Association Between Tumor Necrosis Factor-α Gene Polymorphism and Sasang Constitution in Cerebral Infarction

Tumour necrosis factor-α −308G/A polymorphism is associated with insulin secretory defects in Bangladeshi prediabetic/diabetic subjects

Objectives

Tumour necrosis factor (TNF)-α, an adipocytokine, is closely linked to impaired glucose tolerance (IGT) and insulin resistance (IR) in type 2 diabetes (T2D) subjects. The relationship between the polymorphisms in the TNF-α gene and IR in Bangladeshi prediabetes and T2D subjects has not yet been fully identified. This study aims to reveal the association between TNF-α gene polymorphism and IR in hyperglycaemic patients of Bangladeshi origin.

Methods

In our study, 106 IGT, 100 T2D, and 109 healthy subjects of Bangladeshi origin were recruited to identify the impact of TNF-α gene polymorphism at position −308 with a G>A transition using PCR and subsequent restriction fragment length polymorphism (RFLP).

Results

The −308G>A TNF-α genotype frequency distribution within the control, IGT, and T2D groups showed a significant association (χ² = 21.077; P = 0.001), although allele frequency distribution within the groups showed a statistically non-significant difference (χ² = 1.696; P = 0.091). β-cell functional deficiency (HOMA-B%) was observed to be significantly (P = 0.034) lower in subjects with a variant genotype. In addition, our results indicate that the study subjects’ body mass index (BMI) and residence status were positively correlated (P ≤ 0.05) with −308G>A TNF-α gene polymorphism.

Conclusions

Therefore, it can be concluded that −308G>A TNF-α gene polymorphism may have a causative relationship with lower insulin secretory capacity and higher BMI in Bangladeshi IGT and T2D populations, while the urban population's lifestyle might be associated with this polymorphism.

A Pilot Study on Characteristics of Metabolomics and Lipidomics according to Sasang Constitution

Although classification of an individual's Sasang constitution is a key step in the prescription of traditional Korean medicine, the classifying process is complex and not objective. Identification of metabolic-based biomarkers could allow the development of a reliable and sensitive classification technique and even therapeutic management. Our pilot study investigated whether metabolites in plasma are characteristic of Sasang constitutions. Ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry-based metabolic analysis was conducted against 15 Soyangin (SY), 15 Taeeumin (TE), and 18 Soeumin (SE) individuals, as classified according to the Questionnaire for Sasang Constitution Classification II (QSCC II) and specialist diagnosis. Metabolomics data showed that the TE group was significantly separated from the SY and SE groups. Nine canonical pathways related to constitution; phenylalanine metabolism, aminoacyl-tRNA, tyrosine, and tryptophan biosynthesis were activated in the TE group as compared with the other groups. Similar to the results of the metabolomics analysis, the TE group was also significantly separated from the other two groups by lipidomic analysis. On the other hand, the intensity of lipid metabolites was higher in the SY group than in the other groups. Our findings suggest that the combined analysis of metabolomics and lipidomics can provide useful information for characteristics of Sasang constitutions.

Lower cellular metabolic power can be an explanation for obesity trend in Tae-Eum type: hypothesis and clinical observation

Background

Those classified as Tae-Eum (TE)-type people in Sasang constitutional medicine (SCM) are prone to obesity. Although extensive clinical observations have confirmed this tendency, the underlying physiological mechanisms are unknown. Here, we propose a novel hypothesis using integrative physiology to explain this phenomenon.

Methods

Hypoactive lung function in the TE type indicates that respiration is attenuated at the cellular level—specifically, mitochondrial oxygen consumption. Because a functional reduction in cellular energy metabolism is suggestive of intrinsic hypoactivity in the consumption (or production) of metabolic energy, we reasoned that this tendency can readily cause weight gain via an increase in anabolism. Thus, this relationship can be derived from the graph of cellular metabolic power plotted against body weight. We analyzed the clinical data of 548 individuals to test this hypothesis.

Results

The statistical analysis revealed that the cellular metabolic rate was lower in TE-type individuals and that their percentage of obesity (body mass index >25) was significantly higher compared to other constitutional groups.

Conclusion

Lower cellular metabolic power can be an explanation for the obesity trend in TE type people.

