Integration of molecular pathology, epidemiology and social science for global precision medicine

Oral and para-oral lymphomas: a 10-year multi-center retrospective study in Egypt with time series analysis and forecasting to 2030

BACKGROUND

Little is known about the epidemiology of lymphomas occurring in oral and para-oral sites, especially in developing countries such as Egypt. Hence, the aim of this study was to describe the frequency and time trends of oral and para-oral lymphomas in Cairo governorate from 2010 to 2019, with forecasting to 2030, and to examine relations between age, gender, site and type of lymphoma.

METHODS

Histopathological reports of patients diagnosed with oral and para-oral lymphomas from 2010 to 2019 were retrospectively retrieved from archives of six different centers in Cairo governorate. Data regarding age, gender and site was collected and associations between types of lymphoma and these variables were detected using appropriate statistical methods. The significance level was set at p ≤ 0.05. Time series analysis was used to determine the trend of lymphoma frequency within 10 years of the study and to predict frequency until 2030.

RESULTS

Lymphomas constituted 2.86% of oral and para-oral lesions. Non-Hodgkin lymphoma was more common than Hodgkin lymphoma. Patients with non-Hodgkin lymphoma showed a higher median age than patients with Hodgkin lymphoma (p = 0.001). Non-Hodgkin lymphoma was more prone to occur intra-orally (p = 0.014). No statistical significance was observed in gender distribution between Hodgkin and non-Hodgkin lymphoma. Even though no specific time trend was observed from 2010 to 2019, forecasting for frequency of lymphomas through 10 years (2020 to 2030) showed a predicted increase.

CONCLUSIONS

The findings of this study were consistent with majority of other studies held in various geographic regions. The study revealed that frequency of oral and para-oral lymphomas in Cairo governorate is expected to rise; hence, oral pathologists should be more clinically suspicious and expect to encounter these lesions more in their practice within the upcoming years.

The exposome in rheumatoid arthritis

The exposome integrates the variety and accumulation of exposures (external and internal) to which an individual is submitted to from conception to death. Exposome may therefore be a useful tool for understanding the diversity of these factors and their role in the pathophysiology of rheumatoid arthritis (RA). Life is perceived as a continuum of cumulative changes, with key periods of disruption (e.g. birth, adolescence, pregnancy, prolonged treatment). The combination of these changes and the external signals that cause them constitute an individual's exposome, which is constantly changing and expanding throughout life. Thus, measuring the exposome requires specific tools and approaches as well as a global perspective. RA, a complex, heterogeneous, pro-inflammatory autoimmune disease with a genetic component and for which a large number of environmental factors have already been incriminated is an appropriate field of application for the exposome. The aim of this review is to define the exposome concept, outline the different analytic tools available for its study and finally apply them to the field of RA.

Inflammation, microbiome and colorectal cancer disparity in African-Americans: Are there bugs in the genetics?

Dysregulated interactions between host inflammation and gut microbiota over the course of life increase the risk of colorectal cancer (CRC). While environmental factors and socio-economic realities of race remain predominant contributors to CRC disparities in African-Americans (AAs), this review focuses on the biological mediators of CRC disparity, namely the under-appreciated influence of inherited ancestral genetic regulation on mucosal innate immunity and its interaction with the microbiome. There remains a poor understanding of mechanisms linking immune-related genetic polymorphisms and microbiome diversity that could influence chronic inflammation and exacerbate CRC disparities in AAs. A better understanding of the relationship between host genetics, bacteria, and CRC pathogenesis will improve the prediction of cancer risk across race/ethnicity groups overall.

The association of cytokine gene polymorphisms with tuberculosis susceptibility in several regional populations

PURPOSE

By collecting the data of all relevant articles, the goal of this study was to better understand the relationship between the IL-6/IL-18 polymorphism and susceptibility to tuberculosis in several regional populations.

METHODS

Pubmed, Embase, WOS and CNKI were used to find relevant literature. The findings of separate research were merged using Review Manager.

RESULTS

A total of 25 studies were included in this study. IL-6 rs1800795 (dominant. comparison: p-value < 0.0001, OR 1.43, 95 % CI 1.23-1.67; recessive comparison: p-value < 0.0001, OR 0.48, 95 % CI 0.35-0.65; allele comparison: p-value < 0.0001, OR 1.43, 95 % CI 1.27-1.62), IL-18 rs1946518 (dominant comparison: p-value = 0.01, OR 1.19, 95 % CI 1.04-1.35; recessive comparison: p-value = 0.01, OR 0.82, 95 % CI 0.71-0.96; allele comparison: p-value = 0.002, OR 1.14, 95 % CI 1.05-1.24), IL-18 rs187238 (dominant comparison: p-value = 0.0002, OR 1.35, 95 % CI 1.15-1.58; allele comparison: p-value < 0.0001, OR 1.31, 95 % CI 1.14-1.50). All gene polymorphisms were shown to be substantially linked to tuberculosis in the general population. Positive findings of rs187238 and rs1800795 polymorphisms were primarily driven by several regional populations, according to subgroup analyses.

CONCLUSION

This meta-analysis found that the the IL-6 rs1800795and IL-18 rs187238 polymorphisms may have a role in TB susceptibility.

Effects of IL-6 Polymorphisms on Individual Susceptibility to Allergic Diseases: A Systematic Review and Meta-Analysis

Background: Many studies have assessed the potential link between interleukin-6 polymorphisms and susceptibility to allergic diseases. However, the results are still conflicting. Therefore, a comprehensive meta-analysis can not only resolve differences but also provide clues for future projects.

Methods: A systematic electronic search was conducted on the databases of Web of Science, PubMed, and Cochrane Library to retrieve all published studies. Revman and Stata software were used for statistical analysis.

Results: This meta-analysis included 11 studies. The results revealed that there was a statistically significant association between IL-6 rs1800795 polymorphism and the risk of asthma and allergic rhinitis in the general population. Subgroup analyses demonstrated that rs1800795 affected allergic diseases risk in different populations.

Conclusion: Our findings suggested that IL-6 rs1800795 was associated with allergic diseases susceptibility among Asians and Caucasians in opposite trends, and it might influence the risk of asthma and allergic rhinitis. None of the IL-6 polymorphisms were shared risk variants of allergic diseases.

Clinical Relevance of VEGFA (rs3025039) +936 C>T Polymorphism in Primary Myelofibrosis: Susceptibility, Clinical Co-Variates, and Outcomes

We evaluated the association of VEGFA rs3025039 polymorphism with clinical co-variates and outcomes in 849 subjects with primary myelofibrosis (PMF) and 250 healthy controls. Minor T-allele frequency was higher in subjects with JAK2^V617F compared with those without JAK2^V617F (18% vs. 13%; p = 0.014). In subjects with JAK2^V617F, the TT genotype was associated at diagnosis with lower platelet concentrations (p = 0.033), higher plasma LDH concentration (p = 0.005), higher blood CD34-positive cells (p = 0.027), lower plasma cholesterol concentration (p = 0.046), and higher concentration of high-sensitivity C-reactive protein (p = 0.018). These associations were not found in subjects with PMF without JAK2^V617F. In subjects with the TT genotype, risk of death was higher compared with subjects with CC/CT genotypes (HR = 2.12 [1.03, 4.35], p = 0.041). Finally, the TT genotype was associated with higher frequency of deep vein thrombosis in typical sites (12.5% vs. 2.5%; OR = 5.46 [1.51, 19.7], p = 0.009). In conclusion, in subjects with PMF, the VEGFA rs3025039 CT or TT genotypes are more common in those with JAK2^V617F than in those without JAK2^V67F mutation and are associated with disease severity, poor prognosis, and risk of deep vein thrombosis.

Revisiting social MPE: an integration of molecular pathological epidemiology and social science in the new era of precision medicine

INTRODUCTION

Molecular pathological epidemiology (MPE) is an integrative transdisciplinary area examining the relationships between various exposures and pathogenic signatures of diseases. In line with the accelerating advancements in MPE, social science and its health-related interdisciplinary areas have also developed rapidly. Accumulating evidence indicates the pathological role of social-demographic factors. We therefore initially proposed social MPE in 2015, which aims to elucidate etiological roles of social-demographic factors and address health inequalities globally. With the ubiquity of molecular diagnosis, there are ample opportunities for researchers to utilize and develop the social MPE framework.

