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Najafi A, Alizadeh-Navaei R, Rahimi S, Valadan R, Tehrani M. Genetic Polymorphisms of Cytotoxic T-Lymphocyte Antigen 4 (CTLA-4) and clinical outcomes post-allogeneic hematopoietic stem cell transplantation: A systematic review and meta-analysis. Clin Transplant 2021; 35:e14364. [PMID: 34008865 DOI: 10.1111/ctr.14364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/10/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Although HLA matching is considered as a key genetic predictor of allo-HSCT outcomes, genetic polymorphisms in non-HLA genes, especially in genes encoding immunoregulatory proteins, have also been proposed as additional risk factors linked to the occurrence of transplant complications. This study aimed to carry out a systematic review and meta-analysis from all eligible cohort studies to determine the effect of CTLA-4 gene polymorphisms, including rs231775, rs3087243, rs4553808, rs5742909, and rs733618, on clinical outcomes in patients receiving an allo-HSCT. METHODS A systematic literature search in PubMed, Web of Science, and Scopus was performed to identify the relevant studies, and related information was extracted. The effect size (ES) and corresponding 95% confidence intervals (CIs) were calculated to estimate the association. RESULTS 16 studies were eligible and included in the meta-analysis. The pooled results showed that only the dominant models of rs3087243 were significantly associated with chronic GVHD (cGVHD), while other SNPs were not significantly associated with overall survival, disease-free survival, relapse, and GVHD. CONCLUSIONS Our study represents, for the first time, a comprehensive meta-analysis on the role of CTLA-4 polymorphisms on outcomes after allo-HSCT. The results indicate that the CT60 CTLA-4 polymorphism could be a significant risk factor for cGVHD.
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Affiliation(s)
- Ahmad Najafi
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavash Rahimi
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Valadan
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell-Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohsen Tehrani
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Takahashi H, Okayama N, Yamaguchi N, Nomura M, Miyahara Y, Mahbub MH, Hase R, Morishima Y, Suehiro Y, Yamasaki T, Tamada K, Takahashi S, Tojo A, Tanabe T. Analysis of Relationships between Immune Checkpoint and Methylase Gene Polymorphisms and Outcomes after Unrelated Bone Marrow Transplantation. Cancers (Basel) 2021; 13:cancers13112752. [PMID: 34206082 PMCID: PMC8199545 DOI: 10.3390/cancers13112752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
Simple Summary Hematopoietic stem-cell transplantation (HSCT) is a curative therapy for blood disorders. Unrelated bone marrow transplantation (uBMT) is a type of allogeneic HSCT that uses the bone marrow of an unrelated donor. While HLA mismatch is a risk factor for poor outcomes in HSCT, such as graft-versus-host disease (GVHD), the importance of non-HLA single-nucleotide polymorphisms (SNPs) remains unclear. The clinical application of immune checkpoint and chromatin methylation inhibitors to cancer has been attracting attention. In the present study, we retrospectively genotyped five SNPs in four immune checkpoint genes, BTLA, PD-1, LAG3, and CTLA4, and two SNPs in methylase genes, DNMT1 and EZH2, in 999 uBMT pairs. Although no correlations were observed between these SNPs and post-uBMT outcomes, recipient EZH2 SNP exhibited a low p-value in the analysis of grade 2–4 acute GVHD (p = 0.010). This SNP may be useful for outcome predictions and needs to be confirmed in a larger-scale study. Abstract Unrelated bone marrow transplantation (uBMT) is performed to treat blood disorders, and it uses bone marrow from an unrelated donor as the transplant source. Although the importance of HLA matching in uBMT has been established, that of other genetic factors, such as single-nucleotide polymorphisms (SNPs), remains unclear. The application of immunoinhibitory receptors as anticancer drugs has recently been attracting attention. This prompted us to examine the importance of immunoinhibitory receptor SNPs in uBMT. We retrospectively genotyped five single-nucleotide polymorphisms (SNPs) in the immune checkpoint genes, BTLA, PD-1, LAG3, and CTLA4, and two SNPs in the methylase genes, DNMT1 and EZH2, in 999 uBMT donor–recipient pairs coordinated through the Japan Marrow Donor Program matched at least at HLA-A, -B, and -DRB1. No correlations were observed between these SNPs and post-uBMT outcomes (p > 0.005). This result questions the usefulness of these immune checkpoint gene polymorphisms for predicting post-BMT outcomes. However, the recipient EZH2 histone methyltransferase gene SNP, which encodes the D185H substitution, exhibited a low p-value in regression analysis of grade 2–4 acute graft-versus-host disease (p = 0.010). Due to a low minor allele frequency, this SNP warrants further investigation in a larger-scale study.
