A pilot case-control association study of cytokine polymorphisms in Brazilian women presenting with HPV-related cervical lesions

Haplotype Structures and Protein Levels of TGFB1 in HPV Infection and Cervical Lesion: A Case-Control Study

This study aimed to verify the role of TGFB1 variants (c.-1638G>A, c.-1347C>T, c.29C>T, and c.74G>C) in HPV infection susceptibility and cervical lesions development, and their impact on TGFB1 cervical and plasma levels. TGFB1 genotypes were assessed with PCR-RFLP and haplotypes were inferred for 190 HPV-uninfected and 161 HPV-infected women. TGFB1 levels were determined with immunofluorimetric assay. Case-control analyses were performed with logistic regression adjusted for possible confounders. Women carrying -1347TT or -1347CT+TT as well as those with 29CT, 29CC, or 29CT+CC were more likely to have HPV than -1347CC and 29TT carriers, respectively. Regarding haplotypes, the most frequent were *4 (GCTG) and *3 (GTCG). Women *4/*4 were less likely to have HPV than those with no *4 copy. Comparing the inheritance of *3 and *4, carriers of *3/*4 or *3/*3 were more susceptible to HPV than *4/*4. The TGFB1 plasma and cervical levels were higher in the infected patients. Plasma levels were also higher in infected women with low-grade lesions. HPV-infected patients carrying *3/Other and *3/Other+*3/*3 presented lower TGFB1 plasma levels than those with no copy of *3. TGFB1 variants could contribute to the comprehension of the TGFB1 role in HPV-caused cervical disease.

Genetic Variants in Interleukin-10 Gene Association with Susceptibility and Cervical Cancer Development: A Case Control Study

Objectives  Cervical cancer (CC) is one of the most destructive disease caused by persistent HPV infection which affects women worldwide, especially in developing countries. The genetic basis of host immune response especially cytokine function has been shown to influence CC susceptibility. Studies have demonstrated that IL-10 gene polymorphism have been associated with numerous malignancies, but in context to CC results were inconclusive. Though, aim of our study to investigate the association between IL-10 -1082A/G and -819C/T promoter polymorphism and CC susceptibility.

Material and Methods  This study comprised 192 women with CC and 200 controls. HPV detection was done by RT-PCR and genotyping was assessed through PCR-RFLP method. Serum concentration of IL-10 measured by ELISA.

Results  Women with AG and AG+GG genotypes of IL-10 -1082A/G had two-fold increased risk of CC [OR, 2.35 (95% CI, 1.54–3.58), p  = 0.005], [OR, 2.03 (95% CI, 1.36–3.04), p  = 0.0005] compared to controls. Women with G allele of -1082A/G polymorphism had linked with CC susceptibility [OR, 1.39 (95% CI, 1.02–1.88), p  = 0.036] compared to controls. No significant difference was found between patients and controls in the genotype or allele frequencies of IL–10 -819C/T polymorphism [OR, 1.00 (95% CI, 0.63–1.58), p  = 0.99]. The level of serum concentration of IL-10 was significantly higher in cases compared to controls.

Conclusion  These findings help to understand that polymorphism of IL-10 -1082A/G gene is associated with increased risk of CC development and can serve as a marker of genetic susceptibility to CC.

Polymorphisms in the TGFB1 signal peptide influence human papillomavirus infection and development of cervical lesions

The main purpose was to assess the effect of c.29C>T and c.74G>C polymorphisms in the TGFB1 signal peptide on HPV infection and development of cervical lesions. Cervical swabs and blood samples were obtained from 349 outpatient women, along with socio-demographic and sexual behavioral data. The study population was stratified by absence or presence of HPV DNA, as tested by PCR, as well as by lesion grade. TGFB1 signal peptide polymorphisms were genotyped using PCR-restriction fragment length polymorphism. HPV DNA was detected in 172 (49.3%) patients. c.74GC and the combined c.29CC+CT/c.74GC genotype were more frequent in infected patients (35.1 and 15.7%) than in uninfected women (6.2 and 14.7%). Accordingly, these genotypes were associated with a higher risk of HPV infection, with odds ratio and 95% confidence interval of 2.81 and 1.35-5.86 (P = 0.004) for c.74GC and 3.14 and 1.42-6.94 (P = 0.004) for the combined genotype, respectively. High-grade lesions were also 2.48 times more likely to occur in c.29CC patients than in c.29TT patients, with a 95% confidence interval of 1.01-6.08 (P = 0.047). The data demonstrate that c.74G>C and c.29C>T polymorphisms are significantly associated with risk of HPV infection and high-grade squamous intraepithelial lesions, respectively. Thus, TGFB1 signal peptide polymorphisms are potential susceptibility markers.