AREAS COVERED

Molecular subtypes of breast cancer have been investigated rigorously for understanding its etiologies rooted from social factors. Emerging evidence indicates pathogenic heterogeneity of neurological disorders such as Alzheimer's disease. Presenting specific patterns of social-demographic factors across different molecular subtypes should be promising for advancing the screening, prevention, and treatment strategies of those heterogeneous diseases. This article rigorously reviewed literatures investigating differences of race/ethnicity and socioeconomic status across molecular subtypes of breast cancer and Alzheimer's disease to date.

EXPERT OPINION

With advancements of the multi-omics technologies, we foresee a blooming of social MPE studies, which can address health disparities, advance personalized molecular medicine, and enhance public health.

Relationship between microsatellite status and immune microenvironment of colorectal cancer and its application to diagnosis and treatment

Due to advances in understanding the immune microenvironment of colorectal cancer (CRC), microsatellite classification (dMMR/MSI-H and pMMR/MSS) has become a key biomarker for the diagnosis and treatment of CRC patients and therefore has important clinical value. Microsatellite status is associated with a variety of clinicopathological features and affects drug resistance and the prognosis of patients. CRC patients with different microsatellite statuses have different compositions and distributions of immune cells and cytokines within their tumor microenvironments (TMEs). Therefore, there is great interest in reversing or reshaping CRC TMEs to transform immune tolerant "cold" tumors into immune sensitive "hot" tumors. This requires a thorough understanding of differences in the immune microenvironments of MSI-H and MSS type tumors. This review focuses on the relationship between CRC microsatellite status and the immune microenvironment. It focuses on how this relationship has value for clinical application in diagnosis and treatment, as well as exploring the limitations of its current application.

The Triple Health Threat of Diabetes, Obesity, and Cancer-Epidemiology, Disparities, Mechanisms, and Interventions

Obesity and type 2 diabetes are both chronic, relapsing, progressive diseases that are recognized as risk factors for the development of multiple types of cancer. In a recent symposium titled "Hitting A Triple-Diabetes, Obesity, and the Emerging Links to Cancer Risk," convened by The Obesity Society during ObesityWeek 2019, experts in the field presented the current science and highlighted existing research gaps. Topics included (1) the epidemiology of obesity and diabetes and their links to cancer risk; (2) racial and ethnic differences in obesity, diabetes, and cancer risk; (3) biological mechanisms common to obesity and diabetes that may increase cancer risk; and (4) innovative interventions that can be used to prevent the development of cancers related to obesity and diabetes. This report provides an overview of the symposium and describes key research gaps and pressing questions in need of answers to advance the field. The collective burden of obesity, diabetes, and cancer represents one of the largest public health challenges of the century. Although the symposium was titled "hitting a triple," it was recognized that being able to disrupt the linkages among obesity, diabetes, and cancer would be a "grand slam" for public health and medicine.

From COVID-19 to cancer, watching social determinants decide life: When will we stop spectating?

The COVID-19 pandemic reminds us that African American, Latinx, Indigenous, and poor communities face significant healthcare disparities. Members of these communities have increased exposure to the virus due to higher rates of crowded living conditions and employment in essential occupations. Furthermore, news reports and public health data show that residents of these communities have more comorbidities, utilize hospitals with fewer resources, and experience greater treatment delays, all resulting in higher mortality related to COVID-19. The same social determinants contributing to the inequities seen in COVID-19 drive similar disparities in oncology. Oncologic inequities have long predated the inequities associated with COVID-19 and have led to considerably more deaths. These stark realities demand that we stop merely reporting the impact of adverse social determinants on the health of communities. We must instead target these causes of healthcare disparities. Here, we discuss proposed action items from the 2019 National Cancer Policy Forum workshop entitled "Applying Big Data to Address the Social Determinants of Health in Oncology." These actions are critical first steps to address adverse social determinants and thereby decrease unnecessary deaths in underserved communities.

Epidemiology and Molecular-Pathologic Characteristics of CpG Island Methylator Phenotype (CIMP) in Colorectal Cancer

BACKGROUND

CpG island methylator phenotype (CIMP) forms a distinct epigenetic phenotype in colorectal cancer (CRC). Though associated with distinct clinicopathologic characteristics, limited evidence exists of the association of CIMP with patient's reported lifestyle factors and tumor molecular characteristics. We assessed the associations of these characteristics in a pooled analysis of CRC patients.

PATIENTS AND METHODS

We pooled data from 3 CRC patient cohorts: Assessment of Targeted Therapies Against Colorectal Cancer (ATTACC), biomarker-based protocol (Integromics), and The Cancer Genome Atlas (TCGA). CIMP was measured using the classical 6-gene methylated-in-tumor (MINT) marker panel (MINT1, MINT2, MINT31, p14, p16, and MLH1) in ATTACC and genome-wide human methylation arrays in Integromics and TCGA, respectively. CIMP-High (CIMP-H) was defined as ≥ 3 of 6 methylated markers in ATTACC. In TCGA and Integromics, CIMP-H group was defined on the basis of clusters of methylation profiles and high levels of methylation in tumor samples. Baseline comparisons of characteristics across CIMP groups (CIMP-H vs. CIMP-0) were performed by Student t test or chi-square test for continuous or categorical variables, respectively. Further logistic regression analyses were performed to compute the odds ratio (OR) of these associations.

RESULTS

Pooled prevalence of CIMP-H was 22% across 3 data sets. CIMP-H CRC tumors were associated with older age at diagnosis (OR, 1.02; 95% confidence interval [CI], 1.01, 1.03), microsatellite instability-high (MSI-H) status (OR, 9.15; 95% CI, 4.45, 18.81), BRAF mutation (OR, 7.70; 95% CI, 4.98, 11.87), right-sided tumor location (OR, 2.40; 95% CI, 1.78, 3.22), poor differentiation (OR, 2.94; 95% CI, 1.95, 4.45), and mucinous histology (OR, 2.47; 95% CI, 1.77, 3.47), as reported previously in the literature. CIMP-H tumors were also found to be associated with self-reported history of alcohol consumption (OR, ever vs. never, 1.58; 95% CI, 1.07, 2.34). Pathologically, CIMP-H tumors were associated with the presence of intraepithelial lymphocytes (OR, 3.31; 95% CI, 1.41, 7.80) among patients in the Integromics cohort.

CONCLUSION

CIMP-H tumors were associated with history of alcohol consumption and presence of intraepithelial lymphocytes. In addition, we confirmed the previously known association of CIMP with age, MSI-H status, BRAF mutation, sidedness, and mucinous histology. Molecular pathologic epidemiology associations help us explore the underlying association of lifestyle and clinical factors with molecular subsets like CIMP and help guide cancer prevention and treatment strategies.

A novel path-specific effect statistic for identifying the differential specific paths in systems epidemiology

BACKGROUND

Biological pathways play an important role in the occurrence, development and recovery of complex diseases, such as cancers, which are multifactorial complex diseases that are generally caused by mutation of multiple genes or dysregulation of pathways.

RESULTS

We propose a path-specific effect statistic (PSE) to detect the differential specific paths under two conditions (e.g. case VS. control groups, exposure Vs. nonexposure groups). In observational studies, the path-specific effect can be obtained by separately calculating the average causal effect of each directed edge through adjusting for the parent nodes of nodes in the specific path and multiplying them under each condition. Theoretical proofs and a series of simulations are conducted to validate the path-specific effect statistic. Applications are also performed to evaluate its practical performances. A series of simulation studies show that the Type I error rates of PSE with Permutation tests are more stable at the nominal level 0.05 and can accurately detect the differential specific paths when comparing with other methods. Specifically, the power reveals an increasing trends with the enlargement of path-specific effects and its effect differences under two conditions. Besides, the power of PSE is robust to the variation of parent or child node of the nodes on specific paths. Application to real data of Glioblastoma Multiforme (GBM), we successfully identified 14 positive specific pathways in mTOR pathway contributing to survival time of patients with GBM. All codes for automatic searching specific paths linking two continuous variables and adjusting set as well as PSE statistic can be found in supplementary materials.  CONCLUSION: The proposed PSE statistic can accurately detect the differential specific pathways contributing to complex disease and thus potentially provides new insights and ways to unlock the black box of disease mechanisms.

