Association Of Tnf-Alpha-308g > A Polymorphism With Susceptibility To Tendinopathy In Athletes: A Case-Control Study

Background High levels of the tumor necrosis factor alpha (TNF-alpha) induce apoptosis and pro-inflammatory effects for primary degeneration of tendon and development of tendinopathy. The aim of this study was to investigate the association between the TNF-alpha polymorphisms and tendinopathy in athletes. Methods Two hundred and seventy athletes (135 tendinopathy cases and 135 controls) were included and genotyped (TNF-alpha -1031T > C; -857 C > T; -308G > A) using TaqMan validated assays. The association of the polymorphisms with tendinopathy was evaluated by a multivariate logistic regression model, using odds ratios (OR) and 95 % confidence intervals (CI). Results The variant allele - 308 A was significantly associated with patellar (OR: 1.9; 95 % CI: 1.01-3.6) or Achilles tendinopathies (OR: 2.7; 95 % CI: 1.1-6.7). No significant differences were found in allele or genotype distributions of the - 1031T > C and - 857 C > T polymorphisms between cases and controls. TNF-alpha TCA haplotype was associated with increased tendinopathies risk, either considering all cases (OR: 2.6, 95 % CI: 1.3-5.3), patellar (OR: 3.3, 95 % CI: 1.5-7.3), rotator cuff (OR: 3.1, 95 % CI: 1.4-7.2) or Achilles tendinopathies (OR: 3.8, 95 % CI: 1.1-12.7). Conclusions These results suggest that the TNF-alpha polymorphisms could influence the susceptibility to developing tendinopathy among athletes. Knowledge of the TNF-alpha polymorphisms associated to tendinopathy in athletes can further understanding of the inflammatory role in the early stages of the disease and contribute for sports injury surveillance programmes, in which athletes with TNF-alpha TCA haplotype could be early subjected to cryotherapy after training and competition to avoid tendinopathy development.