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Tripathi G, Khanolkar RA, Faridi RM, Kalra A, Dharmani-Khan P, Shabani-Rad MT, Berka N, Daly A, Storek J, Khan FM. Donor Genetic Predisposition to High Interleukin-10 Production Appears Protective against Acute Graft-Versus-Host Disease. Int J Mol Sci 2022; 23:ijms232415888. [PMID: 36555525 PMCID: PMC9779827 DOI: 10.3390/ijms232415888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
The persistence of graft-versus-host disease (GVHD) as the principal complication of allogeneic hematopoietic cell transplantation (HCT) demonstrates that HLA matching alone is insufficient to prevent alloreactivity. We performed molecular and functional characterization of 22 candidate cytokine genes for their potential to improve matching in 315 myeloablative, 10/10 HLA-matched donor−recipient pairs. Recipients of a graft carrying the -1082GG IL10 gene promoter region variant had a three-fold lower incidence of grade II−IV acute GVHD compared to IL10-1082AA graft recipients (SHR = 0.25, p = 0.005). This was most evident in matched unrelated donor (MUD) transplants, where the greatest alloreactivity is expected. IL10-1082GG transplants did not experience an increased incidence of relapse, and, consequently, overall survival was two-fold higher in IL10-1082GG MUD transplants (HR = 0.17, p = 0.023). Longitudinal post-transplant measurements demonstrated that -1082GG is a high-IL10-producing and -expressing genotype with attenuated CD8+ T-cell reconstitution. High post-transplant donor chimerism in T- and myeloid-cells (>95%) confirmed a predominant donor, rather than recipient, genotype effect on immune function and aGVHD. To date, this is the first study to report corroborating genome-to-cellular evidence for a non-HLA donor immunogenetic variant that appears to be protective against GVHD. The incorporation of IL10 variants in donor selection criteria and clinical-management decisions has the potential to improve patient outcomes.
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Affiliation(s)
- Gaurav Tripathi
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Pathology and Laboratory Medicine, Calgary, AB T2L 1N4, Canada
- Alberta Precision Laboratories, Calgary, AB T2L 2K8, Canada
| | - Rutvij A. Khanolkar
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Rehan M. Faridi
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Pathology and Laboratory Medicine, Calgary, AB T2L 1N4, Canada
- Alberta Precision Laboratories, Calgary, AB T2L 2K8, Canada
| | - Amit Kalra
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Pathology and Laboratory Medicine, Calgary, AB T2L 1N4, Canada
| | - Poonam Dharmani-Khan
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Pathology and Laboratory Medicine, Calgary, AB T2L 1N4, Canada
- Alberta Precision Laboratories, Calgary, AB T2L 2K8, Canada
| | - Meer-Taher Shabani-Rad
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Pathology and Laboratory Medicine, Calgary, AB T2L 1N4, Canada
- Alberta Precision Laboratories, Calgary, AB T2L 2K8, Canada
| | - Noureddine Berka
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Pathology and Laboratory Medicine, Calgary, AB T2L 1N4, Canada
- Alberta Precision Laboratories, Calgary, AB T2L 2K8, Canada
| | - Andrew Daly
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Alberta Health Services, Calgary, AB T2N 4L7, Canada
| | - Jan Storek
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Alberta Health Services, Calgary, AB T2N 4L7, Canada
| | - Faisal M. Khan
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Pathology and Laboratory Medicine, Calgary, AB T2L 1N4, Canada
- Alberta Precision Laboratories, Calgary, AB T2L 2K8, Canada
- Correspondence: ; Tel.: +1-403-220-7671; Fax: +1-403-210-8176
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Granero Farias M, Andrade Dos Santos C, de Mello Vicente B, Habigzang M, de Oliveira da Silva P, Emerim Lemos N, Dieter C, Paz A, Esteves Daudt L. The effects of gene polymorphisms on susceptibility to acute GVHD and survival of allogeneic HSCT recipients: IL-10 gene polymorphisms as a more accessible target to predict prognosis. Hum Immunol 2019; 81:18-25. [PMID: 31889553 DOI: 10.1016/j.humimm.2019.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/28/2019] [Accepted: 12/05/2019] [Indexed: 12/30/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a therapeutic modality commonly used to treat hematological and immunological disorders. Among the main complications of allo-HSCT is the acute graft-versus-host disease (a-GVHD), a condition which accounts for a high incidence of mortality. Several genes encoding inflammatory mediators may present polymorphisms, which have been implicated in the risk of developing a-GVHD. In our study, we investigated the association between genotypes of cytokine-encoding genes and the incidence and severity of a-GVHD and survival of HSCT recipients. No statistically significant association was found between IL and 6-174 G/C, INF-γ + 874 T/A, TNF-α -238 A/G, -308 A/G and IL-10-819C/T, -592 A/C polymorphisms and the presence or severity of a-GVHD. A higher risk of a-GVHD was associated with the IL-10-1082 GG genotype compared to the AA + AG genotypes of recipients and donors. The IL-10-1082 genotype can be used as a prognostic determinant to predict which HSCT recipient will be more responsive to the transplant. Thus, cytokine gene assays may be useful in the individualization of prophylactic regimens and for an appropriate selection of immunosuppressants based on the HSCT recipient's responsiveness.