Patología y salud pública: Oportunidades para el avance

La patología y la salud pública son disciplinas que se complementan en múltiples formas, desde la información que aportan mutuamente a niveles individual y poblacional, hasta la elaboración de políticas públicas en salud y la gestión de la información en los biobancos, así como la articulación para respuesta en emergencias y brotes. En revisión no sistemática resaltamos que los dos campos de mayor colaboración con la salud pública son la patología forense (comprendiendo muertes violentas y no violentas) y la patología molecular, realizando aportes significativos a la planeación de los servicios de salud, la calidad de la información epidemiológica, la salud pública basada en la evidencia que permite una mejor toma de decisiones, y la gestión de la salud comunitaria y poblacional. A partir de la revisión realizada se identificaron como puntos de mejora el uso de los sistemas de información, la necesidad de un enfoque interdisciplinario más tangible, y la urgente transformación educativa que subyace a esta colaboración.

Cancer Risk Studies and Priority Areas for Cancer Risk Appraisal in Uganda

Background

Research into aetiologies and prevention of the commonest cancers and implementation of primary and secondary prevention can reduce cancer risk and improve quality of life. Moreover, monitoring the prevalence of cancer risk factors in a specific population helps guide cancer prevention and early detection efforts and national cancer control programming.

Objective

This article aims to provide the scope and findings of cancer risk studies conducted in Uganda to guide researchers, health-care professionals, and policymakers.

Methods

Between November 2019 to January 2020, we searched peer-reviewed published articles in Pubmed, EMBASE and Cochrane Library (Cochrane central register of controlled trials-CENTRAL). We followed the recommendation of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - the PRISMA. The primary focus was to identify cancer risk and prevention studies conducted in Uganda and published in peer-reviewed journals from January 2000 and January 2020. We used key Boolean search terms with their associated database strings.

Results

We identified 416 articles, screened 269 non-duplicate articles and obtained 77 full-text articles for review. Out of the 77 studies, we identified one (1%) randomized trial, two (2.5%) retrospective cohort studies and 14 (18%) case-control studies, 46 (60%) cross-sectional studies, five (6.4%) ecological studies, three panel studies (4%) and six (8%) qualitative studies. Cervical cancer was the most studied type of cancer in Uganda (23.4%, n = 18 studies), followed by lymphomas - both Hodgkin and Non-Hodgkin sub-types (20.7%), n = 16 studies) and breast cancer (15.6%, n = 12 studies). In lymphoma studies, Burkitt lymphoma was the most studied type of lymphoma (76%, n = 13 studies). The studies concentrated on specific cancer risk awareness, risk perceptions, attitudes, uptake of screening, uptake of human papillomavirus vaccination, the prevalence of some of the known cancer risk factors and obstacles to accessing screening services.

Conclusion

The unmet need for comprehensive cancer risk and prevention studies is enormous in Uganda. Future studies need to comprehensively investigate the known and putative cancer risk factors and prioritize the application of the higher-hierarchy evidence-generating epidemiological studies to guide planning of the national cancer control program.

Associations of six common functional polymorphisms in interleukins with tuberculosis: evidence from a meta-analysis

BACKGROUND

Associations of polymorphisms in interleukin-6 (IL-6), IL-8 and IL-10 with tuberculosis (TB) susceptibility were already reported by many publications. The aim of this meta-analysis was to more precisely clarify associations between polymorphisms in IL-6/IL-8/IL-10 and TB by combing the results of all relevant publications.

METHODS

Eligible publications were searched from PubMed, Embase, Web of Science and CNKI. We used Review Manager to combine the results of individual studies.

RESULTS

A total of 47 publications were included in this study. IL-6 rs1800795 (1750 cases and 2335 controls, dominant, recessive and allele comparisons), IL-8 rs4073 (1125 cases and 1188 controls, dominant, recessive and allele comparisons), IL-10 rs1800871 (5528 cases and 7671 controls, dominant, recessive and allele comparisons), IL-10 rs1800872 (5269 cases and 7013 controls, dominant and allele comparisons) and IL-10 rs1800896 (7564 cases and 8952 controls, recessive comparison) polymorphisms were all significantly associated with TB in overall combined analyses. In subgroup analyses, we found that the positive results were mainly driven by the pulmonary tuberculosis and Asian subgroups.

CONCLUSIONS

Collectively, this meta-analysis proved that IL-6 rs1800795, IL-8 rs4073, IL-10 rs1800871, IL-10 rs1800872 and IL-10 rs1800896 may confer susceptibility to TB.

Common cytokine polymorphisms and predisposition to polycystic ovary syndrome: a meta-analysis

The results of studies on the relationship between cytokine polymorphisms and polycystic ovary syndrome (PCOS) have been controversial. This meta-analysis was thus designed to more precisely assess the relationship between TNF-α/IL-1/IL-6/IL-10 polymorphisms and PCOS by pooling the results of published studies. A search of PubMed, Embase, Web of Science, and CNKI databases turned up 23 studies that were pooled and analyzed in this meta-analysis. The overall results showed that the distributions of TNF-α -238 G/A, TNF-α -857 C/T, and IL-1B -51 C/T polymorphisms among patients and controls differed significantly. Additionally, the distributions of TNF-α -308 G/A and IL-1B -51 C/T polymorphisms among patients and controls from Asian populations differed significantly, whereas the distributions of IL-6 -174 G/C and IL-1A -889 C/T polymorphisms among patients and controls from Caucasian populations also differed significantly. In conclusion, our meta-analysis demonstrated that TNF-α -238 G/A, TNF-α -857 C/T, and IL-1B -51 C/T polymorphisms might influence susceptibility to PCOS in the overall pooled population. Moreover, TNF-α -308 G/A and IL-1B -51 C/T polymorphisms might influence susceptibility to PCOS in Asians, whereas IL-6 -174 G/C and IL-1A -889 C/T polymorphisms might influence susceptibility to PCOS in Caucasians.

Relationship between common eNOS gene polymorphisms and predisposition to coronary artery disease: Evidence from a meta-analysis of 155 published association studies

BACKGROUND

Relationship between endothelial nitric oxide synthase (eNOS) polymorphisms and predisposition to coronary artery disease (CAD) are still controversial and ambiguous. So we performed this meta-analysis to more precisely estimate relationship between eNOS polymorphisms and CAD by pooling the results of already published studies.

METHODS

We searched Pubmed, Embase, Web of Science and CNKI for eligible studies. We used Review Manager to pool the results of eligible studies.

RESULTS

One hundred and fifty-five studies were included in this meta-analysis. We found that eNOS rs1799983, rs2070744 and rs869109213 polymorphisms were all significantly associated with CAD in the general population. We also detected similar significant results for eNOS rs1799983, rs2070744 and rs869109213 polymorphisms in both Caucasians and Asians in further subgroup analyses.

CONCLUSIONS

This meta-analysis demonstrated that eNOS rs1799983, rs2070744 and rs869109213 polymorphisms might influence predisposition to CAD in both Caucasians and Asians.

