TNF-alpha and HLA-DR genotyping as potential prognostic markers in pulmonary sarcoidosis

We have analyzed the HLA-DRB1 alleles and -308 TNF-alpha gene polymorphism in 78 sarcoidosis patients and 50 controls. The sarcoidosis group as a whol e did not show any significant correlation with the TNF-A or the HLA-DR all eles compared to the control group, However, the patient subgroups of Lofgr en and non-Lofgren sarcoidosis exhibited significant allele associations. I n the Lofgren patient group, the TNF-A2 and the HLA-DR3 alleles were repres ented significantly higher, with a highly significant relative risk resulti ng from the presence of the TNF-A2 or the HLA-DR3 allele or both. In the no n-Lofgren patient group, the phenotype expressing HLA-DR2 and lacking TNF-A 2 was significantly higher than in the Lofgren patient group. Due to these significant genetic differences in the subgroups of Lofgren and non-Lofgren sarcoidosis patients, we conclude that the genotyping of these two loci (- 308 TNF-alpha promoter polymorphism and HLA-DR) may be of prognostic value for the course of disease in sarcoidosis.