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Affiliation(s)
- Hidekazu Takahashi
- Department of Public Health and Preventive Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan; (H.T.); (N.Y.); (M.N.); (M.M.); (R.H.)
| | - Naoko Okayama
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; (N.O.); (Y.M.); (T.Y.)
| | - Natsu Yamaguchi
- Department of Public Health and Preventive Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan; (H.T.); (N.Y.); (M.N.); (M.M.); (R.H.)
| | - Moe Nomura
- Department of Public Health and Preventive Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan; (H.T.); (N.Y.); (M.N.); (M.M.); (R.H.)
| | - Yuta Miyahara
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; (N.O.); (Y.M.); (T.Y.)
| | - MH Mahbub
- Department of Public Health and Preventive Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan; (H.T.); (N.Y.); (M.N.); (M.M.); (R.H.)
| | - Ryosuke Hase
- Department of Public Health and Preventive Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan; (H.T.); (N.Y.); (M.N.); (M.M.); (R.H.)
| | - Yasuo Morishima
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan;
| | - Yutaka Suehiro
- Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan;
| | - Takahiro Yamasaki
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Japan; (N.O.); (Y.M.); (T.Y.)
- Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan;
| | - Koji Tamada
- Department of Immunology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan;
| | - Satoshi Takahashi
- Department of Hematology and Oncology, Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan;
| | - Arinobu Tojo
- Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
| | - Tsuyoshi Tanabe
- Department of Public Health and Preventive Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan; (H.T.); (N.Y.); (M.N.); (M.M.); (R.H.)
- Correspondence:
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Wang Z, Zhang Y, Du Y, Song F, Gao S. Association of cytotoxic T-lymphocyte antigen-4 (CTLA-4) single nucleotide polymorphism in donors with clinical outcome after allogeneic hematopoietic stem cell transplantation: a meta-analysis. ACTA ACUST UNITED AC 2021; 26:144-152. [PMID: 33491603 DOI: 10.1080/16078454.2020.1852762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Cytotoxic T-lymphocyte antigen 4 (CTLA-4) polymorphisms at positions of +49 and CT60 in donors have been reported to influence clinical outcome following allogeneic hematopoietic stem cell transplantation (allo-HSCT), such as overall survival (OS), disease free survival (DFS), relapse and the risk of graft versus host disease (GVHD). However, the results still remain controversial. Thus, we conducted the first meta-analysis to get a more accurate estimation of the relationship between CTLA-4 genotype and the above end points. METHODS PubMed, Embase, Web of science and Cochrane Library were searched to select eligible studies, data were extracted and then combined ORs/HRs together with the corresponding 95% confidence intervals (CIs) were calculated. Both the dominant and recessive models were employed to evaluate the associations between genetic variation in donor CTLA-4 and outcome after allo-HSCT. RESULTS A total of 15 studies were included the pooled results indicated that +49 GG homozygote in donors was significantly associated with increased risk of chronic GVHD (OR=1.701, 95% CI, 1.124-2.573, P=0.012, I2=34.7%). With regard to CT60 polymorphism, donors with G allele correlated with worse OS (HR = 1.422, 95% CI, 1.080-1.872, P=0.012, I2=0%) and lower susceptibility to severe acute GVHD (HR=0.619, 95% CI, 0.426-0.899, P=0.012, I2=0%). There was no significant association between CTLA-4 polymorphism and DFS or the incidence of relapse. CONCLUSIONS The present meta-analysis suggests that donors with CT60 G allele might be associated with worse OS but reduced severe aGVHD occurrence, while patients transplanted from donors with GG genotype at position of +49 are more likely to suffer from cGVHD.