Associations of four common VDR polymorphisms with rheumatoid arthritis and systemic lupus erythematosus: evidence from a meta-analysis

Associations of polymorphisms in vitamin D receptor ( VDR) with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have already been explored by many studies. The aim of this meta-analysis was to better clarify associations between polymorphisms in VDR and RA/SLE by combing the results of all relevant studies. Eligible studies were searched from Pubmed, Embase, WOS and CNKI. We used Review Manager to combine the results of eligible studies. Thirty-seven studies were included in this meta-analysis. VDR rs1544410 (recessive comparison: odds ratio (OR) = 1.36, 95% confidence interval (CI) 1.06–1.76; over-dominant comparison: OR = 0.81, 95% CI 0.71–0.93) and rs731236 (over-dominant comparison: OR = 0.77, 95% CI 0.63–0.94) polymorphisms were found to be significantly associated with RA in overall combined analyses. Besides, VDR rs1544410 (dominant comparison: OR = 0.61, 95% CI 0.46–0.82; over-dominant comparison: OR = 1.45, 95% CI 1.16–1.81; allele comparison: OR = 0.75, 95% CI 0.62–0.92), rs2228570 (dominant comparison: OR = 0.58, 95% CI 0.50–0.67; recessive comparison: OR = 1.57, 95% CI 1.21–2.03; allele comparison: OR = 0.69, 95% CI 0.60–0.80) and rs731236 (dominant comparison: OR = 0.69, 95% CI 0.50–0.96; allele comparison: OR = 0.80, 95% CI 0.70–0.90) polymorphisms were also found to be significantly associated with SLE in overall combined analyses. Subgroup analyses revealed that significant associations for VDR polymorphisms and RA/SLE were mainly driven by Asians. Collectively, this meta-analysis proved that VDR rs7975232, rs1544410, rs2228570 and rs731236 polymorphisms may confer susceptibility to RA and SLE, especially for Asians.

CTLA-4 polymorphisms and predisposition to digestive system malignancies: a meta-analysis of 31 published studies

Background

The results of genetic association studies regarding cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) polymorphisms and digestive system malignancies were controversial. The authors designed this meta-analysis to more precisely estimate relationships between CTLA-4 polymorphisms and digestive system malignancies by pooling the results of related studies.

Methods

The authors searched PubMed, Embase, Web of Science, and CNKI for eligible studies. Thirty-one eligible studies were pooled analyzed in this meta-analysis.

Results

The pooled meta-analysis results showed that genetic distributions of rs231775, rs4553808, and rs733618 polymorphisms among patients with digestive system malignancies and controls differed significantly. Moreover, genotypic distribution differences were also observed for rs231775 polymorphism among patients with colorectal cancer/pancreatic cancer and controls, for rs4553808 and rs5742909 polymorphisms among patients with gastric cancer and controls, for rs3087243 polymorphism among patients with liver cancer and controls, and for rs733618 polymorphism among patients with colorectal cancer and controls in pooled meta-analyses.

Conclusions

This meta-analysis suggested that rs231775 polymorphism was associated with predisposition to colorectal cancer and pancreatic cancer, rs4553808 and rs5742909 polymorphisms were associated with predisposition to gastric cancer, rs3087243 polymorphism was associated with predisposition to liver cancer, and rs733618 polymorphism was associated with predisposition to colorectal cancer.

Associations of polymorphisms in interleukins with susceptibility to breast cancer: Evidence from a meta-analysis

BACKGROUND

Associations between polymorphisms in interleukins and breast cancer (BC) were already investigated by many studies, yet with controversial findings. The aim of this meta-analysis was to better clarify associations between polymorphisms in interleukins and BC by combing the results of all relevant articles.

METHODS

Eligible articles were searched from Pubmed, Embase, Web of Science and CNKI. We used Review Manager to combine the results of eligible studies.

RESULTS

Fifty-seven studies were included in this meta-analysis. We found that IL-6 rs1800796 (dominant comparison: OR = 0.70, 95% CI 0.53-0.92), IL-8 rs4073 (dominant comparison: OR = 0.74, 95% CI 0.61-0.89; over-dominant comparison: OR = 1.16, 95% CI 1.05-1.29; allele comparison: OR = 0.82, 95% CI 0.69-0.89), IL-10 rs1800896 (recessive comparison: OR = 1.28, 95% CI 1.12-1.47) and IL-18 rs1946518 (dominant comparison: OR = 0.80, 95% CI 0.65-0.97; allele comparison: OR = 0.74, 95% CI 0.59-0.93) polymorphisms were all significantly associated with BC in overall combined analyses. In subgroup analyses, we noticed that IL-6 rs1800796, IL-8 rs4073, IL-10 rs1800896, IL-18 rs1946518 and rs187238 polymorphisms were all significantly associated with susceptibility to BC in East Asians from China.

CONCLUSIONS

Collectively, this meta-analysis demonstrated that IL-6 rs1800796, IL-8 rs4073, IL-10 rs1800896, IL-18 rs1946518 and rs187238 polymorphisms may confer susceptibility to BC for East Asians from China.

TNF-α polymorphisms might influence predisposition to periodontitis: A meta-analysis

BACKGROUND

Tumor necrosis factor-α (TNF-α) polymorphisms might influence predisposition to periodontitis, but the results of already published studies were still controversial and ambiguous. So the authors designed this meta-analysis to more precisely estimate relationship between TNF-α polymorphisms and periodontitis by pooling the results of already published related studies.

METHODS

The authors searched Pubmed, Embase, Web of Science and CNKI for already published studies. Forty-five already published studies were pooled analyzed in this meta-analysis.

RESULTS

The crude pooled meta-analyses results showed that distributions of TNF-α rs361525, rs1800629, rs1800630 and rs1799964 polymorphisms among patients and controls differed significantly, which suggested that these polymorphisms might influence predisposition to periodontitis in the general population. We also got similar significant results for rs361525, rs1800629, rs1800630 and rs1799964 polymorphisms in subgroup analyses in Asians. The crude findings were further subjected to Bonferroni correction to account for multiple comparisons. For rs361525, rs1800629 and rs1799964 polymorphisms, basically no changes of results were detected. But for rs1800630 polymorphism, the results were no longer significant after adjustment for multiple comparisons.

CONCLUSIONS

This meta-analysis suggested that TNF-α rs361525, rs1800629 and rs1799964 polymorphisms might influence predisposition to periodontitis, particularly in Asians.

Certain interleukin polymorphisms might influence predisposition to lung cancer: A meta-analysis of 35 published studies

Interleukin polymorphisms might influence predisposition to lung cancer (LC), but the results of already published studies regarding the relationship between interleukin polymorphisms and LC were still controversial and ambiguous. So the authors designed this meta-analysis to more precisely estimate relationship between interleukin polymorphisms and LC by pooling the results of already published related studies. The authors searched Pubmed, Embase, Web of Science, and CNKI for already published studies. Thirty-five already published studies were pooled and analyzed in this meta-analysis. The pooled meta-analyses results showed that distributions of IL-4 rs2243250 polymorphism among patients and controls from Asian countries differed significantly (dominant comparison: OR = 1.29, 95% CI 1.07-1.55; overdominant comparison: OR = 0.83, 95% CI 0.73-0.95; allele comparison: OR = 1.26, 95% CI 1.03-1.54), and distributions of IL-10 rs1800872 polymorphism among patients and controls from Caucasian countries also differed significantly (recessive comparison: OR = 0.54, 95% CI 0.35-0.83; overdominant comparison: OR = 1.26, 95% CI 1.05.1.51). No genotypic distribution differences were observed for IL-4 rs2070874, IL-6 rs1800795, IL-6 rs1800796, IL-8 rs4073, IL-10 rs1800871, and IL-10 rs1800896 polymorphisms in pooled meta-analyses. This meta-analysis suggested that IL-4 rs2243250 might influence predisposition to LC in Asians, whereas IL-10 rs1800872 polymorphism might influence predisposition to LC in Caucasians.