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Affiliation(s)
- Mariela Granero Farias
- Graduate Program in Child and Adolescent Health, Federal University of Rio Grande, do Sul/UFRGS, Brazil; Hospital de Clínicas de Porto Alegre/HCPA, Brazil.
| | | | | | | | | | | | | | | | - Liane Esteves Daudt
- Graduate Program in Child and Adolescent Health, Federal University of Rio Grande, do Sul/UFRGS, Brazil; Hospital de Clínicas de Porto Alegre/HCPA, Brazil; Federal University of Rio Grande do Sul/UFRGS, Brazil
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3
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Zhang P, Hill GR. Interleukin-10 mediated immune regulation after stem cell transplantation: Mechanisms and implications for therapeutic intervention. Semin Immunol 2019; 44:101322. [PMID: 31640914 DOI: 10.1016/j.smim.2019.101322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/08/2019] [Indexed: 12/23/2022]
Abstract
Interleukin-10 (IL-10) is a multi-faceted anti-inflammatory cytokine which plays an essential role in immune tolerance. Indeed, deficiency of IL-10 or its receptor results in aberrant immune responses that lead to immunopathology. Graft-versus-host disease (GVHD) is the limiting complication of allogeneic stem cell transplantation (SCT) and results from an imbalance in pathological versus regulatory immune networks. A number of immune cells exert their immunomodulatory role through secretion of IL-10 or induction of IL-10-secreting cells after SCT. Type-1 regulatory T cells (Tr1 cells) and FoxP3+ regulatory T cells (Tregs) are predominant sources of IL-10 after SCT and the critical role of this cytokine in preventing GVHD is now established. Recently, intriguing interactions among IL-10, immune cells, commensal microbes and host tissues in the gastrointestinal (GI) tract and other barrier surfaces have been uncovered. We now understand that IL-10 secretion is dynamically modulated by the availability of antigen, co-stimulatory signals, cytokines, commensal microbes and their metabolites in the microenvironment. In this review, we provide an overview of the control of IL-10 secretion and signaling after SCT and the therapeutic interventions, with a focus on Tr1 cells.
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Affiliation(s)
- Ping Zhang
- Bone Marrow Transplantation Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, 4006, Australia.
| | - Geoffrey R Hill
- Bone Marrow Transplantation Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, 4006, Australia; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; Division of Medical Oncology, The University of Washington, Seattle, WA 98109, USA.
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4
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Allam G, Nasr A, Talaat IM, Abuelsaad ASA, Bakheit AM, Nemenqani D, Alsulaimani AA. Association between cytokine genes polymorphisms and type 1 diabetes: a case-control study on Saudi population. Immunol Invest 2017; 47:229-240. [DOI: 10.1080/08820139.2017.1416398] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Gamal Allam
- Department of Microbiology and Immunology, College of Medicine, Taif University , Taif, Saudi Arabia
- Immunology Section, Department of Zoology, Faculty of Science, Beni-Suef University , Beni-Suef, Egypt
| | - Amre Nasr
- Department of Basic Medical Sciences, College of Medicine, KSAU-HS , Riyadh, Saudi Arabia
- Department of Microbiology, Faculty of Science and Technology, Al-Neelain University , Khartoum, Sudan
| | - Iman M. Talaat
- Department of Pediatrics, Faculty of Medicine, Ain Shams University , Cairo, Egypt
| | - Abdelaziz S. A. Abuelsaad
- Department of Microbiology and Immunology, College of Medicine, Taif University , Taif, Saudi Arabia
- Immunology Section, Department of Zoology, Faculty of Science, Beni-Suef University , Beni-Suef, Egypt
| | - Ali M. Bakheit
- Department of Community Medicine, College of Medicine, Taif University , Taif, Saudi Arabia
| | - Dalal Nemenqani
- Department of Pathology, College of Medicine, Taif University , Taif, Saudi Arabia
| | - Adnan A. Alsulaimani
- Department of Pediatrics, College of Medicine, Taif University , Taif, Saudi Arabia
- Diabetic Center , Department of Pediatrics, Prince Mansour Military Community Hospital, Taif, Saudi Arabia
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Hyvärinen K, Ritari J, Koskela S, Niittyvuopio R, Nihtinen A, Volin L, Gallardo D, Partanen J. Genetic polymorphism related to monocyte-macrophage function is associated with graft-versus-host disease. Sci Rep 2017; 7:15666. [PMID: 29142307 PMCID: PMC5688060 DOI: 10.1038/s41598-017-15915-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 11/03/2017] [Indexed: 12/01/2022] Open
Abstract
Despite detailed human leukocyte antigen (HLA) matching and modern immunosuppressive therapy, severe graft-versus-host disease (GvHD) remains a major hurdle for successful allogeneic hematopoietic stem cell transplantation (HSCT). As the genetic diversity in GvHD complicates the systematic discovery of associated variants across populations, we studied 122 GvHD-associated single nucleotide polymorphisms (SNPs) in 492 HLA-matched sibling HSCT donor-recipient pairs from Finland and Spain. The association between these candidate SNPs and grade III–IV acute GvHD and extensive chronic GvHD was assessed. The functional effects of the variants were determined using expression and cytokine quantitative trait loci (QTL) database analyses. Clear heterogeneity was observed in the associated markers between the two populations. Interestingly, the majority of markers, such as those annotated to IL1, IL23R, TLR9, TNF, and NOD2 genes, are related to the immunological response by monocytes-macrophages to microbes, a step that precedes GvHD as a result of intestinal lesions. Furthermore, cytokine QTL analysis showed that the GvHD-associated markers regulate IL1β, IFNγ, and IL6 responses. These results support a crucial role for the anti-microbial response in GvHD risk. Furthermore, despite apparent heterogeneity in the genetic markers associated with GvHD, it was possible to identify a biological pathway shared by most markers in both populations.
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Affiliation(s)
| | - Jarmo Ritari
- Finnish Red Cross Blood Service, Helsinki, Finland
| | - Satu Koskela
- Finnish Red Cross Blood Service, Helsinki, Finland
| | - Riitta Niittyvuopio
- Helsinki University Hospital, Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland
| | - Anne Nihtinen
- Helsinki University Hospital, Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland
| | - Liisa Volin
- Helsinki University Hospital, Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland
| | - David Gallardo
- Department of Hematology, Institut Català d'Oncologia, Hospital Dr. Josep Trueta, Girona, Spain
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Replication of associations between genetic polymorphisms and chronic graft-versus-host disease. Blood 2016; 128:2450-2456. [PMID: 27758874 DOI: 10.1182/blood-2016-07-728063] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 09/20/2016] [Indexed: 12/27/2022] Open
Abstract
Previous studies have identified single-nucleotide polymorphisms (SNPs) associated with the risk of chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic cell transplantation. The current study determined whether these associations could be replicated in large cohorts of donors and recipients. Each SNP was tested with cohorts of patients having the same donor type (HLA-matched related, unrelated, or both) reported in the original publication, and testing was limited to the same genome (recipient or donor) and genetic model (dominant, recessive, or allelic) reported in the original study. The 21 SNPs reported in this study represent 19 genes, and the analysis encompassed 22 SNP association tests. The hazard ratio (HR) point estimates and risk ratio point estimates corresponding to odds ratios in previous studies consistently fall outside the 95% confidence intervals of HR estimates in the current study. Despite the large size of the cohorts available for the current study, the 95% confidence intervals for most HRs did not exclude 1.0. Three SNPs representing CTLA4, HPSE, and IL1R1 showed evidence of association with the risk of chronic GVHD in unrelated donor-recipient pairs from 1 cohort, but none of these associations was replicated when tested in unrelated donor-recipient pairs from an independent cohort. Two SNPs representing CCR6 and FGFR1OP showed possible associations with the risk of chronic GVHD in related donor-recipient pairs but not in unrelated donor-recipient pairs. These results remain to be tested for replication in other cohorts of related donor-recipient pairs.