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Affiliation(s)
- Zhuo Wang
- Department of Hematology, The First Hospital of Jilin University, Jilin, People's Republic of China
| | - Yunwei Zhang
- Department of Hematology, The First Hospital of Jilin University, Jilin, People's Republic of China
| | - Yazhe Du
- Department of Hematology, The First Hospital of Jilin University, Jilin, People's Republic of China
| | - Fei Song
- Department of Hematology, The First Hospital of Jilin University, Jilin, People's Republic of China
| | - Sujun Gao
- Department of Hematology, The First Hospital of Jilin University, Jilin, People's Republic of China
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Rosik J, Szostak B, Machaj F, Pawlik A. The Role of CTLA4 and Its Polymorphisms in Solid Organ and Haematopoietic Stem Cell Transplantation. Int J Mol Sci 2021; 22:ijms22063081. [PMID: 33802937 PMCID: PMC8002677 DOI: 10.3390/ijms22063081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/08/2021] [Accepted: 03/15/2021] [Indexed: 12/16/2022] Open
Abstract
HLA matching, transplantation technique, or underlying disease greatly influences the probability of long-term transplantation success. It has been hypothesised that genetic variation affecting antigen presentation also contributes to the outcomes of both solid organ transplantation and allogeneic haematopoietic stem cell transplantation (AHSCT). Those genes, along with those responsible for innate and adaptive immunity, have become targets of investigation. In this review, we focus on the role of CTLA4 in the process of acute graft rejection and summarise the progress in our understanding of its role in predicting the outcome. We present the results of the latest studies investigating the link between CTLA4 gene variability and AHSCT, as well as organ transplantation outcomes. While some studies found a link between +49 A/G and −318 C/T and transplantation outcomes, comprehensive meta-analyses have failed to present any association. The most recent field reviews suggest that the −1772 T/C (rs733618) CC genotype is weakly associated with a lower risk of acute graft rejection, while +49 A/G might be clinically meaningful when investigated in the context of combinations with other polymorphisms. Studies verifying associations between 12 CTLA4 gene SNPs and AHSCT outcomes present inexplicit results. Some of the most commonly studied polymorphisms in this context include +49 A/G (rs231775) and CT60 A/G (rs3087243). The results signify that, in order to understand the role of CTLA4 and its gene polymorphisms in transplantology, further studies must be conducted.
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Szostak B, Machaj F, Rosik J, Pawlik A. Umbilical cord blood transplantation and the impact of the CTLA4 genotype on outcomes. Expert Rev Hematol 2019; 12:1089-1094. [PMID: 31607188 DOI: 10.1080/17474086.2019.1680281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Background: Umbilical cord blood transplantation is an effective method of curing multiple diseases when there is no donor available for allogeneic hematopoietic stem cell transplantation (AHSCT). It has been recently suggested that polymorphisms in genes affecting antigen presentation could potentially affect cord blood transplantation (CBT) outcomes.Areas covered: In this review, we present the results of the latest studies investigating the link between CTLA4 gene variability and umbilical cord blood transplantation outcomes.Expert opinion: The search for genetic variants that influence the immune response, both innate and adaptive immunity, may lead to more optimal therapies. Promising candidate genes are those that regulate the expression of proteins associated with T-cell activation. Many genetic variants could be therapeutically important, including those related to innate and adaptive immunity, cytokines, chemokines, drug-metabolizing enzymes, drug transporters, and inflammatory enzymes. The development of an algorithm that includes the determination of selected genetic variants could be helpful for an appropriate donor-recipient CBT matching.
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Affiliation(s)
- Bartosz Szostak
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
| | - Filip Machaj
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
| | - Jakub Rosik
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
| | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
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Genetic Polymorphism in Cytokines and Costimulatory Molecules in Stem Cell and Solid Organ Transplantation. Clin Lab Med 2019; 39:107-123. [PMID: 30709500 DOI: 10.1016/j.cll.2018.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
There is growing evidence supporting the genetic variability outside of HLA system that is contributing to the variation in transplant outcomes. Determining novel predictors could help to identify patients at risk and tailor their immunosuppressive regimens. This article discusses the various single nucleotide polymorphisms in costimulatory molecules and cytokines that have been evaluated for their effect on transplantation. An overview of how gene polymorphism studies are conducted and factors to consider in the experimental design to ensure meaningful data can be concluded are discussed.
