzed using an enzyme-linked immunosorbent assay. Genetic polymorphisms were not detected for the TLR4 and TIRAP genes; however, the protein expression levels of TLR4 and TIRAP differed significantly between the control, sepsis A and sepsis B groups (P<0.01). An APACHE II score of 20 was used as a baseline in order to differentiate sepsis severity. Pearson analysis demonstrated that TLR4 and TIRAP protein expression levels were positively correlated with sepsis severity (r=0.931 and 0.972; P<0.05), and TLR4 protein expression levels were positively correlated with those of TIRAP (r=0.936; P<0.05). The results of the present study suggested that the protein expression levels of, but not genetic polymorphisms in, TLR4 and TIRAP were associated with the severity of sepsis.
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Affiliation(s)
- Jianping Zhang
- Department of Critical Medicine, Ordos Central Hospital, Ordos, Inner Mongolia Autonomous Region 014010, P.R. China
| | - Jingping Yang
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Inner Mongolia Medical University, Baotou, Inner Mongolia Autonomous Region 014010, P.R. China
| | - Xiyuan Xu
- Department of Respiratory and Critical Medicine, The Third Affiliated Hospital of Inner Mongolia Medical University, Baotou, Inner Mongolia Autonomous Region 014010, P.R. China
| | - Liangshen Liang
- Department of Critical Medicine, Ordos Central Hospital, Ordos, Inner Mongolia Autonomous Region 014010, P.R. China
| | - Haixia Sun
- Department of Critical Medicine, Ordos Central Hospital, Ordos, Inner Mongolia Autonomous Region 014010, P.R. China
| | - Guohua Liu
- Department of Critical Medicine, Ordos Central Hospital, Ordos, Inner Mongolia Autonomous Region 014010, P.R. China
| | - Lihong Zhang
- Department of Critical Medicine, Ordos Central Hospital, Ordos, Inner Mongolia Autonomous Region 014010, P.R. China
| | - Yun Su
- Department of Critical Medicine, Ordos Central Hospital, Ordos, Inner Mongolia Autonomous Region 014010, P.R. China
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Liu Y, Yin H, Zhao M, Lu Q. TLR2 and TLR4 in autoimmune diseases: a comprehensive review. Clin Rev Allergy Immunol 2015; 47:136-47. [PMID: 24352680 DOI: 10.1007/s12016-013-8402-y] [Citation(s) in RCA: 265] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Autoimmune diseases are immune disorders characterized by T cell hyperactivity and B cell overstimulation leading to overproduction of autoantibodies. Although the pathogenesis of various autoimmune diseases remains to be elucidated, environmental factors have been thought to contribute to the initiation and maintenance of auto-respond inflammation. Toll-like receptors (TLRs) are pattern recognition receptors belonging to innate immunity that recognize and defend invading microorganisms. Besides these exogenous pathogen-associated molecular patterns, TLRs can also bind with damage-associated molecular patterns produced under strike or by tissue damage or cells apoptosis. It is believed that TLRs build a bridge between innate immunity and autoimmunity. There are five adaptors to TLRs including MyD88, TRIF, TIRAP/MAL, TRAM, and SARM. Upon activation, TLRs recruit specific adaptors to initiate the downstream signaling pathways leading to the production of inflammatory cytokines and chemokines. Under certain circumstances, ligation of TLRs drives to aberrant activation and unrestricted inflammatory responses, thereby contributing to the perpetuation of inflammation in autoimmune diseases. In the past, most studies focused on the intracellular TLRs, such as TLR3, TLR7, and TLR9, but recent studies reveal that cell surface TLRs, especially TLR2 and TLR4, also play an essential role in the development of autoimmune diseases and afford multiple therapeutic targets. In this review, we summarized the biological characteristics, signaling mechanisms of TLR2/4, the negative regulators of TLR2/4 pathway, and the pivotal function of TLR2/4 in the pathogenesis of autoimmune diseases including rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjogren's syndrome, psoriasis, multiple sclerosis, and autoimmune diabetes.