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Kasamatsu T, Saitoh T, Ino R, Gotoh N, Mitsui T, Shimizu H, Matsumoto M, Sawamura M, Yokohama A, Handa H, Tsukamoto N, Murakami H. Polymorphism of IL-10 receptor β affects the prognosis of multiple myeloma patients treated with thalidomide and/or bortezomib. Hematol Oncol 2016; 35:711-718. [PMID: 27405747 DOI: 10.1002/hon.2322] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/02/2016] [Accepted: 05/27/2016] [Indexed: 11/09/2022]
Abstract
Interleukin-10 (IL-10) and IL-10 receptor (IL-10R) single nucleotide polymorphisms have been implicated in the pathogenesis of many cancers. We investigated the influence of IL-10 -592C/A, IL-10RA I224V, and IL-10RB K47E on the risk of developing multiple myeloma (MM) and the clinical features of MM. We extracted the genomic DNA from 128 MM patients and 202 healthy controls and used polymerase chain reaction-restriction fragment length polymorphism method to detect IL-10 promoter -592C/A (rs1800872), IL-10RA (rs2228055), and IL-10RB K47E (rs2834167) genotypes. Overall survival (OS) was defined as the interval from the date of diagnosis to the date of death or last clinical appointment. No statistically significant difference was observed in the genotype and allele frequencies of IL-10 -592C/A, IL-10RA I224V, and IL-10RB K47E between MM patients and healthy controls. IL-10RA II genotype was significantly associated with a hemoglobin level lower than that of IV and VV genotypes (mean ± standard deviation, 9.21 ± 2.46 vs 10.3 ± 2.33 g/dL; P = .021). IL-10 -592 AA genotype was significantly associated with OS better than that of CA and CC genotypes (median OS, 74.5 vs 46.3 months; P = .047). We observed significant differences in survival between patients treated with thalidomide and/or bortezomib and those treated with conventional treatments (median OS, 74.5 vs 38.2 months; P = .021). Therefore, we also examined the effect of IL-10 and IL-10R polymorphisms on the clinical variables and OS of patients treated with thalidomide and/or bortezomib. In addition, IL-10RB EE genotype was significantly associated with poorer survival than KK and KE genotypes (median OS, 46.3 vs 78.8 months; P = .015). Our findings indicate that IL-10 and IL-10R gene polymorphisms may not contribute to the susceptibility to MM but may be associated with the severity and prognosis of MM. In particular, IL-10RB K47E polymorphism may contribute to the poor prognosis of MM patients treated with thalidomide and/or bortezomib.
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Affiliation(s)
- Tetsuhiro Kasamatsu
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
| | - Takayuki Saitoh
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
| | - Rumi Ino
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
| | - Nanami Gotoh
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
| | - Takeki Mitsui
- Department of Medicine and Clinical Science, Gunma University, Maebashi, Gunma, Japan
| | - Hiroaki Shimizu
- Department of Medicine and Clinical Science, Gunma University, Maebashi, Gunma, Japan
| | - Morio Matsumoto
- National Hospital Organization, Nishigunma National Hospital, Shibukawa, Gunma, Japan
| | - Morio Sawamura
- National Hospital Organization, Nishigunma National Hospital, Shibukawa, Gunma, Japan
| | - Akihiko Yokohama
- Blood Transfusion Service, Gunma University Hospital, Maebashi, Gunma, Japan
| | - Hiroshi Handa
- Department of Medicine and Clinical Science, Gunma University, Maebashi, Gunma, Japan
| | | | - Hirokazu Murakami
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
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Yang ZL, Qiu QC, Ding ZX, Pan ZJ, Zhao QQ, He J. [Effects of IL10-592 locus of AA genotype on the incidence of aGVHD and survival after HLA-matched unrelated allogeneic hematopoietic stem cell transplantation]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2016; 37:372-6. [PMID: 27210870 PMCID: PMC7348318 DOI: 10.3760/cma.j.issn.0253-2727.2016.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore the impact of IL10-592 (rs1800872) single nucleic acid polymorphism (SNP) on the prognosis of HLA matched unrelated hematopoietic stem cell transplantation (HSCT). METHODS The polymorphism of IL10-592 in 104 recipient-donor pairs and 100 healthy volunteers was analyzed with sequence based typing (SBT). RESULTS When the genotype of IL10-592 in donors and recipients matched, AA/AA genotype had higher incidence of Ⅲ-Ⅳ aGVHD than AC/AC or CC/CC genotype (47.1%, 3.7%, 0, P=0.002). When the genotype of IL10-592 in donors and recipients mismatched, recipients with AC genotype or donors with AA genotype, there was significant different incidence of Ⅲ-ⅣaGVHD among donors or recipients with different genotype (P=0.046, P=0.041). The recipients with AA genotype had higher incidence of Ⅲ-Ⅳ aGVHD than AC or CC genotype (27.8% vs 10.2%, 11.1%; P=0.072), and higher incidence of intestinal aGVHD (22.2% vs 5.1%,11.1%; P=0.040) , lower incidence of 2-year overall survival (OS: 48.2% vs 75.1%, 85.7%; P=0.002), lower incidence of 2 year disease free survival (DFS: 48.5% vs 66.3%, 76.2%; P=0.045). Patients had higher incidence of Ⅲ-Ⅳ aGVHD with donors of AA genotype than with donors of AC or CC genotype (26.5% vs 8.9%, 0; P= 0.024), and higher incidence of intestinal aGVHD (20.4% vs 4.4%, 0; P=0.026). In multivariate analysis, the genotype of IL10-592AA in recipients and donors had increased risk of Ⅲ-Ⅳ aGVHD (OR=3.3, P= 0.049; OR=3.9, P=0.043). There were no statistical differences on the incidence of cGVHD and relapse. CONCLUSION In HLA-10/10 matched unrelated HSCT, the presence of IL10-592 AA genotype in recipients and/or donors is an adverse factor for Ⅲ-ⅣaGVHD, worse OS and 2-year DFS.
