肿瘤坏死因子的基因多态性与陶工尘肺和肺结核的关系  

Polymorphism in Tumor Necrosis Factor-α Gene on Pathogenesis of Porcelain Workers Pneumoconiosis and Tuberculosis

作　　者：王海椒[1] 苏文进[1] 张小康 祝笑敏 戴启瓷 翁少凡[1] 邬堂春[1] 陈卫红[1] 

机构地区：[1]华中科技大学同济医学院公共卫生学院,湖北武汉430030 [2]景德镇市卫生局,江西景德镇333000

出　　处：《工业卫生与职业病》2008年第5期285-290,共6页Industrial Health and Occupational Diseases

基　　金：国家自然科学基金项目(30571553);国家重点基础研究规划项目(2002CB512905);新世纪优秀人才支持计划

摘　　要：目的探讨肿瘤坏死因子-α（TNF-α）基因多态性在陶工尘肺（以下简称：尘肺）和肺结核发病遗传易感性中的作用及其与累积接尘量（CTE）的交互作用。方法研究对象选自景德镇市陶瓷工人,收集职业史和工厂历年粉尘监测资料,陶工尘肺和肺结核由当地疾病控制中心诊断小组确诊。采集每个研究对象的外周静脉血,提取DNA,应用实时定量PCR技术检测TNF-α基因-308位点多态性。结果研究对象902人,其中接尘598人,诊断尘肺157人。研究表明TNF-α-308位点G/A＋A/A基因型携带者发生尘肺的危险性是G/G基因型的1.9倍,95%CI=0.7-5.1。分层分析发现,高累积接尘量〔≥180 mg/（m^3·a）〕、男性、吸烟者G/A＋A/A基因型携带者发生尘肺的危险性分别是G/G基因型的1.8（0.8-4.4）、2.4（1.1-5.3）和2.4（1.0-5.6）倍。对吸烟指数进一步分层后发现当吸烟指数〉20包/a时,G/A＋A/A基因型携带者发生尘肺的危险性是G/G基因型的3.4倍（95%CI=1.3-8.8）。当3种因素同时存在时,G/A＋A/A基因型携带者发生尘肺的危险性是G/G基因型的8.8倍。TNF-α-308位点G/G基因型携带者发生肺结核的危险性是G/A＋A/A基因型的1.6倍,95%CI：0.7-3.5。结论TNF-α-308位点的基因多态性在尘肺的发病遗传易感性中不起主要作用。TNF-α-308位点的基因多态性在尘肺的发病过程中与累积接尘量、性别和吸烟之间存在交互作用,累积接尘量超过180 mg/（m^3·a）、男性或大量吸烟时,G/A＋A/A基因型携带者发生尘肺的危险性较G/G基因型显著增加。Objective To explore the role of tumor necrosis factor-α （TNF-α） gene polymorphism in genetic susceptibility to porcelain workers pneumoconiosis and tuberculosis, and its interaction with cumulative exposure. Methods Subjects were selected from a cohort of porcelain workers in Jingdezhen. The information of occupational history and dust concentrations in workplaces was collected from records of the factory. The pneumoconiosis and tuberculosis were diagnosed by the diagnosis group of local Center of Disease Control. DNA was extracted from peripheral venous blood for each subject. TNF-α gene polymorphism was analyzed using real-time polymerase chain reaction technique. Results A total of 902 subjects were included in this research. Among them, 598 were dust-exposed workers, and 157 cases were diagnosed as pneumoconiosis. The risk of porcelain workers pneumoconiosis in subjects with G/A＋ A/A genotype was 1.9-fold of those with G/G genotype （95%CI： 0.7-5.1）. For male subjects, the subjects with high dust exposure, or smoking, if they were G/A＋ A/A genotype, the risks of porcelain workers pneumoconiosis were 2. 4 （1.1-5. 3）, 1.8 （0. 8-4.4）, and 2.4 （1.0-5.6） folds of those of G/G genotype. In addition, the risk of tuberculosis in those with G/G genotype was 1.6-fold of those with G/A＋A/A genotype （95-CI： 0. 74 3. 5）. Conclusions TNF-α gene polymorphism did not play important role in susceptibility to pneumoconiosis and tuberculosis. However, TNF-α gene polymorphism interacted with cumulative exposure, gender, and smoking amount during the process of porcelain workers pneumoconiosis. The risks of pneumoconiosis for male heavy smokers and for those worked with cumulative dust exposure≥180 mg / （m^3 · a） of G/A＋A/A genotype were 8.8-fold of workers of G/G genotype.

关 键 词：肿瘤坏死因子-Α 基因多态性 尘肺 肺结核 

分 类 号：R135.2[医药卫生—劳动卫生]