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Hammrich J, Wittig S, Ernst T, Gruhn B. CTLA-4 polymorphism rs231775: Influence on relapse and survival after allogeneic hematopoietic stem cell transplantation in childhood. Eur J Haematol 2019; 102:251-255. [PMID: 30465728 DOI: 10.1111/ejh.13200] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Relapse following allogeneic hematopoietic stem cell transplantation (HSCT) is still linked to a poor prognosis. Mainly, donor`s T-cells mediate the graft-versus-leukemia effect. Cytotoxic T-lymphocyte antigen-4 (CTLA-4) is an inhibitory molecule which down-regulates T-cell activation. Single nucleotide polymorphism (SNP) in CTLA-4 may have an effect on immune response. METHODS Eighty-eight children with acute leukemia and their donors were genotyped of CTLA-4 gene for rs231775. We searched for an association of CTLA-4 SNP with relapse and survival after allogeneic HSCT. RESULTS We identified a significantly reduced relapse rate in children who received a transplant from a donor with the CTLA-4 genotypes AG or GG in comparison with genotype AA of rs231775 (19% vs 40%, P = 0.026). In addition, we observed a significant difference in event-free survival (EFS) depending on the donor´s genotype. The EFS was 70% or 46% if the patient was transplanted from a donor with CTLA-4 genotype AG/GG or AA, respectively (P = 0.025). In multivariate analysis, CTLA-4 genotype was an independent risk factor for relapse rate (P = 0.028). CONCLUSION This study suggests that CTLA-4 polymorphism rs231775 is relevant for relapse and survival after allogeneic HSCT in childhood and should be further investigated in clinical trials.
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Affiliation(s)
- Judith Hammrich
- Department of Pediatrics, Jena University Hospital, Jena, Germany
| | - Susan Wittig
- Department of Pediatrics, Jena University Hospital, Jena, Germany
| | - Thomas Ernst
- Department of Internal Medicine Il, Jena University Hospital, Jena, Germany
| | - Bernd Gruhn
- Department of Pediatrics, Jena University Hospital, Jena, Germany
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PD-1 genotype of the donor is associated with acute graft-versus-host disease after HLA-identical sibling donor stem cell transplantation. Ann Hematol 2018; 97:2217-2224. [PMID: 30019128 DOI: 10.1007/s00277-018-3438-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
Abstract
Programmed death 1 (PD-1) activation triggers an immune checkpoint resulting in inhibition of T cells that leads to peripheral tolerance. Some PD-1 polymorphisms have been described and associated with the development of autoimmune diseases or cancer predisposition, but there are few data concerning the relevance of such polymorphisms on the clinical outcome after allogeneic hematopoietic stem cell transplant (alloHSCT). We analyzed the distribution of the SNPs PD-1.1G/A (rs36084323) and PD-1.3G/A (rs11568821) genotypes of the donor in a cohort of 1485 alloHSCT from HLA-identical sibling donors. We found an increased risk of grades II to IV graft-versus-host disease (GvHD) in patients receiving grafts from donors homozygous for the G allele at the rs36084323 SNP (P = 0.033; hazard ratio [HR] 2.2; 95% confidence interval [CI] 1.1 to 4.8) and also from donors homozygous for the A allele at the rs11568821 position (P < 0.001; HR 4.5, 95%CI 2.0 to 10.1). In contrast, the PD-1 genotype of the donor did not show association with overall survival or relapse incidence. These results suggest that the PD-1 genotype of the donor plays an important role for the development of acute GvHD after alloHSCT from HLA-identical sibling donors.