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Affiliation(s)
- Z L Yang
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Suzhou 215006, China
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Gan G, Leong Y, Bee P, Chin E, Abdul Halim H, Nadarajan V, Teh A. Influence of genetic polymorphisms of cytokine genes in the outcome of HLA-matched allogeneic stem cell transplantation in a South East Asian population. Cytokine 2016; 78:55-61. [DOI: 10.1016/j.cyto.2015.11.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 11/14/2015] [Accepted: 11/22/2015] [Indexed: 11/24/2022]
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Paczesny S, Hakim FT, Pidala J, Cooke KR, Lathrop J, Griffith LM, Hansen J, Jagasia M, Miklos D, Pavletic S, Parkman R, Russek-Cohen E, Flowers MED, Lee S, Martin P, Vogelsang G, Walton M, Schultz KR. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: III. The 2014 Biomarker Working Group Report. Biol Blood Marrow Transplant 2015; 21:780-92. [PMID: 25644957 DOI: 10.1016/j.bbmt.2015.01.003] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 01/07/2015] [Indexed: 01/11/2023]
Abstract
Biology-based markers to confirm or aid in the diagnosis or prognosis of chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic cell transplantation or monitor its progression are critically needed to facilitate evaluation of new therapies. Biomarkers have been defined as any characteristic that is objectively measured and evaluated as an indicator of a normal biological or pathogenic process, or of a pharmacologic response to a therapeutic intervention. Applications of biomarkers in chronic GVHD clinical trials or patient management include the following: (1) diagnosis and assessment of chronic GVHD disease activity, including distinguishing irreversible damage from continued disease activity; (2) prognostic risk to develop chronic GVHD; and (3) prediction of response to therapy. Sample collection for chronic GVHD biomarkers studies should be well documented following established quality control guidelines for sample acquisition, processing, preservation, and testing, at intervals that are both calendar and event driven. The consistent therapeutic treatment of subjects and standardized documentation needed to support biomarker studies are most likely to be provided in prospective clinical trials. To date, no chronic GVHD biomarkers have been qualified for use in clinical applications. Since our previous chronic GVHD Biomarkers Working Group report in 2005, an increasing number of chronic GVHD candidate biomarkers are available for further investigation. This paper provides a 4-part framework for biomarker investigations: identification, verification, qualification, and application with terminology based on Food and Drug Administration and European Medicines Agency guidelines.
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Affiliation(s)
- Sophie Paczesny
- Department of Pediatrics and Immunology, Indiana University of Medicine, Indianapolis, Indiana.
| | - Frances T Hakim
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Joseph Pidala
- Blood and Marrow Transplantation, Moffitt Cancer Center, Tampa, Florida
| | - Kenneth R Cooke
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Julia Lathrop
- Office of In Vitro Diagnostics and Radiological Health, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland
| | - Linda M Griffith
- Division of Allergy, Immunology and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - John Hansen
- Clinical Research Division, Fred Hutchinson Cancer Research Center, and the Division of Medical Oncology, University of Washington School of Medicine, Seattle, Washington
| | - Madan Jagasia
- Department of Medicine, Division of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - David Miklos
- Stanford Bone Marrow Transplant-Cellular Therapy Facility, Stanford University, Stanford, California
| | - Steven Pavletic
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Robertson Parkman
- Department of Pediatrics, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, California
| | - Estelle Russek-Cohen
- Division of Biostatistics, Center for Biologics, Food and Drug Administration, Silver Spring, Maryland
| | - Mary E D Flowers
- Clinical Research Division, Fred Hutchinson Cancer Research Center, and the Division of Medical Oncology, University of Washington School of Medicine, Seattle, Washington
| | - Stephanie Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, and the Division of Medical Oncology, University of Washington School of Medicine, Seattle, Washington
| | - Paul Martin
- Clinical Research Division, Fred Hutchinson Cancer Research Center, and the Division of Medical Oncology, University of Washington School of Medicine, Seattle, Washington
| | - Georgia Vogelsang
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Marc Walton
- Office of Translational Sciences, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | - Kirk R Schultz
- Michael Cuccione Childhood Cancer Research Program, BC Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
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11
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Toor AA, Kobulnicky JD, Salman S, Roberts CH, Jameson-Lee M, Meier J, Scalora A, Sheth N, Koparde V, Serrano M, Buck GA, Clark WB, McCarty JM, Chung HM, Manjili MH, Sabo RT, Neale MC. Stem cell transplantation as a dynamical system: are clinical outcomes deterministic? Front Immunol 2014; 5:613. [PMID: 25520720 PMCID: PMC4253954 DOI: 10.3389/fimmu.2014.00613] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 11/14/2014] [Indexed: 12/22/2022] Open
Abstract
Outcomes in stem cell transplantation (SCT) are modeled using probability theory. However, the clinical course following SCT appears to demonstrate many characteristics of dynamical systems, especially when outcomes are considered in the context of immune reconstitution. Dynamical systems tend to evolve over time according to mathematically determined rules. Characteristically, the future states of the system are predicated on the states preceding them, and there is sensitivity to initial conditions. In SCT, the interaction between donor T cells and the recipient may be considered as such a system in which, graft source, conditioning, and early immunosuppression profoundly influence immune reconstitution over time. This eventually determines clinical outcomes, either the emergence of tolerance or the development of graft versus host disease. In this paper, parallels between SCT and dynamical systems are explored and a conceptual framework for developing mathematical models to understand disparate transplant outcomes is proposed.