Note of clarification of data in the paper entitled "Interferon gamma +874 T/A polymorphism increases the risk of cervical cancer: evidence from a meta-analysis"

We read with great interest the paper entitled "Interferon gamma +874 T/A polymorphism increases the risk of cervical cancer: evidence from a meta-analysis" published online by Sun et al. Their results suggest that interferon gamma ( IFNG) gene +874 T/A polymorphism might contribute to women's susceptibility to cervical cancer. They also found that IFNG +874 T/A polymorphism is associated with increased cervical cancer risk in Asian female population. The result is encouraging. Nevertheless, several key issues are worth noticing. We re-evaluate the association between IFNG +874 T/A polymorphism and cervical cancer risk by performing an updated meta-analysis based on 2777 cases and 2542 controls of 11 studies. We found that IFNG +874 T/A polymorphism was not significantly associated with cervical cancer risk in overall population. We also observed that the polymorphism was associated with enhanced cervical cancer risk in Asian population and was relevant to increased squamous cell cervical cancer risk.

Cervical Carcinogenesis and Immune Response Gene Polymorphisms: A Review

The local immune response is considered a key determinant in cervical carcinogenesis after persistent infection with oncogenic, high-risk human papillomavirus (HPV) infections. Genetic variation in various immune response genes has been shown to influence risk of developing cervical cancer, as well as progression and survival among cervical cancer patients. We reviewed the literature on associations of immunogenetic single nucleotide polymorphism, allele, genotype, and haplotype distributions with risk and progression of cervical cancer. Studies on HLA and KIR gene polymorphisms were excluded due to the abundance on literature on that subject. We show that multiple genes and loci are associated with variation in risk of cervical cancer. Rather than one single gene being responsible for cervical carcinogenesis, we postulate that variations in the different immune response genes lead to subtle differences in the effectiveness of the antiviral and antitumour immune responses, ultimately leading to differences in risk of developing cervical cancer and progressive disease after HPV infection.

Influence of IL-6, IL-8, and TGF-β1 gene polymorphisms on the risk of human papillomavirus-infection in women from Pernambuco, Brazil

Human papillomavirus (HPV) infections are strongly associated with the development of cervical intraepithelial neoplasias and invasive cervical cancer. Polymorphisms in cytokine-encoding genes and behavioural cofactors could play an important role in protecting an individual against viral infections and cancer. Here, we investigated whether IL-6 -174 G>C, IL-8 +396 G>T, and TGF-β1 +869 G>C and +915 G>C polymorphisms were associated with susceptibility to HPV infection in women from north-east (Pernambuco) Brazil. We analysed 108 healthy uninfected women (HC) and 108 HPV-positive women with cervical lesions. Genetic polymorphisms were assessed using Sanger sequencing and polymerase chain reaction-restriction fragment length polymorphism. Comparison of the distribution of the genotypic and allelic frequencies of the IL-18 +396 T>G polymorphism between HPV infected woman an uninfected controls showed that the GG genotype and G allele were both more frequent in the HC group, and were associated with protection from HPV infection (p = 0.0015; OR = 0.29 CI95% = 0.13-0.61; p = 0.0005; OR = 0.45 CI95% 0.29-0.7, respectively). Individuals from the control group could have previously had HPV infection that was spontaneously eliminated; however, it was undetectable at the time of sample collection. Based on our findings, we hypothesize that the IL-8 +396 G>T polymorphism could interfere with susceptibility to HPV infection, by modulating the ability of immune system to fight the virus.

Circulating interleukin-10 levels and human papilloma virus and Epstein-Barr virus-associated cancers: evidence from a Mendelian randomization meta-analysis based on 11,170 subjects

Recent studies have showed interleukin 10 (IL-10) is a critical cytokine that determines antiviral immune response and is related to virus-associated cancers. However, whether genetically elevated circulating IL-10 levels are associated with the risk of human papilloma virus and Epstein–Barr virus-associated cancers (HEACs) is still unclear. Mendelian randomization method was implemented to meta-analyze available observational studies by employing IL-10 three variants (−592C>A, −819C>T, and −1082A>G) as instruments. A total of 24 articles encompassing 11,170 subjects were ultimately eligible for the meta-analysis. Overall, there was a significant association between IL-10 promoter variant −1082A>G and HEACs under allelic and dominant models (both P<0.01). Subgroup analysis by cancer type indicated that the risk estimate of −1082A>G was significant for nasopharyngeal cancer under allelic, homozygous genotypic and dominant models (all P<0.001). Moreover by ethnicity, carriers of −1082G allele had a 74% increased risk for nasopharyngeal cancer in Asians under dominant model (odds ratio [OR] =1.737; 95% confidence interval [CI]: 1.280–2.358; P<0.001). In further Mendelian randomization analysis, the predicted OR for 10 pg/mL increment in IL-10 levels was 1.14 (95% CI: 1.01–16.99) in HEACs. Our findings provided strong evidence for a critical role of genetically elevated circulating IL-10 levels in the development of HEACs, especially in Asian population and for nasopharyngeal cancer.