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Replication and validation of genetic polymorphisms associated with survival after allogeneic blood or marrow transplant. Blood 2017; 130:1585-1596. [PMID: 28811306 DOI: 10.1182/blood-2017-05-784637] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 08/02/2017] [Indexed: 12/11/2022] Open
Abstract
Multiple candidate gene-association studies of non-HLA single-nucleotide polymorphisms (SNPs) and outcomes after blood or marrow transplant (BMT) have been conducted. We identified 70 publications reporting 45 SNPs in 36 genes significantly associated with disease-related mortality, progression-free survival, transplant-related mortality, and/or overall survival after BMT. Replication and validation of these SNP associations were performed using DISCOVeRY-BMT (Determining the Influence of Susceptibility COnveying Variants Related to one-Year mortality after BMT), a well-powered genome-wide association study consisting of 2 cohorts, totaling 2888 BMT recipients with acute myeloid leukemia, acute lymphoblastic leukemia, or myelodysplastic syndrome, and their HLA-matched unrelated donors, reported to the Center for International Blood and Marrow Transplant Research. Gene-based tests were used to assess the aggregate effect of SNPs on outcome. None of the previously reported significant SNPs replicated at P < .05 in DISCOVeRY-BMT. Validation analyses showed association with one previously reported donor SNP at P < .05 and survival; more associations would be anticipated by chance alone. No gene-based tests were significant at P < .05. Functional annotation with publicly available data shows these candidate SNPs most likely do not have biochemical function; only 13% of candidate SNPs correlate with gene expression or are predicted to impact transcription factor binding. Of these, half do not impact the candidate gene of interest; the other half correlate with expression of multiple genes. These findings emphasize the peril of pursing candidate approaches and the importance of adequately powered tests of unbiased genome-wide associations with BMT clinical outcomes given the ultimate goal of improving patient outcomes.
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Queirolo P, Dozin B, Morabito A, Banelli B, Piccioli P, Fava C, Leo C, Carosio R, Laurent S, Fontana V, Ferrucci PF, Martinoli C, Cocorocchio E, Battaglia A, Ascierto PA, Capone M, Simeone E, De Galitiis F, Pagani E, Antonini Cappellini GC, Marchetti P, Guida M, Tommasi S, Mandalà M, Merelli B, Quaglino P, Fava P, Guidoboni M, Romani M, Spagnolo F, Pistillo MP. Association of CTLA-4 Gene Variants with Response to Therapy and Long-term Survival in Metastatic Melanoma Patients Treated with Ipilimumab: An Italian Melanoma Intergroup Study. Front Immunol 2017; 8:386. [PMID: 28446908 PMCID: PMC5388686 DOI: 10.3389/fimmu.2017.00386] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 03/20/2017] [Indexed: 01/14/2023] Open
Abstract
Ipilimumab (IPI) blocks CTLA-4 immune checkpoint resulting in T cell activation and enhanced antitumor immunity. IPI improves overall survival (OS) in 22% of patients with metastatic melanoma (MM). We investigated the association of CTLA-4 single nucleotide variants (SNVs) with best overall response (BOR) to IPI and OS in a cohort of 173 MM patients. Patients were genotyped for six CTLA-4 SNVs (−1661A>G, −1577G>A, −658C>T, −319C>T, +49A>G, and CT60G>A). We assessed the association between SNVs and BOR through multinomial logistic regression (MLR) and the prognostic effect of SNVs on OS through Kaplan–Meier method. Both −1577G>A and CT60G>A SNVs were found significantly associated with BOR. In particular, the proportion of responders was higher in G/G genotype while that of stable patients was higher in A/A genotype. The frequency of patients experiencing progression was similar in all genotypes. MLR evidenced a strong downward trend in the probability of responsiveness/progression, in comparison to disease stability, as a function of the allele A “dose” (0, 1, or 2) in both SNVs with reductions of about 70% (G/A vs G/G) and about 95% (A/A vs G/G). Moreover, −1577G/G and CT60G/G genotypes were associated with long-term OS, the surviving patients being at 3 years 29.8 and 30.8%, respectively, as compared to 12.9 and 14.4% of surviving patients carrying −1577G/A and CT60G/A, respectively. MM patients carrying −1577G/G or CT60G/G genotypes may benefit from IPI treatment in terms of BOR and long-term OS. These CTLA-4 SNVs may serve as potential biomarkers predictive of favorable outcome in this subset of patients.