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Affiliation(s)
- Amir A Toor
- Stem Cell Transplant Program, Department of Internal Medicine, Massey Cancer Center, Virginia Commonwealth University , Richmond, VA , USA
| | - Jared D Kobulnicky
- Stem Cell Transplant Program, Department of Internal Medicine, Massey Cancer Center, Virginia Commonwealth University , Richmond, VA , USA
| | - Salman Salman
- Stem Cell Transplant Program, Department of Internal Medicine, Massey Cancer Center, Virginia Commonwealth University , Richmond, VA , USA
| | - Catherine H Roberts
- Stem Cell Transplant Program, Department of Internal Medicine, Massey Cancer Center, Virginia Commonwealth University , Richmond, VA , USA
| | - Max Jameson-Lee
- Stem Cell Transplant Program, Department of Internal Medicine, Massey Cancer Center, Virginia Commonwealth University , Richmond, VA , USA
| | - Jeremy Meier
- Stem Cell Transplant Program, Department of Internal Medicine, Massey Cancer Center, Virginia Commonwealth University , Richmond, VA , USA
| | - Allison Scalora
- Stem Cell Transplant Program, Department of Internal Medicine, Massey Cancer Center, Virginia Commonwealth University , Richmond, VA , USA
| | - Nihar Sheth
- Center for the Study of Biological Complexity, Virginia Commonwealth University , Richmond, VA , USA
| | - Vishal Koparde
- Center for the Study of Biological Complexity, Virginia Commonwealth University , Richmond, VA , USA
| | - Myrna Serrano
- Center for the Study of Biological Complexity, Virginia Commonwealth University , Richmond, VA , USA
| | - Gregory A Buck
- Center for the Study of Biological Complexity, Virginia Commonwealth University , Richmond, VA , USA
| | - William B Clark
- Stem Cell Transplant Program, Department of Internal Medicine, Massey Cancer Center, Virginia Commonwealth University , Richmond, VA , USA
| | - John M McCarty
- Stem Cell Transplant Program, Department of Internal Medicine, Massey Cancer Center, Virginia Commonwealth University , Richmond, VA , USA
| | - Harold M Chung
- Stem Cell Transplant Program, Department of Internal Medicine, Massey Cancer Center, Virginia Commonwealth University , Richmond, VA , USA
| | - Masoud H Manjili
- Department of Microbiology and Immunology, Virginia Commonwealth University , Richmond, VA , USA
| | - Roy T Sabo
- Department of Biostatistics, Virginia Commonwealth University , Richmond, VA , USA
| | - Michael C Neale
- Department of Psychiatry and Statistical Genomics, Virginia Commonwealth University , Richmond, VA , USA
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Zhao H, Jia M, Wang Z, Cheng Y, Luo Z, Chen Y, Xu X, Yang S, Tang Y. Association between NOD2 single nucleotide polymorphisms and Grade III-IV acute graft-versus-host disease: A meta-analysis. ACTA ACUST UNITED AC 2014; 20:254-62. [PMID: 25248089 DOI: 10.1179/1607845414y.0000000202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Objectives The effects of NOD2 single nucleotide polymorphisms (SNPs) on Grade III-IV acute graft-versus-host disease (aGVHD) risk are somewhat contradictory in different studies. The aim of the meta-analysis was to clarify the effects of NOD2 SNPs on the incidence of Grade III-IV aGVHD. Methods We searched PubMed, EMBASE, Web of SCIENCE, WanFang and Chinese National Knowledge Infrastructure (CNKI) databases to collect eligible publications. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association between NOD2 polymorphisms and Grade III-IV aGVHD risk. Results A total of nine studies from eight publications met the inclusion criteria and were included in this meta-analysis. Patient NOD2 SNPs were not associated with aGVHD risk. A tendency of higher risk to develop Grade III-IV aGVHD was found in patients with pairs NOD2 SNPs. Subgroup analyses showed that pairs NOD2 SNPs were associated with Grade III-IV aGVHD in the Caucasian population and in identical sibling donors (IS), but not in matched unrelated donors (MUD). In patients who received hematopoietic stem cell transplantation (HSCT) with T-cell depletion and gut decontamination, there was still an association between pairs NOD2 SNPs and Grade III-IV aGVHD risk. Conclusions Our meta-analysis suggests that pairs NOD2 SNPs, not patient NOD2 SNPs, may be associated with Grade III-IV aGVHD risk, especially in the Caucasian population. It is also indicated that in pairs NOD2 polymorphisms group, patients who receive HSCT from IS may experience higher risk of Grade III-IV aGVHD.
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Impola U, Turpeinen H, Alakulppi N, Linjama T, Volin L, Niittyvuopio R, Partanen J, Koskela S. Donor Haplotype B of NK KIR Receptor Reduces the Relapse Risk in HLA-Identical Sibling Hematopoietic Stem Cell Transplantation of AML Patients. Front Immunol 2014; 5:405. [PMID: 25202311 PMCID: PMC4142321 DOI: 10.3389/fimmu.2014.00405] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 08/07/2014] [Indexed: 11/17/2022] Open
Abstract
Successful allogeneic hematopoietic stem cell transplantation (HSCT) depends not only on good HLA match but also on T-cell mediated graft-versus-leukemia (GvL) effect. Natural killer (NK) cells are able to kill malignant cells by receiving activation signal from the killer-cell immunoglobulin-like receptors (KIR) recognizing HLA molecules on a cancer cell. It has been recently reported that the risk of relapse in allogeneic hematopoietic stem cell transplantation (HSCT) is reduced in acute myeloid leukemia (AML) patients whose donors have several activating KIR genes or KIR B-motifs in unrelated donor setting, obviously due to enhanced GvL effect by NK cells. We studied the effect on relapse rate of donor KIR haplotypes in the HLA-identical adult sibling HSCT, done in a single center, in Helsinki University Central Hospital, Helsinki, Finland. Altogether, 134 patients with 6 different diagnoses were identified. Their donors were KIR genotyped using the Luminex and the SSP techniques. The clinical endpoint, that is, occurrence of relapse, was compared with the presence or absence of single KIR genes. Also, time from transplantation to relapse was analyzed. The patients with AML whose donors have KIR2DL2 or KIR2DS2 had statistically significantly longer relapse-free survival (P = 0.015). Our data support previous reports that donors with KIR B-haplotype defining genes have a lower occurrence of relapse in HSCT of AML patients. Determination of donor KIR haplotypes could be a useful addition for a risk assessment of HSCT especially in AML patients.