TNF-α -308 G/A as a risk marker of cervical cancer progression in the Polish population

BACKGROUND AND OBJECTIVE

There are inconclusive data on the tumor necrosis factor-α (TNF-α) -308 G/A (rs1800629) polymorphism as a risk factor for cervical carcinogenesis.

METHODS

Using high-resolution melting curve analysis, we investigated the prevalence of the TNF-α -308 G/A transition (rs1800629) in patients with cervical cancer (n = 362) and control subjects (n = 399).

RESULTS

The p trend value calculated for the TNF-α -308 G/A transition was statistically significant (p trend = 0.026) for all patients. Logistic regression analysis with adjustment for age demonstrated that the A/A versus G/G genotype was significantly associated with cervical tumors. The adjusted odds ratio (OR) was 1.599 (95 % confidence interval [CI] 1.017-2.513; p = 0.042). Stratification of patients on the basis of the tumor stage revealed no contribution of the TNF-α -308 G/A transition to cervical cancer in stages I and II. However, we found a significant trend for the p value, as well as the contribution of TNF-α -308 G/A to cervical cancer, in stages III and IV. The p trend value was 0.003 in this group of patients. Moreover, logistic regression analysis with adjustment for age demonstrated that the adjusted OR for A/A versus G/G was 2.014 (95 % CI 1.122-3.613; p = 0.019) and the adjusted OR for A/A or A/G versus G/G was 1.583 (95 % CI 1.025-2.444; p = 0.038) for cervical cancer in stages III and IV.

CONCLUSION

Our results indicate that the TNF-α -308 G/A transition is a risk factor for cervical cancer, particularly in stages III and IV.

Interferon gamma +874 T/A polymorphism increases the risk of cervical cancer: evidence from a meta-analysis

Data from previous studies about the association between interferon gamma (IFN-γ) +874 T/A (rs2430561) polymorphism and cervical cancer risk offer controversial results. To obtain a more dependable conclusion, this meta-analysis was performed. We selected eight articles including nine case-control studies with 1,116 cases and 1,290 controls, odds ratios (OR) with 95 % confidence intervals (CI) were used to assess the strength of the association. Subgroup analysis was carried out by ethnicity, source of controls, genotyping methods, and score of quality assessment. Our meta-analysis indicated that the IFN-γ (+874 T/A) polymorphism significantly increased the risk of cervical cancer in the codominant model (TA vs. TT: OR = 1.471, 95 % CI = 1.137-1.903, P = 0.003, I (2) % = 0.0, P Q  = 0.785) and the dominant model (TA + AA vs. TT: OR = 1.399, 95 % CI = 1.097-1.784, P = 0.007, I (2) % = 0.0, P Q  = 0.486) in the overall population. Stratified analysis by ethnicity indicated a significantly increased risk of cervical cancer in Asians in the codominant model (TA vs. TT: OR = 1.494, 95 % CI = 1.069-2.087, P = 0.019, I (2) % = 0.0, P Q  = 0.440) and the dominant model (OR = 1.455, 95 % CI = 1.062-1.993, P = 0.019, I (2) % = 42.9, P Q  = 0.154). Thus, the IFN-γ (+874 T/A) polymorphism is likely to increase the risk of cervical cancer. Because of the limited studies and sample sizes included in our meta-analysis, further well-designed and large-scale studies are demanded to confirm our results.

Tumor necrosis factor alpha rs1800629 polymorphism and risk of cervical lesions: a meta-analysis

Background

Tumor necrosis factor- alpha (TNF-α) is an inflammatory cytokine which may play important role on the immune response may control the progression of cervical lesions. There is a possible association between TNF-α rs1800629 G/A polymorphism and cervical lesions, but previous studies report conflicting results. We performed a meta-analysis to comprehensively assess the association between TNF-α rs1800629 polymorphism and cervical lesions risk.

Methods

Literature searches of Pubmed, Embase, Web of Science, and Wanfang databases were performed for all publications on the association between TNF-α rs1800629 polymorphism and cervical lesions through December 15, 2012. The pooled odds ratios (ORs) with their 95% confidence interval (95%CIs) were calculated to assess the strength of the association.

