Polymorphisms inTNFandIFNGare associated with clinical characteristics of aplastic anemia in Argentinean population

Clonal evolution in aplastic anemia: failed tumor surveillance or maladaptive recovery?

Clonal evolution to secondary paroxysmal nocturnal hemoglobinuria (PNH) or myeloid neoplasia (MN) represents one of the long-term complications of patients with aplastic anemia (AA). The recent evidence in the field of immunology and the application of next-generation sequencing have shed light on the molecular underpinnings of these clonal complications, revealing clinical and molecular risk factors as well as potential immunological players. Particularly, whether MN evolution represents a failed tumor surveillance or a maladaptive recovery is still a matter of controversy in the field of bone marrow failure syndromes. However, recent studies have explored the precise dynamics of the immune-molecular forces governing such processes over time, generating knowledge useful for potential early therapeutic strategies. In this review, we will discuss the immune pathophysiology of AA and the emergence of clonal hematopoiesis with regard to the adaptive and maladaptive mechanisms at the basis of secondary evolution trajectories operating under the immune pressure.

Prognostic value of TNF-a-308 and IFN-g-874 single nucleotide polymorphisms and their plasma levels in patients with aplastic anemia

Background

Aplastic anemia (AA), an unusual hematological disease, is characterized by hypoplasia of the bone marrow and failure to form blood cells of all three lineages resulting in pancytopenia. This study aimed to investigate TNF-α-308 and IFN-γ-874 gene polymorphisms and their respective plasma protein levels in patients with AA and healthy controls.

Methods

Two hundred and forty individuals were included in this study; the case group comprised 120 AA patients, while 120 healthy individuals served as controls. Genotyping was performed using the PCR-restriction length fragment polymorphism method and TNF-α-308 and IFN-γ-874 plasma levels were evaluated using an ELISA kit.

Results

There was a significantly higher prevalence of the IFN-γ-874 genotype in patients with AA than in healthy controls, while the TNF-α-308 genotype was associated with lower risk of developing AA. Furthermore, the levels of both TNF-α-308 and IFN-γ-874 were higher in the plasma of AA patients.

Conclusion

Our findings suggest that the IFN-γ-874 genotype may be a greater risk factor in the causation of AA, whereas the TNF-α-308 genotype has a protective role in the North Indian population.

The relationship between interferon-gamma (INF-γ) single nucleotide polymorphism +874(T/A) and occurrence risk of aplastic anemia: a meta-analysis

Objective: This meta-analysis was designed to investigate the association between interferon-gamma (IFN-γ) polymorphisms and occurrence risk of aplastic anemia.Methods: Literature search was conducted in PubMed, Embase and Cochrane Library up to April 2018. The pooled odds ratios (ORs) and 95% confidence interval (CI) were calculated by R 3.12.Results: Total five studies with 304 aplastic anemia patients and 588 controls were included. The statistically significant results were found in the following models: allele genetic model (T vs A: OR = 2.1749, 95% CI = 1.6825-2.8114, P < 0.01), additive genetic model (TA vs AA: OR = 2.1071, 95% CI = 1.3962-3.1799, P < 0.01; TT vs AA: OR = 4.5788, 95% CI = 2.6606-7.8797, P < 0.01), recessive genetic model (TT vs AA + TA: OR = 2.5579, 95% = 1.6680-3.9226, P < 0.01), dominant genetic model (TT + TA vs AA: OR = 2.5599, 95% = 1.7424-3.7611, P < 0.01), the results suggested that the increased occurrence risk of aplastic anemia is significantly associated with the IFN-γ polymorphism.Conclusions: Patients with IFN-γ genotype carrying allele T have higher occurrence risk of aplastic anemia.