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Affiliation(s)
- Ulla Impola
- FRC Blood Service, Research and Development , Helsinki , Finland
| | - Hannu Turpeinen
- Institute of Biosciences and Medical Technology (BioMediTech), University of Tampere , Tampere , Finland
| | - Noora Alakulppi
- FRC Blood Service, Research and Development , Helsinki , Finland
| | - Tiina Linjama
- FRC Blood Service, Research and Development , Helsinki , Finland
| | - Liisa Volin
- Division of Hematology, Helsinki University Central Hospital , Helsinki , Finland
| | - Riitta Niittyvuopio
- Division of Hematology, Helsinki University Central Hospital , Helsinki , Finland
| | - Jukka Partanen
- FRC Blood Service, Research and Development , Helsinki , Finland
| | - Satu Koskela
- FRC Blood Service, Research and Development , Helsinki , Finland
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Cho IH, Song YK, Kim MG, Han N, Kim T, Oh JM. Association between interleukin-10 promoter gene polymorphisms and acute graft-versus-host disease after hematopoietic stem cell transplantation: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2014; 20:121-8. [PMID: 25116082 DOI: 10.1179/1607845414y.0000000183] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Interleukin-10 (IL-10) is an important immunomodulatory cytokine. The association between IL-10 promoter gene polymorphisms and acute graft-versus-host disease (aGVHD) risk is established; however, results of these studies remain inconclusive. We performed a meta-analysis to clarify the effects of IL-10 promoter gene polymorphisms on aGVHD risk. METHODS The authors searched MEDLINE, EMBASE, and Cochrane Library databases. Two independent authors extracted data, and the effects were estimated from an odds ratio (OR) with 95% confidence intervals (CIs). Subgroup and sensitivity analyses identified sources of heterogeneity. RESULTS Finally, a total of 11 studies encompassing 3588 recipients and 3221 donors were included to study IL-10 -1082 G > A, -819 C > T, and -592 C > A polymorphisms. IL-10 -819 CC genotype was associated with an increased aGVHD risk (grade I-IV: OR, 2.722 (95% CI, 1.360-5.450); grade II-IV: OR, 2.265 (95% CI, 1.015-5.053)). Furthermore, patients who received grafts from donors with an IL-10 -819 CC genotype experienced more frequent grade I-IV aGVHD (OR, 2.306 (95% CI, 1.168-4.551)). Recipients with IL-10 -592 CC genotypes were at increased risk for grade II-IV aGVHD (OR, 1.999 (95% CI, 1.230-3.250)). Together, this meta-analysis found that IL-10 -819 CC and -592 CC polymorphisms increased aGVHD risk. DISCUSSION AND CONCLUSION This meta-analysis found the evidence that the IL-10 -819 CC and -592 CC genotypes in both recipients and donors increased the risk of aGVHD in allogeneic hematopoietic stem cell transplantation (HSCT) patients. These results contribute towards improving patient outcome through insight and rationale for individualized treatment strategies considering genetic determinants.
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Role of non-HLA gene polymorphisms in graft-versus-host disease. Int J Hematol 2013; 98:309-18. [PMID: 23949916 DOI: 10.1007/s12185-013-1416-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 08/05/2013] [Accepted: 08/06/2013] [Indexed: 01/05/2023]
Abstract
A large number of reports have associated various non-HLA gene polymorphisms with the risk and severity of graft-versus-host disease (GVHD). To date, candidate gene studies and genome-wide association studies have been performed to investigate such non-HLA gene polymorphisms in relation to GVHD. Candidate gene studies are hypothesis-driven and cost-effective, whereas genome-wide association studies have the potential to discover new gene polymorphisms, including possible biomarkers and therapeutic targets. Some gene polymorphisms have the potential to affect protein function or gene expression, or to encode minor histocompatibility antigens. Non-HLA genotyping for genes influencing GVHD prior to transplantation should provide useful information that will facilitate choosing the donor, type of graft, conditioning treatment, and GVHD prophylaxis. However, attention should be paid to the need for validation studies and ethical issues.
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Reyes-Gibby CC, Wang J, Spitz M, Wu X, Yennurajalingam S, Shete S. Genetic variations in interleukin-8 and interleukin-10 are associated with pain, depressed mood, and fatigue in lung cancer patients. J Pain Symptom Manage 2013; 46:161-72. [PMID: 23149083 PMCID: PMC3578112 DOI: 10.1016/j.jpainsymman.2012.07.019] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 07/12/2012] [Accepted: 07/24/2012] [Indexed: 11/19/2022]
Abstract
CONTEXT A report by the National Cancer Institute identified that an important gap in symptom research is the investigation of multiple symptoms of cancer that might identify common biological mechanisms among cancer-related symptoms. OBJECTIVES We applied novel statistical methods to assess whether variants of 37 inflammation genes may serve as biologic markers of risk for severe pain, depressed mood, and fatigue in non-Hispanic white patients with non-small cell lung cancer. METHODS Pain, fatigue, and depressed mood were assessed before cancer treatment. We used a generalized, multivariate, classification tree approach to explore the influence of single-nucleotide polymorphisms in the inflammation genes in pain, depressed mood, and fatigue in lung cancer patients. RESULTS Among patients with advanced-stage disease, interleukin (IL)-8-T251A was the most relevant genetic factor for pain (odds ratio [OR] = 2.18, 95% CI = 1.34-3.55, P = 0.001), depressed mood (OR = 0.37, 95% CI = 0.14-1.0), and fatigue (OR = 2.07, 95% CI = 1.16-3.70). Among those with early-stage non-small cell lung cancer, variants in the IL-10 receptor were relevant for fatigue among women. Specifically, women with Lys_Glu or Glu_Glu genotype in the IL-10 gene had a 0.49 times lower risk of severe fatigue compared with those with Lys_Lys genotype (OR = 0.49, 95% CI = 0.25-0.92, P = 0.027). Among men with early-stage lung cancer, a marginal significance was observed for IL-1A C-889T, C/T, or T/T genotypes. These men had a lower risk of severe fatigue compared with those with C/C genotype (OR = 0.38, 95% CI = 0.13-1.06). CONCLUSION The interaction of multiple inflammation genes, along with nongenetic factors, underlies the occurrence of symptoms. IL-8 and IL-10 may serve as potential targets for treating multiple symptoms of cancer.
