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NEUROLOGY 1997;49:378-385
© 1997 American Academy of Neurology

Genetic variation in the tumor necrosis factor alpha gene and the outcome of multiple sclerosis

B. G. Weinshenker, MD, D. M. Wingerchuk, MD, Q. Liu, MD, A. S. Bissonet, BS, D. J. Schaid, PhD and S. S. Sommer, MD, PhD

From the Department of Neurology (Drs. Weinshenker and Wingerchuk), Department of Biochemistry and Molecular Biology (Drs. Liu and Sommer), Section of Biostatistics (Ms. Bissonet and Dr. Schaid), Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, MN; and the Department of Molecular Genetics (Drs. Liu and Sommer), City of Hope, Duarte, CA.

Address correspondence and reprint requests to Dr. Brian G. Weinshenker, Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

The objective of this study was to determine whether sequence variation in the tumor necrosis factor alpha (TNF{alpha}) gene is associated with MS course and severity in Olmsted County, MN. The severity and temporal course of MS are heterogeneous. Genetic factors may play a role in determining the course of MS. TNF{alpha} expression is temporally associated with exacerbations of MS and is increased in individuals with progressive disease. The entire TNF{alpha} gene was amplified by polymerase chain reaction in 78 MS patients and in 39 patients with schizophrenia. Denaturation fingerprinting, a modification of direct sequencing that detects virtually all genetic polymorphisms, was performed for four regions spanning the functionally significant portions of the gene, including the promoter region. Polymorphisms were confirmed by complete sequencing. The severity and temporal course of MS were compared in those with wild-type versus variant alleles. Four sequence changes were detected, three of which occurred in MS patients. None occurred in a protein-encoding sequence. Neither of the two most common sequence variants were associated with disease severity or temporal course. Genetic variation of the TNF{alpha} gene is not associated with variation in the course or long-term outcome of MS in this population-based sample.


Supported by grants from the Minnesota Northstar Chapter of the National Multiple Sclerosis Society and by Mayo Foundation.

Presented in part at the 48th annual meeting of the American Academy of Neurology; San Francisco, CA; March 27, 1996.

Received October 30, 1996. Accepted in final form February 9, 1997.




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