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Affiliation(s)
- Paola Queirolo
- Department of Medical Oncology, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Beatrice Dozin
- Unit of Clinical Epidemiology, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Anna Morabito
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Barbara Banelli
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.,Department of Health Sciences, University of Genova, Genova, Italy
| | - Patrizia Piccioli
- Unit of Cellular Biology, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Cristiana Fava
- Department of Medical Oncology, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Claudio Leo
- Department of Medical Oncology, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Roberta Carosio
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Stefania Laurent
- Intergruppo Melanoma Italiano (IMI) and Department of Internal Medicine, University of Genova, Genova, Italy
| | - Vincenzo Fontana
- Unit of Clinical Epidemiology, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | | | - Chiara Martinoli
- Oncology of Melanoma Unit, European Institute of Oncology, Milan, Italy
| | | | - Angelo Battaglia
- Oncology of Melanoma Unit, European Institute of Oncology, Milan, Italy
| | - Paolo A Ascierto
- Melanoma, Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori Fondazione 'G. Pascale', Naples, Italy
| | - Mariaelena Capone
- Melanoma, Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori Fondazione 'G. Pascale', Naples, Italy
| | - Ester Simeone
- Melanoma, Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori Fondazione 'G. Pascale', Naples, Italy
| | - Federica De Galitiis
- Istituto Dermopatico dell'Immacolata IDI-IRCCS, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Elena Pagani
- Istituto Dermopatico dell'Immacolata IDI-IRCCS, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Paolo Marchetti
- Istituto Dermopatico dell'Immacolata IDI-IRCCS, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.,Medical Oncology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Michele Guida
- Department of Medical Oncology and Molecular Genetics Laboratory, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Stefania Tommasi
- Department of Medical Oncology and Molecular Genetics Laboratory, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Mario Mandalà
- Unit of Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Barbara Merelli
- Unit of Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paolo Fava
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Massimo Romani
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Francesco Spagnolo
- Department of Medical Oncology, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Maria Pia Pistillo
- Unit of Tumor Epigenetics, IRCCS AOU San Martino-IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
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Impact of CTLA4 genotype and other immune response gene polymorphisms on outcomes after single umbilical cord blood transplantation. Blood 2016; 129:525-532. [PMID: 27811020 DOI: 10.1182/blood-2016-06-722249] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 10/17/2016] [Indexed: 12/25/2022] Open
Abstract
We evaluated the impact of recipient and cord blood unit (CBU) genetic polymorphisms related to immune response on outcomes after unrelated cord blood transplantations (CBTs). Pretransplant DNA samples from 696 CBUs with malignant diseases were genotyped for NLRP1, NLRP2, NLRP3, TIRAP/Mal, IL10, REL, TNFRSF1B, and CTLA4. HLA compatibility was 6 of 6 in 10%, 5 of 6 in 39%, and ≥4 of 6 in 51% of transplants. Myeloablative conditioning was used in 80%, and in vivo T-cell depletion in 81%, of cases. The median number of total nucleated cells infused was 3.4 × 107/kg. In multivariable analysis, patients receiving CBUs with GG-CTLA4 genotype had poorer neutrophil recovery (hazard ratio [HR], 1.33; P = .02), increased nonrelapse mortality (NRM) (HR, 1.50; P < .01), and inferior disease-free survival (HR, 1.41; P = .02). We performed the same analysis in a more homogeneous subset of cohort 1 (cohort 2, n = 305) of patients who received transplants for acute leukemia, all given a myeloablative conditioning regimen, and with available allele HLA typing (HLA-A, -B, -C, and -DRB1). In this more homogeneous but smaller cohort, we were able to demonstrate that GG-CTLA4-CBU was associated with increased NRM (HR, 1.85; P = .01). Use of GG-CTLA4-CBU was associated with higher mortality after CBT, which may be a useful criterion for CBU selection, when multiple CBUs are available.