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Affiliation(s)
- Cielito C Reyes-Gibby
- Department of Emergency Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
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Biologic markers of chronic GVHD. Bone Marrow Transplant 2013; 49:324-31. [PMID: 23872737 DOI: 10.1038/bmt.2013.97] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 05/30/2013] [Accepted: 06/11/2013] [Indexed: 12/13/2022]
Abstract
Biologic markers of chronic GVHD may provide insight into the pathogenesis of the syndrome, identify molecular targets for novel interventions, and facilitate advances in clinical management. Despite extensive work performed to date largely focused on prediction and diagnosis of the syndrome, little synthesis of findings and validation of promising candidate markers in independent populations has been performed. Studies suggest that risk for subsequent chronic GVHD development may be associated with donor-recipient genetic polymorphism, deficiency in regulatory immune cell populations (NK, Treg, DC2), and variation in inflammatory and immunoregulatory mediators post-HCT (increased TNFα, IL-10 and BAFF, and decreased TGFβ and IL-15). Established chronic GVHD is associated with alteration in immune cell populations (increased CD3(+) T cells, Th17, CD4(+) and CD8(+) effector memory cells, monocytes, CD86 expression, BAFF/B cell ratio, and deficiency of Treg, NK cells, and naïve CD8(+) T cells). Inflammatory and immunomodulatory factors (TNFα, IL-6, IL-1β, IL-8, sIL-2R, and IL-1Ra, BAFF, anti-dsDNA, sIL-2Rα, and sCD13) are also perturbed. Little is known about biologic markers of chronic GVHD phenotype and severity, response to therapy, and prognosis.
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IL-10 promoter polymorphism associated with decreased risk of aGvHD after stem cell transplantation: a meta-analysis. Int J Hematol 2013; 98:102-11. [DOI: 10.1007/s12185-013-1363-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 05/05/2013] [Accepted: 05/07/2013] [Indexed: 01/01/2023]
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Luo Y, Gong Y, Yu Y. Interleukin-10 gene promoter polymorphisms are associated with cyclosporin A-induced gingival overgrowth in renal transplant patients. Arch Oral Biol 2013; 58:1199-207. [PMID: 23643609 DOI: 10.1016/j.archoralbio.2013.03.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 01/23/2013] [Accepted: 03/20/2013] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Interleukin-10 (IL-10) is an anti-inflammatory cytokine whose genetic polymorphisms are associated with the production of IL-10 and the susceptibility to periodontal diseases. The aim of this study was to investigate the possible association of IL-10 single nucleotide polymorphisms (SNPs) and cyclosporin A (CsA)-induced gingival overgrowth (GO) in renal transplant patients in a Chinese population, taking into account subgingival microbiota as additional variables. MATERIAL AND METHODS A total of 202 patients were dichotomized into two groups: 122 with GO and 80 without GO. The IL-10-1082 SNP, -819 SNP and -592 SNP were measured using an allele-specific PCR method. The levels of subgingival bacteria were measured by real-time PCR. Genotype and allele frequencies were analyzed using the Chi-square test and logistic regression analysis. RESULTS The frequency of IL-10-819TT (-592AA) genotype was statistically higher in patients with GO than that in patients without GO (P<0.05). Multiple logistic regression analysis demonstrated that the prevalence of GO is not dependent on age, gender, and pharmacological variables, being significantly associated with the carriers of ATA haplotype (OR=2.425, 95%CI=1.214-4.845, P=0.012). Moreover, ATA positive carriers in the GO group presented significantly higher levels of Porphyromonas gingivalis and Treponema denticola than those negative carriers. CONCLUSIONS Our results show that IL-10-819TT (-592AA) genotype and ATA halpotype are associated with susceptibility to CsA-induced GO. Meanwhile, ATA haplotype is associated with a higher detection of P. gingivalis and T. denticola in GO patients, and may increase the risk of developing GO.
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Affiliation(s)
- Yixi Luo
- Department of Stomatology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China
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20
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Expression and possible role of interleukin-10 receptors in patients with adenomyosis. Eur J Obstet Gynecol Reprod Biol 2012; 161:194-8. [DOI: 10.1016/j.ejogrb.2011.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 09/10/2011] [Accepted: 12/14/2011] [Indexed: 02/04/2023]
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Ting C, Alterovitz G, Merlob A, Abdi R. Genomic studies of GVHD-lessons learned thus far. Bone Marrow Transplant 2012; 48:4-9. [PMID: 22343675 DOI: 10.1038/bmt.2012.9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
GVHD remains the most significant complication of hematopoietic SCT, despite advances in HLA matching and the identification of risk various factors. To account for the variation in the incidence and severity of this disease, many genetic association studies have been performed in order to explore the role of immunoregulatory gene polymorphisms. These genes include those that encode cytokines, chemokines, and costimulatory molecules. Polymorphisms in other classes of genes such as those involved in drug metabolism, protein folding, and DNA replication have also been studied. In this review, we address the current knowledge of the role of genetic polymorphisms in GVHD. We also discuss the potential pitfalls inherent in genetic association testing and alternative strategies to address these problems.