Associations between genetic polymorphisms in interleukin-10 and hematological oncology: evidence from a meta-analysis

Background: Associations between polymorphisms in interleukin-10 (IL-10) and hematological oncology were already explored by many genetic association studies, with controversial findings. The aim of this meta-analysis was to more comprehensively analyze associations between polymorphisms in IL-10 and hematological oncology by combing the results of all relevant studies.Methods: Eligible articles were searched from Pubmed, Embase, WOS and CNKI. The latest literature searching update was performed on 8 October 2019. We used Review Manager to combine the results of eligible studies.Results: Forty-one articles were included in this meta-analysis. IL-10 rs1800890 polymorphism was found to be significantly associated with hematological oncology under AA vs. TT+TA (recessive comparison, OR = 1.12, 95% CI 1.02-1.24), and rs1800896 polymorphism was also found to be significantly associated with hematological oncology under AA vs. AG+GG (dominant comparison, OR = 0.89, 95% CI 0.83-0.95) in overall combined analyses. In subgroup analyses, we observed positive results for rs1800871 (recessive comparison), rs1800872 (dominant, recessive and allele comparisons), and rs1800896 (dominant and allele comparisons) polymorphisms in the non-Hodgkin's lymphoma (NHL) subgroup. Besides, we also detected positive associations between rs1800872 polymorphism and acute leukemia (AL) (dominant and recessive comparisons) and found significant associations between rs1800896 polymorphism and chronic leukemia (CL) (recessive comparison).Conclusion: In summary, this meta-analysis demonstrated that IL-10 rs1800890, rs1800896, rs1800871 and rs1800872 polymorphisms may confer susceptibility to hematology oncology, especially for NHL.

Associations between twelve common gene polymorphisms and susceptibility to hepatocellular carcinoma: evidence from a meta-analysis

Background

Associations between polymorphisms in vitamin D receptor (VDR)/vascular endothelial growth factor (VEGF)/interleukin-18 (IL-18)/mannose-binding lectin (MBL) and susceptibility to hepatocellular carcinoma (HCC) were already explored by many studies, yet the results of these studies were inconsistent. The aim of this meta-analysis was to better clarify associations between polymorphisms in VDR/VEGF/IL-18/MBL and HCC by combing the results of all relevant studies.

Methods

Eligible publications were searched from PubMed, Embase, WOS, and CNKI. We used Review Manager to combine the results of individual studies.

Results

Thirty studies were included in this study. Combined results revealed that VDR rs7975232, VDR rs2228570, VEGF rs699947, VEGF rs3025039, IL-18 rs1946518, and MBL rs7096206 polymorphisms were all significantly associated with HCC in the overall pooled population. We also obtained similar significant associations for VDR rs7975232, VDR rs2228570, IL-18 rs1946518, and MBL rs7096206 polymorphisms in Asians.

Conclusions

Collectively, this meta-analysis proved that VDR rs7975232, VDR rs2228570, VEGF rs699947, VEGF rs3025039, IL-18 rs1946518, and MBL rs7096206 polymorphisms may confer susceptibility to HCC in certain populations.

Relationship of genetic polymorphisms in CTLA-4 and IL-18 with viral hepatitis: evidence from a meta-analysis

Relationship of genetic polymorphisms in cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and interleukin-18 (IL-18) with susceptibility to viral hepatitis was already investigated by many association studies. The aim of this study was to more comprehensively analyse associations between genetic polymorphisms in CTLA-4/IL-18 and viral hepatitis by combing the results of all relevant association studies. We searched Pubmed, Embase, Web of Science and CNKI for eligible studies. We used Review Manager to combine the results of eligible studies. Thirty-seven studies were finally included in this meta-analysis. Combined results demonstrated that CTLA-4 rs231775 (recessive comparison: OR 1.31, 95% CI 1.11-1.55), IL-18 rs1946518 (dominant comparison: OR 0.82, 95% CI 0.75-0.90; recessive comparison: OR 1.29, 95% CI 1.11-1.50; allele comparison: OR 0.76, 95% CI 0.68-0.86) and IL-18 rs187238 (dominant comparison: OR 1.25, 95% CI 1.03-1.52; allele comparison: OR 1.20, 95% CI 1.05-1.37) polymorphisms were all significantly associated with viral hepatitis in the general population. Further subgroup analyses revealed that CTLA-4 rs231775, IL-18 rs1946518 and IL-18 rs187238 polymorphisms were significantly associated with susceptibility to hepatitis B virus (HBV), especially among East Asians. Moreover, CTLA-4 rs5742909, IL-18 rs1946518 and IL-18 rs187238 polymorphisms were also significantly associated with susceptibility to hepatitis C virus (HCV), especially among South Asians. So to conclude, this meta-analysis demonstrated that CTLA-4 rs231775, IL-18 rs1946518 and IL-18 rs187238 polymorphisms may confer susceptibility to HBV in East Asians, while CTLA-4 rs5742909, IL-18 rs1946518 and IL-18 rs187238 polymorphisms may confer susceptibility to HCV in South Asians.

A Meta-Analysis of the Relationship between Tumor Necrosis Factor-α Polymorphisms and Psoriasis

BACKGROUND

Some previous studies already explored associations between tumor necrosis factor-α (TNF-α) polymorphisms and psoriasis, with conflicting findings. Here, we aimed to better analyze the relationship between TNF-α polymorphisms and psoriasis in a larger pooled population by performing a meta-analysis.

METHODS

We searched Pubmed, Embase, Web of Science and CNKI for related articles. We calculated OR and 95% CI to estimate whether there are genetic associations between TNF-α polymorphisms and psoriasis.

RESULTS

Twenty-nine studies were included for this meta-analysis. TNF-α-238 G/A (dominant comparison: OR 0.44, 95% CI 0.34-0.59; recessive comparison: OR 1.63, 95% CI 1.03-2.57; overdominant comparison: OR 2.21, 95% CI 1.71-2.85; allele comparison: OR 0.48, 95% CI 0.36-0.62) and -857 C/T (dominant comparison: OR 0.58, 95% CI 0.41-0.80; overdominant comparison: OR 1.58, 95% CI 1.12-2.23; allele comparison: OR 0.62, 95% CI 0. 0.47-0.82) polymorphisms were found to be significantly associated with psoriasis in the general population. Subgroup analyses indicated that the -238 G/A polymorphism was significantly associated with psoriasis in Caucasians and East Asians, the -308 G/A polymorphism was significantly associated with psoriasis in East Asians, and the -857 C/T polymorphism was significantly associated with psoriasis in Caucasians.

CONCLUSIONS

TNF-α -238 G/A, -308 G/A and -857 C/T polymorphisms could be used to identity individuals with elevated susceptibility to psoriasis in certain populations.

Lifestyle factors and risk of sporadic colorectal cancer by microsatellite instability status: a systematic review and meta-analyses

Introduction

The association of lifestyle factors with molecular pathological subtypes of colorectal cancer (CRC), such as microsatellite instability (MSI), could provide further knowledge about the colorectal carcinogenic process. The aim of this review was to evaluate possible associations between lifestyle factors and risk of sporadic CRC by MSI status.

Methods

PubMed and Web of Science were searched for studies investigating the association between alcohol, body mass index, dietary fiber, hormone replacement therapy (HRT), non-steroidal anti-inflammatory drugs, physical activity, red meat, smoking, or statin use, with MSI-high (MSI-H) and microsatellite stable (MSS) CRC. Meta-analyses were carried out to calculate summary relative risks (sRR).

Results

Overall, 31 studies reporting on the association between lifestyle factors and CRC according to MSI status were included in this review. Ever smoking was associated with MSI-H (sRR = 1.62; 95% CI: 1.40-1.88) and MSS/MSI-low CRC (sRR = 1.10; 95% CI: 1.01-1.20), but the association was significantly stronger for MSI-H CRC. The use of HRT was associated with a 20% decrease (sRR = 0.80; 95% CI: 0.73-0.89) in the risk of MSS CRC, but was not associated with MSI-H CRC. An increase in body mass index per 5 kg/m2 was equally associated with MSS and MSI-H CRC (sRR = 1.22, in both cases), but was statistically significant for MSS CRC only (95% CI: 1.11-1.34 and 0.94-1.58, respectively). Limited evidence for associations between other lifestyle factors and CRC by MSI status exists.

Conclusions

Lifestyle factors, such as HRT and smoking are differentially associated with the risk of MSI-H and MSS CRC. Further research on associations of lifestyle factors and CRC subtypes is necessary to provide a better understanding of the CRC disease pathway.