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Affiliation(s)
- Yu Liu
- Department of Dermatology, Second Xiangya Hospital, Central South University, #139 Renmin Middle Rd, Changsha, Hunan, 410011, People's Republic of China
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Association of Toll like receptor Asp299Gly with rheumatoid arthritis risk: a systematic review of case-control studies and meta-analysis. Pathol Res Pract 2014; 211:219-25. [PMID: 25499175 DOI: 10.1016/j.prp.2014.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 09/25/2014] [Accepted: 11/04/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Rheumatoid arthritis (RA) is thought to be triggered by various genetic and environmental factors. Few human epidemiologic studies demonstrated that single nucleotide polymorphisms (SNPs) in Toll-like receptor (TLR) genes are associated with RA. We aimed to evaluate the effects of TLR polymorphisms on the risk of RA pathogenesis by using a meta-analysis approach. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a systematic search and meta-analysis of the literature was conducted. We screened the medical literature based on keywords search in MEDLINE and EMBASE 'Toll-like receptor', 'polymorphism', and rheumatoid arthritis. Meta-analyses were performed under the random-effects model by using: (1) recessive, (2) homozygous, (3) dominant, (4) codominant and allele contrast models. RESULTS A total of 3086 cases and 3756 controls in nine studies were included in the meta-analysis. Association between TLR4 Asp299Gly and RA risk was marginally significant [OR = 0.856 (95% CI, 0.716-1.022); P = 0.086] in the homozygous model. AA and GG homozygote genotypes tended to be significant protective factors against RA risk. CONCLUSION Our overall analyses indicated that TLR4 Asp299Gly polymorphism might contribute to RA pathogenesis.
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Wang H, Wei Y, Zeng Y, Qin Y, Xiong B, Qin G, Li J, Hu D, Qiu X, Sooranna SR, Pinhu L. The association of polymorphisms of TLR4 and CD14 genes with susceptibility to sepsis in a Chinese population. BMC MEDICAL GENETICS 2014; 15:123. [PMID: 25394369 PMCID: PMC4411696 DOI: 10.1186/s12881-014-0123-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 10/23/2014] [Indexed: 02/27/2023]
Abstract
Background Sepsis is now the leading cause of death in the non-cardiovascular intensive care unit (ICU). Recent research suggests that sepsis is likely to be due to an interaction between genetic and environmental factors. Genetic mutations of toll-like receptor 4 (TLR4) and cluster of differentiation 14 (CD14) genes are involved in the immune and (or) inflammatory response. These may contribute to the susceptibility to sepsis in patients. This study was designed to evaluate whether the TLR4 and cluster CD14 gene polymorphisms are associated with susceptibility to sepsis. Methods The single nucleotide polymorphisms (SNPs) of TLR4 (rs10759932, rs11536889, rs7873784, rs12377632, rs1927907, rs1153879) and CD14 (rs2569190 and rs2563298) in patients with sepsis and control subjects in the Guangxi Province were analyzed by using the polymerase chain reaction-single base extension (PCR-SBE) and DNA sequencing methods. Results The rs11536889 polymorphism in TLR4 and rs2563298 polymorphism in CD14 were significantly associated with the risk of sepsis when compared to the control group. The frequencies of rs11536889 and rs2563298 polymorphisms in the group with sepsis were higher than that in the control group (OR = 1.430, 95% CI, 1.032-1.981, P<0.05; OR = 2.454, 95% CI, 1.458-4.130, P<0.05, respectively). Followed up haplotype analysis suggested that there were two haplotypes in which increased risk factors for sepsis were indicated. Conclusions The rs11536889 polymorphism in TLR4 and rs2563298 polymorphism in CD14, and two haplotypes were associated with increased susceptibility to sepsis.
