A META-ANALYSIS OF TOLL-LIKE RECEPTOR-4 GENE POLYMORPHISM FOR DETERMINATION OF SUSCEPTIBILITY TO, AND SEVERITY OF ACUTE PANCREATITIS

HONGXIA YANG, WEI GAO, CHENGEN MA

Department of Intensive Care Unit, The Second Hospital of Shandong University, Jinan City, Shandong Province 250033, China

Objective: To carry out meta-analysis on the association of Toll-like receptor 4 (TLR4) gene polymorphism with susceptibility to, and severity of acute pancreatitis (AP).

Methods: Literature published from January 2014 to December 2017 on the relationship between TLR4 Asp299Gly and Thr399Ile gene polymorphisms, and AP in case-control studies were retrieved. Studies that met the inclusion criteria were analyzed statistically. Publication bias of included literature was evaluated, and sensitivity analysis and meta-analysis were performed.

Results: A total number of 15 studies were included in the meta-analysis, including 467 AP patients and 3412 control cases. The analysis showed absence of any obvious publication bias in symmetrical funnel plots. In allele models (G/A versus C/T), TLR4 gene polymorphism increased the risk of AP (P < 0.05). Gene polymorphisms in Thr399Ile and Asp299Gly also increased the risk of AP (P < 0.05). In codominance models (GG/AA versus CC/TT), TLR4 gene polymorphism, as well as Thr399Ile and Asp299Gly gene polymorphisms increased the risk of AP (P < 0.05).

Conclusion: Acute pancreatitis (AP) is a complex disease affected by multiple genes and factors. Polymorphisms in Thr399Ile and Asp299Gly are associated with the susceptibility and severity of AP. These results indicate that TLR4 gene mutation is implicated in the occurrence of AP.