A meta-analysis of the relationship between paraoxonase 1 polymorphisms and cancer

Some previous studies already explored associations between paraoxonase 1 (PON1) polymorphisms and cancer, with conflicting findings. Here, we aimed to better analyse the relationship between PON1 polymorphisms and cancer in a larger combined population by performing a meta-analysis. We searched PubMed, Embase, and Web of Science for related articles. We calculated odds ratio (OR) and 95% confidence interval (CI) to estimate whether there are genetic associations between PON1 polymorphisms and cancer. Forty studies were included for this meta-analysis. The PON1 rs854560 polymorphism (L55M) was found to be significantly associated with cancer in general population (dominant comparison: p = .04, OR = 0.85, 95%CI 0.73-0.99; recessive comparison: p = .007, OR = 1.27, 95%CI 1.07-1.51; allele comparison: p = 0.02, OR = 0.85, 95%CI 0.75-0.97). Subgroup analyses indicated that the significant findings were mainly driven by the haematological tumours and breast cancer subgroups. We did not observe any positive findings for PON1 rs662 polymorphism (Q192R) in combined analyses. In summary, this meta-analysis proved that PON1 rs854560 polymorphism could be used to identify individual with elevated susceptibility to cancer, especially for haematological tumours and breast cancer.

Estimation of associations between 10 common gene polymorphisms and gastric cancer: evidence from a meta-analysis

AIMS

Associations between polymorphisms in cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4)/mannose-binding lectin (MBL)/interleukin-4 (IL-4)/interleukin-6 (IL-6)/phospholipase C ε-1 (PLCE1) and gastric cancer (GC) were already reported by many studies, yet the conclusions of these studies were somehow controversial. The aim of this meta-analysis was to better clarify associations between polymorphisms in CTLA-4/MBL/IL-4/IL-6/PLCE1 and GC by combing the results of all relevant studies.

METHODS

Eligible studies were searched from PubMed, Embase, WOS and CNKI. We used Review Manager to combine the results of individual studies.

RESULTS

Forty-three studies were included in this meta-analysis. Combined results revealed that CTLA-4 rs5742909 (dominant comparison: OR: 1.58, 95 % CI: 1.01 to 2.48; allele comparison: OR: 1.69, 95 % CI: 1.12 to 2.56) and PLCE1 rs2274223 (dominant comparison: OR: 0.84, 95 % CI: 0.72 to 0.98; recessive comparison: OR: 1.23, 95 % CI: 1.08 to 1.40; over-dominant comparison: OR: 1.16, 95 % CI: 1.00 to 1.34; allele comparison: OR 0.88, 95 % CI 0.78 to 0.99) polymorphisms were significantly associated with GC in the general population. We also obtained similar significant associations with GC for rs5742909 and rs2274223 polymorphisms in East Asians. Nevertheless, no positive results were observed for the other eight investigated polymorphisms.

CONCLUSION

Collectively, this meta-analysis demonstrated that CTLA-4 rs5742909 and PLCE1 rs2274223 polymorphisms may confer susceptibility to GC, especially for East Asians.

VDR Gene Polymorphisms and Allergic Diseases: Evidence from a Meta-analysis

Associations between vitamin D receptor (VDR) gene polymorphisms and allergic diseases were already reported by many publications. The aim of this meta-analysis was to clarify associations between VDR gene polymorphisms and allergic diseases by combing the results of all relevant publications. Eligible publications were searched from Pubmed, Embase, WOS and CNKI. We used Review Manager to combine the results of individual studies. Twenty-one studies were included in this study. Combined results proved that VDR rs1544410 BsmI (over-dominant comparison: p = .04, OR = 1.14, 95% CI 1.01-1.29; allele comparison: p = .03, OR = 1.11, 95% CI 1.01-1.22) and rs731236 TaqI (dominant comparison: p = .01, OR = 1.18, 95% CI 1.04-1.33) polymorphisms were both associated with allergic diseases. In subgroup analyses by type of disease, we confirmed positive results for rs1544410 BsmI polymorphism in both asthma and atopic dermatitis, and for rs731236 TaqI polymorphism in atopic dermatitis. Besides, in subgroup by ethnicity of participants, we observed significant associations with allergic diseases for rs7975232 ApaI polymorphism in Caucasians, for rs1544410 BsmI polymorphism in Asians and Caucasians, and for rs731236 TaqI polymorphism in Asians. We also investigated associations between VDR rs2228570 FokI polymorphism and allergic diseases, yet no any positive results were detected for this polymorphism. If we only focused on asthma, then positive findings were detected for rs1544410 BsmI polymorphism in Caucasians, and for rs731236 TaqI polymorphism in Asians. Collectively, this meta-analysis proved that VDR rs7975232 ApaI, rs1544410 BsmI and rs731236 TaqI gene polymorphisms may confer susceptibility to allergic diseases in certain populations.

Associations of genetic polymorphisms in CTLA-4 and IL-18 with chronic liver diseases: Evidence from a meta-analysis

BACKGROUND

The aim of this meta-analysis was to explore associations between polymorphisms in CTLA-4/IL-18 and chronic liver diseases by combing the results of all relevant studies.

METHODS

Eligible studies were searched from Pubmed, Embase, Web of Science and Cochrane library. We used Review Manager to combine the results of eligible studies.

RESULTS

Sixty-seven studies were included in this meta-analysis. Combined results revealed that CTLA-4 rs231775 (dominant, recessive and allele comparisons), IL-18 rs1946518 (dominant, recessive and allele comparisons) and IL-18 rs187238 (dominant, over-dominant and allele comparisons) polymorphisms were all significantly associated with chronic liver diseases in the overall population. We also obtained similar positive results for rs231775, rs5742909, rs3087243, rs1946518 and rs187238 polymorphisms in subgroup analyses by ethnicity and type of disease.

CONCLUSIONS

This meta-analysis demonstrated that CTLA-4 rs231775, CTLA-4 rs5742909, CTLA-4 rs3087243, IL-18 rs1946518 and IL-18 rs187238 polymorphisms may confer susceptibility to certain types of chronic liver diseases.

Associations of polymorphisms in IL-6 and IL-18 with tuberculosis: Evidence from a meta-analysis

BACKGROUND

Associations between polymorphisms in interleukin-6 (IL-6)/interleukin-18 (IL-18) and tuberculosis (TB) were already reported by many publications. The aim of this meta-analysis was to better clarify associations between polymorphisms in IL-6/IL-18 and TB by combing the results of all relevant publications.

METHODS

Eligible publications were searched from Pubmed, Embase, WOS and CNKI. We used Review Manager to combine the results of individual studies.

RESULTS

Twenty-five studies were included in this study. IL-6 rs1800795 (dominant comparison: OR 1.43, 95% CI 1.23-1.67; recessive comparison: OR 0.48, 95% CI 0.35-0.65; allele comparison: OR 1.43, 95% CI 1.27-1.62), IL-18 rs1946518 (dominant comparison: OR 1.19, 95% CI 1.04-1.35; recessive comparison: OR 0.82, 95% CI 0.71-0.96; allele comparison: OR 1.14, 95% CI 1.05-1.24) and IL-18 rs187238 (dominant comparison: OR 1.35, 95% CI 1.15-1.58; allele comparison: OR 1.31, 95% CI 1.14-1.50) polymorphisms were all significantly associated with TB in the total population. Subgroup analyses showed that positive findings for rs1946518, rs187238 and rs1800795 polymorphisms were mainly driven by the Asians.

CONCLUSIONS

Collectively, this meta-analysis proved that IL-6 rs1800795, IL-18 rs1946518 and IL-18 rs187238 polymorphisms may confer susceptibility to TB, especially for Asians.