Body composition and personality traits in so-Yang type males

BACKGROUND

The purpose of the present study was to examine the body composition of So-Yang type males according to Sasang constitutional medicine, which is popular in Korea. Different Sasang constitutional types are associated with different muscle distributions, body shapes, and disease susceptibilities. We used the Sasang Personality Questionnaire (SPQ) as a measure of the temperament of each Sasang type.

METHODS

In total, 953 subjects aged over 20 years were recruited in Korea. We collected anthropometric parameters and bioimpedence information from the subjects and administered the SPQ. A logistic regression was conducted to calculate propensity scores.

RESULTS

The percentage of skeletal muscle mass in So-Yang (SY) and non-So-Yang (non-SY) males was 45.8 ± 2.7 and 44.2 ± 3.3, respectively, before matching and 45.8 ± 2.6 and 44.9 ± 3.0, respectively, after propensity score matching. The extracellular water (ECW)/intracellular water (ICW) and extracellular water (ECW)/total body water (TBW) ratios and SPQ scores were significantly different between the SY and non-SY types.

CONCLUSIONS

This study suggested that the SY type may be significantly and independently associated with body composition and could be associated with personality.

Impact of TLR5 rs5744174 on stroke risk, gene expression and on inflammatory cytokines, and lipid levels in stroke patients

Many studies reported that toll-like receptors (TLRs) played an important role in the process of ischemic stroke (IS). However, the impact of TLR5 rs5744174 on stroke risk, gene expression and on inflammatory cytokines, and lipid levels in ischemic stroke patients has not yet been reported and was therefore the subject of this study. In this case-control study, a total of 816 ischemic stroke patients and 816 healthy controls were genotyped using Sequenom MassArray technology. The mRNA expression of TLR5 was detected through quantitative real-time PCR among 52 ischemic stroke patients. The levels of IL-1b, IL-6, IL-8, and TNFα were measured by ELISA among 62 IS patients. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were determined among 816 IS patients using a Hitachi 7600 Automatic Biochemistry Analyzer. Our result showed TLR5 rs5744174 polymorphism was not associated with stroke risk, TLR5 mRNA expression and inflammatory cytokines of IS patients (P > 0.050), but was significantly associated with HDL-C (recessive model: β = - 0.14, 95 % CI: -0.24 to -0.03, P = 0.009). TLR5 rs5744174 polymorphism may have no impact on the stroke risk, gene expression and inflammatory cytokines, but may influence the HDL-C serum level of IS patients in Chinese Han population.

Genetic characteristics of Sasang typology: a systematic review

A systematic review on studies related to the genetic characteristics of Sasang types was conducted with the goal of delineating genetic characteristics of Sasang typology. Six electronic databases of up to the March 2011 were examined with the key words of Sasang typology, constitution, and genetics in both Korean and English. Predefined review criteria were used, including demographic characteristics, type classification methods, genotyping methods, and genotypes. Fifty-nine potentially relevant studies were identified and 40 peer reviewed research articles that contained genetic data were included. Fourteen articles reported statistically significant differences among Sasang types, which are heritability, structural variation, genome-wide screening, and pathophysiological function. Although significant genotypes were reported with vWA, CSF1PO, Penta D, HLA-Cw*04, HLA-Cw*07, PPAR-γ, MDR1, IL-α, IL-β, and IL-6 receptor, results of the review indicate that there was no conclusive genotype related to the Sasang typology. Considering the features of Sasang typology, it is recommended that the macroscopic systems medical approach on genetics be employed, rather than the single genes association approach.

Polymorphism of tumor necrosis factor alpha (TNF-alpha) gene promoter, circulating TNF-alpha level, and cardiovascular risk factor for ischemic stroke

Background

Tumor necrosis factor-α (TNF-α) is one of the most typical pro-inflammatory cytokines with both beneficial and destructive properties for the central nervous system. Increasing evidences have demonstrated the important role of TNF-α in the development of ischemic stroke, but studies examining the possible association with stroke or direct functional effects of polymorphisms in TNF-α have been contradictory.

