Association Between Tlr4 Gene Polymorphisms And Risk Of Preeclampsia: Systematic Review And Meta-Analysis

Background: Toll-like receptor 4 (TLR4) plays a pivotal role in the innate immune response and is hyperactivated in pre-eclampsia (PE). Several researchers have published conflicting evidence for TLR4 rs4986790 and rs4986791 single nucleotide polymorphisms (SNPs) as risk factors for PE. The present meta-analysis was conducted to ob-tain a more definitive conclusion about the effects of these SNPs on PE susceptibility Material/Methods: To determine the correlation between rs4986790 and rs4986791 polymorphisms in the TLR4 gene and suscep-tibility to PE, the PubMed, Web of Science, EMBASE, Chinese National Knowledge Infrastructure, and Chinese WANFANG databases were searched for eligible articles. Statistical analysis was performed with STATA soft-ware, version 12.0. Pooled odds ratios with corresponding 95% confidence intervals (CIs) were extracted for assessment of correlation strength. Results: We identified 5 studies including 578 cases and 631 controls for the rs4986790 SNP and 4 studies includ-ing 469 cases and 457 controls for the rs4986791 SNP, mainly from a White population. The pooled analyses showed no statistical relationship between the polymorphisms rs4986790 and rs4986791 and PE susceptibil-ity in 5 genetic models (all P>0.05). Moreover, the allelic and dominant gene models of rs4986790 and the al-lelic, heterozygous, and dominant gene models of rs4986791 had high heterogeneity. The sensitivity analysis explored potential sources of heterogeneity and confirmed the findings of this meta-analysis. Conclusions: TLR4 rs4986790 and rs4986791 polymorphisms may not be implicated in PE susceptibility, primarily in a White population. More high-quality studies of genetic associations with PE are warranted.