Association Between TLR4 And AP-1 Gene Polymorphisms And Magnetic Resonance Imaging Signs Of Ischemic Stroke With Wind Phlegm And Blood Stasis Syndrome

Objective: This study aimed to investigate the association of TLR4 rs1927914,rs10759932,rs11536889 and AP-1 rs1323288,rs2760501 polymorphisms on magnetic resonance imaging signs of ischemic stroke(IS)with wind phlegm and blood stasis syndrome.Methods: 631 IS patients with wind phlegm and blood stasis syndrome patients were recruited in this study.The TLR4 rs1927914,rs10759932 and rs11536891 and AP-1 rs1323288,rs2760501 were genotyped through Sequenom MassARRAY technology.All cases were examined by magnetic resonance imaging(MRI).Examination contents with MRI include the location,size and number of lesions,and the effects on the surrounding tissues.PLINK software was used for statistical analysis.Result: 1.Hardy Weinberg equilibrium(HWE)test: TLR4 gene polymorphism sites rs1927914,rs10759932,rs11536889 and AP-1 gene polymorphism sites rs1323288,rs2760501 genotype frequency distribution in ischemic stroke patients were consistent with the HWE equilibrium(P>0.050).2.Association of TLR4 and AP-1 gene polymorphisms with lesion location of IS patient with wind phlegm and blood stasis syndrome:(1)TLR4 rs11536889 and AP-1 rs2760501 were associated with frontal lobe in IS patients with wind phlegm and blood stasis syndrome(recessive model: rs11536889 P=0.043,Padj =0.026;allele model: rs2760501 P=0.037).(2)TLR4 rs11536889 and AP-1 rs1323288 were associated with occipital lobe in IS patients with wind phlegm and blood stasis syndrome(recessive model: rs11536889 P=0.007,Padj=0.011;rs1323288 P=0.041,the dominant model: Padj=0.031).(3)AP-1 rs2760501 was associated with temporal lobe in IS patients with wind phlegm and blood stasis syndrome(rs2760501 dominant model: Padj=0.042).(4)TLR4 rs1927914 and AP-1 rs1323288,rs2760501 were associated with insula in IS patients with wind phlegm and blood stasis syndrome(additive model: rs1927914 P=0.027,Padj=0.034;rs1927914 P=0.041,the dominant model: Padj=0.047;allele model: rs1927914 P=0.026: rs1323288 P=0.045;dominant model Padj=0.042,the additive model: rs2760501;P=0.002,Padj=0.002;rs2760501 P=0.004,the dominant model: Padj=0.003;allele model: rs2760501 P=0.002).3.Association of TLR4 and AP-1 gene polymorphism with lesion size of IS patient with wind phlegm and blood stasis syndrome:(1)TLR4 rs1927914 and AP-1 rs1323288 were associated with large infarction in IS patients with wind phlegm and blood stasis syndrome(additive model: rs1927914 P=0.037,Padj=0.027;rs1927914 P=0.07,the dominant model: Padj=0.055;allele model: rs1927914 P=0.036;dominant model rs1323288: P=0.01,Padj=0.009).(2)TLR4 rs10759932 was associated with medium infarction in IS patients with wind phlegm and blood stasis syndrome(additive model: rs10759932 Padj=0.028;dominant model: rs10759932 Padj=0.047).(3)TLR4 rs10759932 was associated with small infarction in IS patients with wind phlegm and blood stasis syndrome(rs10759932 dominant model: P=0.048,Padj=0.049).4.Association of TLR4 and AP-1 gene polymorphisms with lesion number of IS patient with wind phlegm and blood stasis syndrome: TLR4 rs11536889 was associated with multiple lesions of IS patient with wind phlegm and blood stasis syndrome(recessive model: rs11536889 P=0.006,Padj=0.006).5.There was a statistically significant association between the AP-1 rs2760501 and the lesion's effect on ventricle(additive model: rs2760501 P=0.042,Padj=0.044;rs2760501 P=0.022,the dominant model: Padj=0.023;allele model: rs2760501 P=0.037).Conclusion: 1.The TLR4 and AP-1 polymorphisms were associatiated with lesion location of IS patients with wind phlegm and blood stasis syndrome,including frontal lobe,occipital lobe,temporal lobe,insula.2.TLR4 gene and AP-1 polymorphisms affected the lesion size of IS patients with wind phlegm and blood stasis syndrome.3.AP-1 polymorphisms affected the lesion's effect on ventricle.