Tumor necrosis factor-alpha (
TNF-α
) plays an important role in
autoimmune diseases. Previous studies have investigated the association of
TNF-α-238G/A
(rs361525) and
-308G/A
(rs1800629) polymorphisms with rheumatoid arthritis (RA) and systemic lupus
erythematosus (SLE). However, no agreed conclusion had been made. Therefore,
this meta-analysis was conducted to assess the associations of
TNF-α-238G/A
and
-308G/A
polymorphisms
with RA and SLE risk. A systematic search was conducted in commonly used
databases. Meta-analysis was performed by STATA12.0. A total of 43 studies were
included. In the overall population, the
TNF-α-238A
allele was
observed to be a protective factor for RA (A
vs
G: OR=0.75,
95%CI=0.57–0.99, P=0.040) and the
TNF-α-308A
allele was found
to be a risk factor for SLE (A
vs
G: OR=1.78, 95%CI=1.45–2.19,
P<0.001). However, no evidence of association was found between
TNF-α
-238 G/A polymorphism and SLE nor between -308G/A and
RA. In the subgroup analysis,
TNF-α-308A
allele played a
pathogenic role for RA in Latin Americans (A
vs
G: OR=1.46,
95%CI=1.15–1.84, P=0.002) and for SLE in Latin Americans (A
vs
G: OR=2.12, 95%CI=1.32–3.41, P=0.002) and Europeans (A
vs
G:
OR=2.03, 95%CI=1.56–2.63, P<0.001), while it played a protective role for RA
in Asians (A
vs
G: OR=0.54, 95%CI=0.32–0.90, P=0.017). No
significant association was found between
TNF-α-308G/A
and SLE
susceptibility in Africans and Asians. This meta-analysis demonstrated that
TNF-α-238A
was associated with decreased risk of RA rather
than SLE, while
-308G/A
polymorphism was associated with SLE
rather than RA. Stratification analysis indicated that different ethnicities
would have different risk alleles.