Association of Genetic Polymorphisms in Tumor Necrosis Factor-Alpha gene with the risk of Intracerebral Hemorrhage in North Indian Population

摘要

Intracerebral Hemorrhage (ICH) refers to the bleeding in the intracranial vault, meninges, and also the brainparenchyma.[1] Microglia are the inhabiting immune cells in the brain. An injury to the brain results in theactivation of these microglial cells. Various states of modulation of microglia can have either neurotoxic orneuroprotective effect. An inflammatory molecule tumor necrosis factor-alpha (TNF-alpha) derived fromactivated microglia has not only been shown to induce the production of other inflammatory molecules butalso as an autocrine mediator in microglial activation in response to traumatic brain injury (TBI) and spinalcord injury (SCI).[2],[3] Alteration in the TNF-alpha expression has been associated with cerebral aneurysmsand subarachnoid hemorrhage but no direct role has been established.[4],[5] There are limited reports oninvestigation of the association between TNF-α gene polymorphism and the risk of hemorrhagic stroke inmultiple ethnicities. Ruigrok et al. have evaluated the role of APOE, IGF-1, TNF-alpha among other genes insubarachnoid hemorrhage, which has established the role of TNF-alpha as a high risk factor.[6] The pathwayby which TNF-alpha cause ICH is yet to be identified.