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Affiliation(s)
- Haiyan Wang
- Intensive Care Medicine, Affiliated Hospital of Youjiang Medical University for Nationalities, No.18 Zhongshan Road II, Baise, 533099, Guangxi, PR China.
| | - Yesheng Wei
- Intensive Care Medicine, Affiliated Hospital of Youjiang Medical University for Nationalities, No.18 Zhongshan Road II, Baise, 533099, Guangxi, PR China.
| | - Yi Zeng
- Intensive Care Medicine, Affiliated Hospital of Youjiang Medical University for Nationalities, No.18 Zhongshan Road II, Baise, 533099, Guangxi, PR China.
| | - Yueqiu Qin
- Intensive Care Medicine, Affiliated Hospital of Youjiang Medical University for Nationalities, No.18 Zhongshan Road II, Baise, 533099, Guangxi, PR China.
| | - Bin Xiong
- Intensive Care Unit, the People's Hospital of Guangxi Zhuang Autonomous Region, 6 Taoyuan Road, Nanning, 530021, Guangxi, PR China.
| | - Gang Qin
- Intensive Care Unit, Minzu Hospital of Guangxi Zhuang Autonomous Region, 323 Mingxiu East Road, Nanning, 530021, Guangxi, PR China.
| | - Jun Li
- Intensive Care Medicine, Affiliated Hospital of Youjiang Medical University for Nationalities, No.18 Zhongshan Road II, Baise, 533099, Guangxi, PR China.
| | - Donghai Hu
- Intensive Care Medicine, Affiliated Hospital of Youjiang Medical University for Nationalities, No.18 Zhongshan Road II, Baise, 533099, Guangxi, PR China.
| | - Xiaowen Qiu
- Intensive Care Medicine, Affiliated Hospital of Youjiang Medical University for Nationalities, No.18 Zhongshan Road II, Baise, 533099, Guangxi, PR China.
| | - Suren R Sooranna
- Department of Surgery and Cancer, Imperial College London, Chelsea and Westminster Hospital, London, SW10 9NH, UK.
| | - Liao Pinhu
- Intensive Care Medicine, Affiliated Hospital of Youjiang Medical University for Nationalities, No.18 Zhongshan Road II, Baise, 533099, Guangxi, PR China.
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Association of Toll-like receptor polymorphisms with HIV status in North Americans. Genes Immun 2014; 15:569-77. [PMID: 25253287 PMCID: PMC4257894 DOI: 10.1038/gene.2014.54] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 07/11/2014] [Accepted: 08/22/2014] [Indexed: 12/11/2022]
Abstract
Single nucleotide polymorphisms (SNPs) in toll-like receptor (TLR) genes TLR2-4 and TLR7-9, but not in TLR1 and TLR6, have been previously evaluated regarding HIV acquisition and disease progression in various populations, most of which were European. In the present study, we examined associations between a total of 41 SNPs in 8 TLR genes (TLR1-4, TLR6-9) and HIV status in North American subjects (total n = 276 [Caucasian, n = 102; African American, n = 150; other, n = 24]). Stratification of the data by self-identified race revealed that a total of 9 SNPs in TLR1, TLR4, TLR6, and TLR8 in Caucasians, and 2 other SNPs, one each in TLR4 and TLR8, in African Americans were significantly associated with HIV status at P < 0.05. Concordant with the odds ratios of these SNPs, significant differences were observed in the SNP allele frequencies between HIV+ and HIV− subjects. Finally, in Caucasians, certain haplotypes of single (TLR1, TLR4) and heterodimer (TLR2_TLR6) genes may be inferred as “susceptible” or “protective”. Our study provides in-depth insight into the associations between TLR variants, particularly TLR1 and TLR6, and HIV status in North Americans, and suggests that these associations may be race-specific.
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Xiao W, Liu Z, Lin J, Xiong C, Li J, Wu K, Ma Y, Gong Y, Liu Z. Association of TLR4 and TLR5 gene polymorphisms with Graves’ disease in Chinese Cantonese population. Hum Immunol 2014; 75:609-13. [DOI: 10.1016/j.humimm.2014.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 05/11/2014] [Accepted: 05/04/2014] [Indexed: 01/22/2023]
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C-reactive protein gene and Toll-like receptor 4 gene polymorphisms can relate to the development of psoriatic arthritis. Clin Rheumatol 2014; 34:301-6. [DOI: 10.1007/s10067-014-2581-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 03/05/2014] [Accepted: 03/11/2014] [Indexed: 10/25/2022]
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Toll-like receptor-4 signaling: a new potential therapeutic pathway for rheumatoid arthritis. Rheumatol Int 2014; 34:1613-4. [DOI: 10.1007/s00296-013-2890-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 10/21/2013] [Indexed: 10/25/2022]
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