Associations between Folate Metabolism Enzyme Polymorphisms and Lung Cancer: A Meta-Analysis

Some previous studies already investigated potential associations between folate metabolism enzyme polymorphisms and lung cancer (LC). However, the results of these studies were inconsistent. Thus, we performed this meta-analysis to explore associations between folate metabolism enzyme polymorphisms and LC in a larger pooled population. Systematic literature research of PubMed, WOS, Embase and CNKI was performed to identify eligible studies. Review Manager Version 5.3.3 was used to conduct statistical analyses. Totally 37 genetic association studies were included for analyses. The pooled analyses showed that MTRR rs1801394 (dominant model: p = 0.01; recessive model: p = 0.04; allele model: p = 0.005) and MTHFR rs1801133 (dominant model: p = 0.008; recessive model: p = 0.0003; allele model: p = 0.0002) polymorphisms were both significantly associated with susceptibility to LC in overall population. Subgroup analyses revealed similar significant findings for MTHFR rs1801133 polymorphism in East Asians. Significant associations with LC were also observed for MTRR rs1801394 and MTHFR rs1801133 polymorphisms in smokers. In conclusion, this meta-analysis indicated that MTRR rs1801394 was significantly associated with LC in smokers, and MTHFR rs1801133 polymorphisms was also significantly associated with LC in smokers and East Asians. These results suggested that these two polymorphisms could be used to identify individuals at high risk of developing LC in certain populations.

Genetic association between mannose-binding lectin polymorphisms and viral hepatitis: a meta-analysis

Some previous genetic association studies have tried to investigate potential associations between mannose-binding lectin (MBL) polymorphisms and viral hepatitis. However, the results of those studies were not consistent. Therefore, we performed the current meta-analysis to explore associations between MBL polymorphisms and viral hepatitis in a large pooled population. A systematic literature research of PubMed, Web of Science, Embase and CNKI was performed to identify eligible studies for pooled analyses. We used Review Manager version 5.3.3 to conduct statistical analyses. In total, 27 studies were included for analysis (4840 cases and 5729 controls). The pooled analyses showed that MBL promoter (-211C/G, dominant model: P = 0.0002, I2 = 40%; over-dominant model: P = 0.0001, I2 = 22%) and exon 1 (codon 52, 54 and 57, dominant model: P = 0.04, I2 = 49%; allele model: P = 0.01, I2 = 48%) polymorphisms were both significantly associated with viral hepatitis in the overall population. Further subgroup analyses revealed similarly significant findings for MBL promoter polymorphism in HBV and HCV, but no positive results were detected in subgroup analyses for MBL exon 1 polymorphism. These results suggested that MBL promoter and exon 1 polymorphisms could be used to identify individuals at higher susceptibility to HBV and HCV.

Associations between folate metabolism enzyme polymorphisms and breast cancer: A meta-analysis

We performed this meta-analysis to explore associations between folate metabolism enzyme polymorphisms and breast cancer (BC) in a larger pooled population. Systematic literature research was performed to identify eligible studies for pooled analyses. Totally 92 genetic association studies were included for analyses. The pooled analyses revealed significant findings for MTRR rs1801394 polymorphism in South Asians, for MTR rs1805087 polymorphism in Caucasians and East Asians, and for MTHFR rs1801133 polymorphism in East Asians. In conclusion, the present meta-analysis indicated that MTRR rs1801394, MTR rs1805087, and MTHFR rs1801133 polymorphisms could be used to identify individuals at high risk of developing BC.

A meta-analysis on associations of FTO, MTHFR and TCF7L2 polymorphisms with polycystic ovary syndrome

BACKGROUND

We aimed to better clarify the relationship between FTO/MTHFR/TCF7L2 polymorphisms and PCOS in a larger combined population by performing a meta-analysis.

METHODS

Eligible articles were retrieved from Pubmed, Embase, Web of Science and CNKI. Review Manager Version was used to perform statistical analyses.

RESULTS

Forty-six studies were included for this meta-analysis. FTO rs9939609 polymorphism was found to be significantly associated with PCOS under dominant, recessive, over-dominant and allele comparisons, MTHFR rs1801131 polymorphism was found to be significantly associated with PCOS under recessive and allele comparisons, and MTHFR rs1801133 polymorphism was also found to be significantly associated with PCOS under dominant, recessive and allele comparisons in general population. In subgroup analyses, we found that positive results were mainly driven by the Asians.

CONCLUSIONS

Collectively, this meta-analysis proved that FTO rs9939609, MTHFR rs1801131 and MTHFR rs1801133 polymorphisms may serve as predisposing factors of PCOS, especially for Asians.

A meta-analysis of the relationship between VEGFR2 polymorphisms and atherosclerotic cardiovascular diseases

Background

Some previous studies explored associations between vascular endothelial growth factor receptor 2 (VEGFR2) polymorphisms and atherosclerotic cardiovascular diseases (ASCVD), with conflicting findings.

Hypothesis

We thought that VEGFR2 polymorphisms may influence susceptibility to ASCVD. Here, we aimed to better analyze the relationship between VEGFR2 polymorphisms and ASCVD in a larger combined population by performing a meta‐analysis.

Methods

We searched Pubmed, Embase, and Web of Science for related articles. We calculated odds ratio (OR) and 95% confidence interval (CI) to estimate whether there are genetic associations between VEGFR2 polymorphisms and ASCVD.

Results

Ten studies were included for this meta‐analysis (5474 cases and 8584 controls). VEGFR2 rs1870377 (dominant comparison: 0.81 (0.73‐0.89), I² = 56%; recessive comparison: 1.40 (1.25‐1.57), I² = 34%; allele comparison: 0.81 (0.76‐0.87), I² = 0%), rs2071559 (dominant comparison: 0.83 (0.76‐0.91), I² = 0%; recessive comparison: 1.22 (1.07‐1.38), I² = 0%; allele comparison: 0.86 (0.81‐0.92), I² = 0%) and rs2305948 (dominant comparison: 0.79 (0.72‐0.87), I² = 25%; recessive comparison: 1.44 (1.08‐1.92), I² = 60%; allele comparison: 0.79 (0.68‐0.92), I² = 73%) polymorphisms were all found to be significantly associated with susceptibility to ASCVD in general population. Subgroup analyses by type of disease revealed similar significant findings for rs1870377, rs2071559, and rs2305948 polymorphisms in coronary artery disease (CAD) subgroup. Besides, positive results were also found for rs1870377 polymorphism in ischemic stroke (IS) subgroup.

Conclusions

In summary, this meta‐analysis proved that these VEGFR2 polymorphisms could be used to identify individual with elevated susceptibility to ASCVD.

Associations between genetic polymorphisms of TLRs and susceptibility to tuberculosis: A meta-analysis

Some genetic association studies have tried to investigate potential associations between TLR polymorphisms and tuberculosis. However, the results of these studies have not been consistent. Thus, we performed the present meta-analysis to explore associations between TLR polymorphisms and tuberculosis in a larger combined population. A systematic literature research of PubMed, Web of Science and Embase was performed to identify eligible studies for combined analyses. I² statistics were employed to assess between-study heterogeneities. If I² was >50%, random-effects models were used to combine the data. Otherwise, fixed-effects models were applied for synthetic analyses. A total of 39 genetic association studies were included in the analyses. The combined analyses showed that TLR1 rs4833095, TLR1 rs5743557, TLR1 rs5743596, TLR2 rs3804099, TLR2 rs5743704, TLR2 rs5743708, TLR6 rs5743810 and TLR8 rs3764879 polymorphisms were significantly associated with susceptibility to TB in the overall population. Further subgroup analyses revealed similar significant findings for TLR1 rs4833095, TLR1 rs5743557, TLR1 rs5743596, TLR1 rs5743618, TLR2 rs3804099, TLR2 rs5743704, TLR2 rs5743708, TLR4 rs4986790 and TLR4 rs4986791 polymorphisms in certain ethnicities. In conclusion, our findings support that these TLR polymorphisms may be used to identify individuals at high risk of developing tuberculosis.

The roles of transmembrane 6 superfamily member 2 rs58542926 polymorphism in chronic liver disease: A meta-analysis of 24,147 subjects

Background

Some genetic association studies tried to investigate potential associations of transmembrane 6 superfamily member 2 (TM6SF2) polymorphisms with chronic liver disease. However, the results of these studies were not consistent. Thus, we performed the present meta‐analysis to explore associations between TM6SF2 polymorphisms and chronic liver disease in a larger pooled population.

Methods

Systematic literature research of PubMed, Web of Science, Embase, and CNKI was performed to identify eligible studies for pooled analyses. I² statistics were employed to assess between‐study heterogeneities. If I² was greater than 50%, random‐effect models (REMs) would be used to pool the data. Otherwise, fixed‐effect models (FEMs) would be applied for synthetic analyses.

