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<p>Abstract</p> <p>Background</p> <p>Toll-like receptor 2 (<it>TLR2</it>) represents a reasonable functional and positional candidate gene for Alzheimer's disease (AD) as it is located under the linkage region of AD on chromosome 4q, and functionally is involved in the microglia-mediated inflammatory response and amyloid-β clearance. The -196 to -174 del polymorphism affects the <it>TLR2 </it>gene and alters its promoter activity.</p> <p>Methods</p> <p>We recruited 800 unrelated Northern Han Chinese individuals comprising 400 late-onset AD (LOAD) patients and 400 healthy controls matched for gender and age. The -196 to -174 del polymorphism in the <it>TLR2 </it>gene was genotyped using the polymerase chain reaction (PCR) method.</p> <p>Results</p> <p>There were significant differences in genotype (P = 0.026) and allele (P = 0.009) frequencies of the -196 to -174 del polymorphism between LOAD patients and controls. The del allele was associated with an increased risk of LOAD (OR = 1.31, 95% CI = 1.07-1.60, Power = 84.9%). When these data were stratified by apolipoprotein E (<it>ApoE</it>) ε4 status, the observed association was confined to <it>ApoE </it>ε4 non-carriers. Logistic regression analysis suggested an association of LOAD with the polymorphism in a recessive model (OR = 1.64, 95% CI = 1.13-2.39, Bonferroni corrected P = 0.03).</p> <p>Conclusions</p> <p>Our data suggest that the -196 to -174 del/del genotype of <it>TLR2 </it>may increase risk of LOAD in a Northern Han Chinese population.</p>