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Affiliation(s)
- C Ting
- Transplantation Research Center, Renal Division, Brigham and Women's Hospital and Children's Hospital, Harvard Medical School, Boston, MA, USA
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22
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Abstract
Candidate genetic associations with acute GVHD (aGVHD) were evaluated with the use of genotyped and imputed single-nucleotide polymorphism data from genome-wide scans of 1298 allogeneic hematopoietic cell transplantation (HCT) donors and recipients. Of 40 previously reported candidate SNPs, 6 were successfully genotyped, and 10 were imputed and passed criteria for analysis. Patient and donor genotypes were assessed for association with grades IIb-IV and III-IV aGVHD, stratified by donor type, in univariate and multivariate allelic, recessive and dominant models. Use of imputed genotypes to replicate previous IL10 associations was validated. Similar to previous publications, the IL6 donor genotype for rs1800795 was associated with a 20%-50% increased risk for grade IIb-IV aGVHD after unrelated HCT in the allelic (adjusted P = .011) and recessive (adjusted P = .0013) models. The donor genotype was associated with a 60% increase in risk for grade III-IV aGVHD after related HCT (adjusted P = .028). Other associations were found for IL2, CTLA4, HPSE, and MTHFR but were inconsistent with original publications. These results illustrate the advantages of using imputed single-nucleotide polymorphism data in genetic analyses and demonstrate the importance of validation in genetic association studies.
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Abstract
Chronic graft-versus-host disease (cGVHD ) is a leading cause of allogeneic hematopoietic stem-cell transplantation-related mortality and morbidity. It is an immune-mediated disorder that can target almost any organ in the body, often with devastating consequences. The immune-suppressive medications currently used to treat it are equally toxic and are often not very effective. At this time, our understanding of its pathophysiology is limited. The discovery of potential biomarkers offers new possibilities in the clinical management of cGVHD. They could potentially be used for diagnosing cGVHD, for predicting or evaluating response to therapy and for unique insights into the pathophysiology underlying the clinical manifestations of cGVHD. Understanding the biological origins of these biomarkers can help us construct a more comprehensive and clinically relevant model for the pathogenesis of this disease. In this article, we review existing evidence for candidate biomarkers that have been identified in the framework of how they may contribute to the pathophysiology of cGVHD. Issues regarding the discovery and application of biomarkers are discussed.
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Affiliation(s)
- Jacob Rozmus
- Division of Oncology, Hematology and BMT, Department of Pediatrics, BC Children’s Hospital/University of British Columbia, Vancouver, BC, Canada
| | - Kirk R Schultz
- Division of Oncology, Hematology and BMT, Department of Pediatrics, BC Children’s Hospital/University of British Columbia, Vancouver, BC, Canada
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Hansen JA, Chien JW, Warren EH, Zhao LP, Martin PJ. Defining genetic risk for graft-versus-host disease and mortality following allogeneic hematopoietic stem cell transplantation. Curr Opin Hematol 2010; 17:483-92. [PMID: 20827186 PMCID: PMC3177530 DOI: 10.1097/moh.0b013e32833eb770] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW This review explores what is known about the genetics of hematopoietic stem cell transplantation (HCT) and how genetic polymorphism affects risk of graft-versus-host disease (GVHD) and mortality. RECENT FINDINGS Genetic variation found across the human genome can impact HCT outcome by causing genetic disparity between patient and donor and modifying gene function. Single nucleotide polymorphism (SNP) and structural variation can result in mismatching for cellular peptides known as histocompatibility antigens. At least 25-30 polymorphic genes are known to encode functional histocompatibility antigens in mismatched individuals, but their individual contribution to clinical GVHD is unclear. HCT outcome may also be affected by polymorphism in donor or recipient. Association studies have implicated several genes associated with GVHD and mortality, however results have been inconsistent most likely due to limited sample size, and differences in racial diversity and clinical covariates. New technologies using DNA arrays genotyping for a million or more SNPs promise genome-wide discovery of HCT-associated genes, however adequate statistical power requires study populations of several thousand patient-donor pairs. SUMMARY Available data offers strong preliminary support for the impact that genetic variation has on risk of GVHD and mortality following HCT. Definitive results however await future genome-wide studies of large multicenter HCT cohorts.
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Affiliation(s)
- John A Hansen
- The Fred Hutchinson Cancer Research Center, The University of Washington School of Medicine, Seattle, Washington 98109-1024, USA.
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Yoon SI, Jones BC, Logsdon NJ, Harris BD, Deshpande A, Radaeva S, Halloran BA, Gao B, Walter MR. Structure and mechanism of receptor sharing by the IL-10R2 common chain. Structure 2010; 18:638-48. [PMID: 20462497 PMCID: PMC2879597 DOI: 10.1016/j.str.2010.02.009] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Revised: 02/12/2010] [Accepted: 02/15/2010] [Indexed: 01/07/2023]
Abstract
IL-10R2 is a shared cell surface receptor required for the activation of five class 2 cytokines (IL-10, IL-22, IL-26, IL-28, and IL-29) that play critical roles in host defense. To define the molecular mechanisms that regulate its promiscuous binding, we have determined the crystal structure of the IL-10R2 ectodomain at 2.14 A resolution. IL-10R2 residues required for binding were identified by alanine scanning and used to derive computational models of IL-10/IL-10R1/IL-10R2 and IL-22/IL-22R1/IL-10R2 ternary complexes. The models reveal a conserved binding epitope that is surrounded by two clefts that accommodate the structural and chemical diversity of the cytokines. These results provide a structural framework for interpreting IL-10R2 single nucleotide polymorphisms associated with human disease.
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Affiliation(s)
- Sung-il Yoon
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, Alabama 35294
| | - Brandi C. Jones
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, Alabama 35294
| | - Naomi J. Logsdon
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, Alabama 35294
| | - Bethany D. Harris
- Center for Biophysical Sciences and Engineering, University of Alabama at Birmingham, Birmingham, Alabama 35294
| | - Ashlesha Deshpande
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, Alabama 35294
| | - Svetlana Radaeva
- Section on Liver Biology, Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892
| | - Brian A. Halloran
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, Alabama 35294
| | - Bin Gao
- Section on Liver Biology, Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892
| | - Mark R. Walter
- Department of Microbiology, University of Alabama at Birmingham, Birmingham, Alabama 35294
- Center for Biophysical Sciences and Engineering, University of Alabama at Birmingham, Birmingham, Alabama 35294
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