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Karabon L, Markiewicz M, Partyka A, Pawlak-Adamska E, Tomkiewicz A, Dzierzak-Mietla M, Kyrcz-Krzemien S, Frydecka I. A CT60G>A polymorphism in the CTLA-4 gene of the recipient may confer susceptibility to acute graft versus host disease after allogeneic hematopoietic stem cell transplantation. Immunogenetics 2015; 67:295-304. [PMID: 25940108 PMCID: PMC4427628 DOI: 10.1007/s00251-015-0840-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 04/20/2015] [Indexed: 12/20/2022]
Abstract
T cell activation plays a crucial role in the development of acute graft versus host disease (aGvHD). Cytotoxic T cell antigen-4 (CTLA-4) is a co-inhibitory molecule that negatively regulates T cell activation, differentiation, and proliferation. Single-nucleotide polymorphisms (SNPs) in CTLA-4 gene may affect its function. Inconsistent observations have been reported regarding the associations of CTLA-4 SNPs with complications after hematopoietic stem cell transplantation (HSCT). Moreover, the majority of the observations were focused on the donors' SNPs. Recently, a few studies have shown that recipients' genetic variations in the CTLA-4 gene might influence HSCT results. The aim of our study was to determine the influence of the CTLA-4 gene polymorphisms of the donors and the recipients on the outcome of HSCT. Altogether, 312 donor-recipient pairs were genotyped for the CTLA-4c.49A>G (rs231775) and CT60G>A (rs3087243) SNPs using the TaqMan®SNP Genotyping Assays. In this study, it was shown that the recipients' CT60G>A[GG] genotype, the myeloablative conditioning regimen, and HSCT from an unrelated donor were independent aGvHD risk factors (odds ratio (OR) 2.63, 95% confidence intervals (95% CI) 1.45-4.59, p = 0.001; OR 2.68, 95% CI 1.65-4.07, p = 0.00003; and OR 1.87, 95 % CI 1.02-3.24, p = 0.04, respectively). Moreover, haplotype analysis revealed that possessing allele A in both of the SNPs decreased the risk of aGvHD approximately 1.5-fold (RR 0.69, p = 0.008). Our data suggest that the CT60G>A[GG] genotype in the recipient has an impact on aGvHD development, especially in patients receiving transplants from unrelated donors together with the myeloablative conditioning regimen.
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Affiliation(s)
- Lidia Karabon
- Department of Experimental Therapy, L. Hirszfeld Institute of Immunology & Experimental Therapy, Polish Academy of Science, R. Weigl 12, 53-114, Wroclaw, Poland,
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13
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Banelli B, Morabito A, Laurent S, Piccioli P, Dozin B, Ghio M, Ascierto PA, Monteghirfo S, Marasco A, Ottaviano V, Queirolo P, Romani M, Pistillo MP. A novel multiplex pyrosequencing assay for genotyping functionally relevant CTLA-4 polymorphisms: Potential applications in autoimmunity and cancer. Hum Immunol 2014; 75:730-9. [DOI: 10.1016/j.humimm.2014.04.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 03/24/2014] [Accepted: 04/27/2014] [Indexed: 10/25/2022]
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14
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Karimi MH, Ebadi P, Pourfathollah AA. Association of cytokine/costimulatory molecule polymorphism and allograft rejection: a comparative review. Expert Rev Clin Immunol 2014; 9:1099-112. [PMID: 24168415 DOI: 10.1586/1744666x.2013.844462] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
One reason for genetic variations among human individuals is SNP which may confer diverse disease susceptibility or resistance in a population. Genetic variations in a key immunoregulatory agent can manifest various immunological responses, such as graft rejection. In fact, the outcome of organ transplantation can be impacted by several genetic causes including polymorphisms in genes encoding cytokines and costimulatory molecules in the donor or recipient. Thus, it can be helpful to contemplate the SNPs relating to these immunological determinants in order to achieve an improved transplantation therapy.
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Affiliation(s)
- Mohammad H Karimi
- Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Mossallam GI, Samra MA. CTLA-4 polymorphism and clinical outcome post allogeneic hematopoietic stem cell transplantation. Hum Immunol 2013; 74:1643-8. [PMID: 23973330 DOI: 10.1016/j.humimm.2013.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 07/09/2013] [Accepted: 08/10/2013] [Indexed: 12/16/2022]
Abstract
CTLA-4 inhibitory molecule plays an important role in regulating T cell activation. It is considered a crucial element in keeping the immune balance and has been implicated in cancer, autoimmunity and transplantation immunology. Inconsistent observations are reported regarding its association with hematopoietic stem cell transplantation (HSCT). Genotyping of CTLA-4 was performed in recipients and their HLA-matched donors for +49A/G and CT60 polymorphisms (80 and 94 pairs, respectively) using PCR-RFLP. No association was encountered between both polymorphisms in patients and donors and acute or chronic graft versus host disease. Significant association was observed between recipient +49A/G G allele and lower disease-free survival and overall survival compared to AA genotype (HR: 2.17, p = 0.03, 95% CI: 1.05-4.48 and HR: 2.54, p = 0.01, 95% CI: 1.16-5.54), respectively. Our results suggest that CTLA-4 genotyping may predict outcome in patients post HSCT. To validate our results, further studies on a larger cohort are needed.
