“…On the other hand, Sobhan et al [35] in a case-control study followed by a meta-analysis, demonstrated that this polymorphism in question may not be associated with susceptibility of OA, as other authors complement, ratifying the lack of relationship between the − 308 SNP TNF and OA [32,36]. In contrast, there are several studies with results agreeing with our data, where the presence of the A allele at position − 308 has a direct relation to the prevalence and severity of knee and hip OA [21,22,24,25,33,37], which is associated with a six-fold increase in transcriptional activity and higher levels of TNF-α protein [38,39]. In this same sense, Chen et al 2018 and Kou et al 2014 in metaanalyzes, with 983 and 257 cases of AO and 1355 and 305 controls, respectively, found an association between the − 308 G / A polymorphism of TNF in relation to the higher risk of OA.…”