Abstract
BackgroundA promoter polymorphism in the pro-inflammatory cytokine tumor necrosis factor (TNF) (TNF G-308A) is associated with increased non-Hodgkin lymphoma (NHL) risk. The protein product, TNF-α, activates the nuclear factor kappa beta (NF-κB) transcription factor, and is critical for inflammatory and apoptotic responses in cancer progression. We hypothesized that the TNF and NF-κB pathways are important for NHL and that gene variations across the pathways may alter NHL risk.Methodology/Principal FindingsWe genotyped 500 tag single nucleotide polymorphisms (SNPs) from 48 candidate gene regions (defined as 20 kb 5′, 10 kb 3′) in the TNF and TNF receptor superfamilies and the NF-κB and related transcription factors, in 1946 NHL cases and 1808 controls pooled from three independent population-based case-control studies. We obtaineded a gene region-level summary of association by computing the minimum p-value (“minP test”). We used logistic regression to compute odds ratios and 95% confidence intervals for NHL and four major NHL subtypes in relation to SNP genotypes and haplotypes. For NHL, the tail strength statistic supported an overall relationship between the TNF/NF-κB pathway and NHL (p = 0.02). We confirmed the association between TNF/LTA on chromosome 6p21.3 with NHL and found the LTA rs2844484 SNP most significantly and specifically associated with the major subtype, diffuse large B-cell lymphoma (DLBCL) (p-trend = 0.001). We also implicated for the first time, variants in NFKBIL1 on chromosome 6p21.3, associated with NHL. Other gene regions identified as statistically significantly associated with NHL included FAS, IRF4, TNFSF13B, TANK, TNFSF7 and TNFRSF13C. Accordingly, the single most significant SNPs associated with NHL were FAS rs4934436 (p-trend = 0.0024), IRF4 rs12211228 (p-trend = 0.0026), TNFSF13B rs2582869 (p-trend = 0.0055), TANK rs1921310 (p-trend = 0.0025), TNFSF7 rs16994592 (p-trend = 0.0024), and TNFRSF13C rs6002551 (p-trend = 0.0074). All associations were consistent in each study with no apparent specificity for NHL subtype.Conclusions/SignificanceOur results provide consistent evidence that variation in the TNF superfamily of genes and specifically within chromosome 6p21.3 impacts lymphomagenesis. Further characterization of these susceptibility loci and identification of functional variants are warranted.
Highlights
There is convincing evidence that a promoter polymorphism in the pro-inflammatory cytokine tumor necrosis factor (TNF) (TNF G-308A) is associated with increased risk for nonHodgkin lymphoma (NHL) and with the non-Hodgkin lymphoma (NHL) subtype, diffuse large B-cell lymphoma (DLBCL) [1,2]
The National Cancer Institute-Surveillance, Epidemiology, and End Results (NCI-SEER) and Connecticut studies had similar distributions of NHL subtypes, while the New South Wales (NSW) study had a higher frequency of follicular lymphoma (FL) and a lower frequency of chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) and NHL not otherwise specified (NOS), compared to the other two studies
Of the 16 polymorphisms we evaluated in the TNF/LTA region on chromosome 6p21.3 which included the genes TNF, LTA and NFKBIL1, a number of SNPs were associated with NHL, DLBCL, and marginal zone lymphoma
Summary
There is convincing evidence that a promoter polymorphism in the pro-inflammatory cytokine tumor necrosis factor (TNF) (TNF G-308A) is associated with increased risk for nonHodgkin lymphoma (NHL) and with the NHL subtype, diffuse large B-cell lymphoma (DLBCL) [1,2]. NF-kB stimulates the immune response, the production of pro-inflammatory cytokines, which permits survival and proliferation of these cells [7]. These roles are supported by mouse models that implicate both NF-kB and TNF-a in tumor promotion [8,9]. A promoter polymorphism in the pro-inflammatory cytokine tumor necrosis factor (TNF) (TNF G-308A) is associated with increased non-Hodgkin lymphoma (NHL) risk. We hypothesized that the TNF and NF-kB pathways are important for NHL and that gene variations across the pathways may alter NHL risk
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