Abstract

Maintenance of a balance between commensal bacteria and the mucosal immune system is crucial and intestinal dysbiosis may be a key event in the pathogenesis of colorectal cancer (CRC). The toll-like receptor 4 (TLR4) is an important pattern-recognition receptor that regulates inflammation and barrier function in the gut by a mechanism that involves activation of the nuclear factor–κB (NF-κB) transcription factor. Dietary and life style factors may impact these functions. We therefore used a Danish prospective case-cohort study of 1010 CRC cases and 1829 randomly selected participants from the Danish Diet, Cancer and Health cohort to investigate three polymorphisms in NFKB1 and TLR4 and their possible interactions with diet and life style factors in relation to risk of CRC. Homozygous carriage of the variant allele of the TLR4/rs5030728 polymorphism was associated with increased risk of CRC (incidence rate ratio (IRR) = 1.30; 95% confidence interval (CI): 1.05–1.60; P = 0.02 (gene-dose model); IRR = 1.24; 95%CI: 1.01–1.51; P = 0.04 (recessive model)). Del-carriers of the NFKB1/rs28362491 polymorphism had a 17% (95%CI: 1.03–1.34; P = 0.02) increased risk of CRC compared to homozygous carriers of the ins-allele. However, none of these risk estimates withstood adjustment for multiple comparisons. We found no strong gene-environment interactions between the examined polymorphism and diet and life style factors in relation to CRC risk.

Highlights

  • Colorectal cancer (CRC) is the third most common cancer type in men and the second in women worldwide [1]

  • Homozygous variant carriers of the toll-like receptor 4 (TLR4)/rs5030728 polymorphism were at 1.30-fold (95%confidence interval (CI): 1.05–1.60) increased risk of CRC in a gene-dose model and at 1.24-fold (95%CI: 1.01–1.51) increased risk of CRC compared to wild type and heterozygous carriers in a recessive model (Table 2)

  • There was no interaction between the two risk genotypes TLR4/rs5030728 and NFKB1/rs28362491 but on the other hand, there was no additive effect of being homozygous carrier of both variant alleles (S1 Table)

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Summary

Introduction

Colorectal cancer (CRC) is the third most common cancer type in men and the second in women worldwide [1]. Hereditary factors are estimated to contribute to only 35% of the risk [2] emphasizing the importance of environmental factors in the etiology of CRC. Health cohort” from the Danish Council for Independent Research; Medical Sciences The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

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