Results

Twenty individual case-control studies from 19 publications with a total of 4,146 cases and 4,731 controls were finally included into the meta-analysis. Overall, TNF-α rs1800629 polymorphism was significantly associated with increased risk of cervical lesions under two main genetic comparison models (For A versus G: OR 1.22, 95%CI 1.04–1.44, P = 0.017; for AA versus GG: OR 1.32, 95%CI 1.02–1.71, P = 0.034). Subgroup analysis by ethnicity further showed that there was a significant association between TNF-α rs1800629 polymorphism and increased risk of cervical lesions in Caucasians but not in Asians. Subgroup analysis by the types of cervical lesions showed that there was a significant association between TNF-α rs1800629 polymorphism and increased risk of cervical cancer (For A versus G: OR 1.24, 95%CI 1.05–1.47, P = 0.011; for AA versus GG: OR 1.31, 95%CI 1.01–1.70, P = 0.043; for AA/GA versus GG: OR 1.25, 95%CI 1.01–1.54, P = 0.039).

Conclusion

The meta-analysis suggests that TNF-α rs1800629 polymorphism is associated with increased risk of cervical lesions, especially in Caucasians.

An interleukin-10 gene polymorphism associated with the development of cervical lesions in women infected with Human Papillomavirus and using oral contraceptives

Human Papillomavirus (HPV) infection plays a crucial role in the development of cervical lesions and tumors, however most lesions containing high-risk HPVs do not progress to cervical tumors. Some studies suggest that the use of oral contraceptives may increase the risk of cervical carcinogenesis, but this has not been confirmed by all the studies. Cytokines are important molecules that act in the defense of an organism against viral infections. Several genetic studies have attempted to correlate cytokine polymorphisms with human diseases, including cancer. The significance of IL10 polymorphisms for cancer is that they have both immunosuppressive and antiangiogenic properties. We aimed to investigate the role of promoter polymorphisms in the IL10 gene in women with cervical lesions associated with HPV infection, in the presence of the use of oral contraceptives. Using High Resolution Melt analysis (HRM), we analyzed an SNP -1082A/G and -819C/T in interleukin-10 promoter region in 364 Brazilian women: 171 with cervical lesions and HPV infection, and 193 with normal cytological results and HPV-negative. We observed no significant differences in genotype and allele frequencies in the two loci between patients and healthy controls. Furthermore, in the haplotype analysis of IL10, we found that CA haplotype was significantly more frequent in patients infected with HPV than in the control group (p = 0.0188). We did not find any genotype and allelic association of the IL10 gene polymorphisms between cases and controls. However, in this study, when the HPV-positive patients were stratified according to their use of contraceptives, we found a significant association between the -1082G allele (p = 0.0162) and -1082GG genotype (p = 0.0332) among HPV-infected patients who used oral contraceptives. Our findings suggest that -1082A/G gene polymorphism represents a greater susceptibility to progressive cervical lesions in HPV- infected women who use oral contraceptives.

Interleukin 10 Polymorphisms and Cervical Cancer Risk: A Meta-Analysis

Background

A debate exists about whether interleukin 10 (IL-10) polymorphisms (IL-10−1082G/A and IL-10−592C/A) confer additional risk for cervical cancer. To derive a more precise estimation of the relationship between IL-10 polymorphisms and cervical cancer risk, we conducted a meta-analysis of all available studies relating the −1082G/A and −592C/A polymorphisms of the IL-10 gene to the risk of developing cervical cancer.

Methods

Eight studies were eligible for IL-10 −1082G/A (1498 cases and 1608 controls), and 5 studies were eligible for IL-10 −592C/A (2396 cases and 1388 controls). Pooled odds ratios (ORs) were appropriately derived from fixed-effects or random-effects models. Subgroup analyses were performed by ethnicity and Hardy-Weinberg equilibrium in the controls.

Results

In the overall analysis, no significant association between the IL-10−1082G/A polymorphism and the risk of cervical cancer was observed. In the subgroup analysis by ethnicity, IL-10 −1082A allele was associated with decreased cervical cancer susceptibility among whites (A vs G: OR, 0.39; 95% confidence interval [CI], 0.32–0.47). Studies with controls deviated from Hardy-Weinberg equilibrium showed an evident association in dominant model (GA/AA vs GG: OR, 1.73 [95% CI, 1.04–2.89]). On the other hand, with respect to −592C/A polymorphism, significantly elevated cervical cancer risk was found in the overall analysis (A vs C: OR, 1.16 [95% CI, 1.04–1.31]; AA vs CC: OR, 1.36 [95% CI, 1.00–1.84]; CA/AA vs CC: OR, 1.18 [95% CI, 1.01–1.39]; AA vs CC/CA: OR, 1.25 [95% CI, 1.01–1.55]). Stratified analysis indicated that significantly increased risks were also found among Asians in the allelic model (A vs C: OR, 1.23 [95% CI, 1.01–1.49]).

Conclusions

Interleukin 10−1082 G/A polymorphism showed no effect on cervical cancer risk in the overall analysis. The genetic polymorphism in IL-10−592C/A is a risk factor for developing cervical cancer, especially for Asians.