Findings

In this study, a 2-kb length of the proximal promoter of the TNF-α was screened and four polymorphisms were investigated in the case–control study. Our data confirmed the association between -308G/A variant with stroke in 1,388 stroke patients and 1,027 controls and replicated in an independent population of 961 stroke patients and 821 controls (odds ratio (OR) = 1.34, 95% confidence interval (CI) =1.02 to 1.77 and OR = 1.56, 95% CI = 1.09 to 2.23, respectively). To reconcile the association between polymorphisms and stroke and to give a comprehensive picture of the genetic architecture of this important gene, we performed a meta-analysis of 15 published studies in an Asian population. Our results demonstrated an association between rs1800629 and ischemic stroke (OR = 1.43, 95% CI = 1.21 to 1.69). Another meta-analysis results of 14 studies demonstrated that ischemic stroke patients have higher serum TNF-α level than the control subjects (standardized mean difference (SMD) = 2.33, 95% CI = 1.85 to 2.81). In vitro evaluation of potential interaction between variants of the TNF-α gene (−308G/A, -857C/T, and -1031T/C) demonstrated that these three polymorphisms could interact together to determine the overall activity of the TNF-α gene.

Conclusions

These findings strongly implicate the involvement of TNF-α in the pathogenesis of stroke.

Genetic approach to elucidation of sasang constitutional medicine

Sasang Constitutional Medicine (SCM) offers a medical principle that classifies humans into four constitution groups and guides their treatment with constitution-matched medical assistance. The principle of this traditional medicine, although requires significant scientific support, appears to suggest a genetic influence on constitution type. The relative frequency of constitution types in a population, for instance, has remained relatively constant since Jema Lee first described them from his observations. In addition, the body compartment concept of SCM appears to be related to the anterio-posterior patterning of the embryonic gut and associated internal organs. This study describes the attributes of the constitution concept of SCM that can be interpreted in the language of genetics and current approaches to identity the genetic factors that make up the constitution. These efforts should make it possible to interpret the principle of this traditional medicine scientifically. Considering the recent trend in medicine that pursues individualized or tailored medical offerings, once SCM is proven to be explainable with scientific evidence, it will be able to contribute to and take a place in the rapidly evolving medicine environment.

The role of functional polymorphisms of the TNF-alpha gene promoter in the risk of ischemic stroke in Chinese Han and Uyghur populations: Two case-control studies

BACKGROUND

Increasing evidences for the role of tumor necrosis factor-alpha (TNF-alpha) in the occurrence of ischemic stroke (IS) have shown that it belongs to pro-inflammatory cytokines and carries functional polymorphisms (TNF-alpha -238G/A and TNF-alpha -308G/A) in its promoter region, which affect their transcription rate and plasma cytokine level. We determined the association between these polymorphisms and the occurrence of IS in the Chinese Han and Uyghur populations.

METHODS

The TNF-alpha -238G/A and TNF-alpha -308G/A polymorphisms were determined by TaqMan SNP Genotyping assays in cases (n=748) and controls (n=748). Multivariate logistic regression analysis was used to show the association between the TNF-alpha genotypes and the IS events.

RESULTS

No significant difference was found in the association between TNF-alpha -238G/A and IS in both ethnic populations. The result showed that carriage of the TNF-alpha -308GA was a decreased risk of IS in both Han and Uyghur populations (OR:0.453, 0.213). In addition, the significant difference in GA frequency in TNF-alpha was found between the two ethnic controls (P=0.000).

CONCLUSIONS

TNF-alpha -308 GA heterozygous may be an independent protective factor for IS in the Chinese Han and Uyghur populations.

Genome-wide association study of the four-constitution medicine

BACKGROUND

Four-constitution medicine (FCM), also known as Sasang constitutional medicine, and the heritage of the long history of individualized acupuncture medicine tradition, is one of the holistic and traditional systems of constitution to appraise and categorize individual differences into four major types.

OBJECTIVE

This study first reports a genome-wide association study on FCM, to explore the genetic basis of FCM and facilitate the integration of FCM with conventional individual differences research.

DESIGN

Healthy individuals of the Korean population were classified into the four constitutional types (FCTs). A total of 353,202 single nucleotide polymorphisms (SNPs) were typed using whole genome amplified samples, and six-way comparison of FCM types provided lists of significantly differential SNPs.

RESULTS

In one-to-one FCT comparisons, 15,944 SNPs were significantly differential, and 5 SNPs were commonly significant in all of the three comparisons. In one-to-two FCT comparisons, 22,616 SNPs were significantly differential, and 20 SNPs were commonly significant in all of the three comparison groups.

CONCLUSIONS

This study presents the association between genome-wide SNP profiles and the categorization of the FCM, and it could further provide a starting point of genome-based identification and research of the constitutions of FCM.