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Affiliation(s)
- Ghada I Mossallam
- Bone Marrow Transplantation Laboratory Unit, National Cancer Institute, Cairo University, Cairo, Egypt.
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Queirolo P, Morabito A, Laurent S, Lastraioli S, Piccioli P, Ascierto PA, Gentilcore G, Serra M, Marasco A, Tornari E, Dozin B, Pistillo MP. Association of CTLA-4 polymorphisms with improved overall survival in melanoma patients treated with CTLA-4 blockade: a pilot study. Cancer Invest 2013; 31:336-45. [PMID: 23641913 DOI: 10.3109/07357907.2013.793699] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
CTLA-4 blockade with monoclonal antibodies can lead to cancer regression in patients with metastatic melanoma (MM). CTLA-4 gene polymorphisms may influence the response to anti-CTLA-4 antibodies although few data are available regarding this issue. We analyzed six CTLA-4 single nucleotide polymorphisms (-1661A > G, -1577G > A, -658C > T, -319C > T, +49A > G, and CT60G > A) in 14 Italian MM patients and 45 healthy subjects. We found a significant association between the -1577G/A and CT60G/A genotypes and improved overall survival (Pc < 0.006, Bonferroni corrected), further confirmed by the diplotype analysis (-1577 & CT60 GG-AA diplotype, p < 0.001). A positive trend toward an association between these genotypes and response to therapy was also observed.
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Affiliation(s)
- P Queirolo
- UOC Oncologia Medica A, IRCCS A.O.U. San Martino-IST, Genova, Italy
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Recipient CTLA-4*CT60-AA genotype is a prognostic factor for acute graft-versus-host disease in hematopoietic stem cell transplantation for thalassemia. Hum Immunol 2011; 73:282-6. [PMID: 22245568 PMCID: PMC3314940 DOI: 10.1016/j.humimm.2011.12.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 12/20/2011] [Accepted: 12/21/2011] [Indexed: 01/16/2023]
Abstract
Polymorphisms of the cytotoxic T-lymphocyte antigen-4 gene (CTLA-4) have been associated with autoimmune diseases and it has recently been reported that donor genotypes correlate with the outcome of allogeneic hematopoietic stem cell transplantation in leukemia patients. With the aim of confirming this finding in thalassemia patients, we investigated the influence of genotype distribution of 3 CTLA-4 gene polymorphisms in 72 thalassemia patients and their unrelated donors. A significant association was observed for recipient CT60-AA genotype and onset of grade II-IV (63.2% vs 24.5%; p = 0.001) and grade III-IV (36.4% vs 7.6%; p = 0.005) acute graft-versus-host disease (aGVHD). The same association was observed for the 88-base-pair allele of the CTLA-4 (AT)n polymorphism, which was determined to be in complete linkage disequilibrium with the CT60 A allele. Multinomial Cox regression demonstrated that this association was independent of CT60 donor genotypes or other risk factors (p = 0.016; hazard ratio = 2.8). Our data confirm that the genetic variability in CTLA-4 is an important prognostic factor for aGVHD and suggest that some of the risk factors for this complication are generated by recipient cells that persist after the myeloablative conditioning regimen.
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Stem cell associated genes working with one miRNA cluster have different clinic pathologic values in gastric cancer. Pathol Oncol Res 2011; 17:939-46. [PMID: 21553350 DOI: 10.1007/s12253-011-9407-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 04/26/2011] [Indexed: 10/18/2022]
Abstract
Cancer stem cells are nowadays considered to be the origin of cancer. Also, stem cell associated genes are emerging as predictors of cancer malignancy. We investigated the association of several stemness genes (c-Myc, PTEN, p57 and p21) with clinic pathological parameters and survival in stomach cancer by performing immunohistochemistry on paraffin sections of gastric cancer patients who underwent surgical staging with following-up statistics. We discovered that expression of c-Myc was significantly related to distant metastasis, the combined expression of PTEN and p21 correlated positively to overall survival, while p57 was less useful in overall survival prediction in gastric cancer. Additionally, there is a positive correlation between expressions of p57 and p21. In conclusion, our present study indicated that expression of stemness genes (c-Myc, PTEN, p57 and p21) performed different predictive potential in the evaluation of clinical malignancy levels in gastric cancer.
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