Results

Totally 28 studies were included for analyses (13,137 cases and 11,010 controls). The pooled analyses showed that rs58542926 polymorphism was significantly associated with chronic liver disease in overall population (dominant model: p < 0.0001, OR = 0.70, 95% CI = 0.64–0.76, I² = 47%; recessive model: p < 0.0001, OR = 2.94, 95% CI = 2.05–4.20, I² = 0%; over‐dominant model: p < 0.0001, OR = 1.34, 95% CI = 1.23–1.47, I² = 0%; allele model: p < 0.0001, OR = 0.68, 95% CI = 0.63–0.73, I² = 47%), and these significant findings were further confirmed in both Asians and Caucasians. Stratified analyses by type of disease revealed similar positive results in hepatocellular carcinoma (HCC), cirrhosis, alcoholic liver disease (ALD) and NAFLD (Nonalcoholic fatty liver disease), but not in chronic hepatitis B infection (CHB) and chronic hepatitis C infection (CHC).

Conclusions

These results suggested that TM6SF2 rs58542926 could be used to identify individuals at higher susceptibility to chronic liver disease, especially for HCC, cirrhosis, ALD, and NAFLD.

A meta-analysis on relationship between paraoxonase 1 polymorphisms and atherosclerotic cardiovascular diseases

BACKGROUND

Some previous studies already explored associations between paraoxonase 1 (PON1) polymorphisms and atherosclerotic cardiovascular diseases (ASCVD), with conflicting findings. Here, we aimed to better analyze the relationship between PON1 polymorphisms and ASCVD in a larger combined population by performing a meta-analysis.

METHODS

We searched Pubmed, Embase and Web of Science for related articles. We calculated odds ratio (OR) and 95% confidence interval (CI) to estimate whether there are genetic associations between PON1 polymorphisms and ASCVD.

RESULTS

One hundred and nine studies were included for this meta-analysis. The PON1 rs854560 (17,220 cases and 18,570 controls, recessive comparison: OR = 0.83, 95%CI 0.72-0.96) and rs662 (30,717 cases and 54,894 controls, dominant comparison: OR = 0.82, 95% CI 0.77-0.89; recessive comparison: OR = 1.17, 95% CI 1.07-1.28; allele comparison: OR = 0.85, 95% CI 0.81-0.90) polymorphisms were both found to be significantly associated with susceptibility to ASCVD in general population. Subgroup analyses by ethnicity revealed similar significant findings for rs854560 polymorphism only in East Asians, while similar positive findings for rs662 polymorphism were observed in Caucasians, East Asians and South Asians. Subgroup analyses by type of disease indicated that the significant findings for rs854560 polymorphism were mainly driven by the ischemic stroke (IS) subgroup, whereas the positive results for rs662 polymorphism were mainly driven by the coronary artery disease (CAD) subgroup.

CONCLUSIONS

In summary, this meta-analysis proved that PON1 rs854560 polymorphism could be used to identify individual with elevated susceptibility to IS, whereas rs662 polymorphism could be used to identify individual with elevated susceptibility to CAD.

Associations of leptin and leptin receptor genetic variants with coronary artery disease: a meta-analysis

Background: Some pilot studies already tried to investigate potential associations of leptin (LEP) and LEP receptor (LEPR) variants with coronary artery disease (CAD). However, the results of these studies were not consistent. Thus, we performed the present meta-analysis to explore associations between LEP/LEPR variants and CAD in a larger pooled population.

Methods: Systematic literature research of PubMed, Web of Science, Embase and CNKI was performed to identify eligible case–control studies on associations between LEP/LEPR variants and CAD. The initial search was conducted in September 2018 and the latest update was performed in December 2018. Q test and I² statistic were employed to assess between-study heterogeneities. If probability value(P-value) of Q test was less than 0.1 or I² was greater than 50%, random-effect models (REMs) would be used to pool the data. Otherwise, fixed-effect models (FEMs) would be applied for synthetic analyses.

Results: A total of ten studies published between 2006 and 2018 were eligible for analyses (1989 cases and 2601 controls). Pooled analyses suggested that LEP rs7799039 variant was significantly associated with CAD under over-dominant model (P=0.0007, odds ratio (OR) = 1.36, 95% confidence interval (CI): 1.14–1.63, I² = 41%, FEM) in overall population, and this significant finding was further confirmed in East Asians in subsequent subgroup analyses. However, no positive findings were observed for LEPR rs1137100 and rs1137101 variants in overall and subgroup analyses.

Conclusions: Our meta-analysis suggested that LEP rs7799039 variant might affect individual susceptibility to CAD.

Molecular biomarkers and precision medicine in colorectal cancer: a systematic review of health economic analyses

An increased understanding of the biology of colorectal cancer (CRC) has fuelled identification of biomarkers with potential to drive a stratified precision medicine care approach in this common malignancy.

We conducted a systematic review of health economic assessments of molecular biomarkers (MBMs) and their employment in patient stratification in CRC. Our analysis revealed scenarios where health economic analyses have been applied to evaluate the cost effectiveness of MBM-guided clinical interventions: (i) evaluation of Dihydropyrimidine dehydrogenase gene (DPYD) status to identify patients susceptible to 5-Fluouracil toxicity; (ii) determination of Uridine 5′-diphospho- glucuronosyltransferase family 1 member A1 gene (UGT1A1) polymorphism status to help guide irinotecan treatment; (iii) assessment of RAS/RAF mutational status to stratify patients for chemotherapy or Epidermal Growth Factor Receptor (EGFR) therapy and (iv) multigene expression analysis (Oncotype Dx) to identify and spare non-responders the debilitating effects of particular chemotherapy interventions.

Our findings indicate that Oncotype Dx is cost-effective in high income settings within specific price points, by limiting treatment toxicity in CRC patients. DPYD status testing may also be cost effective in certain settings to avoid specific 5-FU toxicities post treatment. In contrast, current research does not support UGT1A1 polymorphism status as a cost-effective guide to irinotecan dosing, while the health economic evidence to support testing of KRAS/NRAS mutational status and chemo/EGFR therapy choice was inconclusive, despite its widespread adoption in CRC treatment management. However, we also show that there is a paucity of high-quality cost-effectiveness studies to support clinical application of precision medicine approaches in CRC.

At the crossroads of oral health inequities and precision public health

OBJECTIVES

This paper reviews the precision public health literature pertaining to oral health, identifies possible threats that could inadvertently increase health inequities, and proposes potential opportunities that precision public health could utilize to reduce oral health inequities.

METHODS

The health sciences literature was reviewed and supplemented with new data to identify important issues relating to precision medicine, precision oral health, precision public health, and health equity.

RESULTS

Examples from general health and oral health were provided to illustrate salient concepts.

CONCLUSIONS

Future precision public health should utilize multifactorial, multi-level conceptual frameworks and conceptual causal models with upstream social determinants and downstream health effects, as well as a proportionate universalism perspective; and proper analytic methods, including sufficient sample sizes, appropriate statistical competitors, health disparity indices, causal modeling, and internal and external validation.

Exercise Science and Child Health: A Tale of Many Journeys

Children are the most naturally physically active human beings; reduced physical activity is a cardinal sign of childhood disease, and exercise testing provides mechanistic insights into health and disease that are often hidden when the child is at rest. The physical inactivity epidemic is leading to increased disease risk in children and, eventually, in adults in unprecedented ways. Cardiopulmonary exercise testing (CPET) biomarkers are used to assess disease severity, progress, and response to therapy across an expanding range of childhood diseases and conditions. There is mounting data that fitness in children tracks across the life span and may prove to be an early, modifiable indicator of cardiovascular disease risk later in life. Despite these factors, CPET has failed to fulfill its promise in child health research and clinical practice. A major barrier to more accurate and effective clinical use of CPET in children is that data analytics and testing protocols have failed to keep pace with enabling technologies and computing capacity. As a consequence, biomarkers of fitness and physical activity have yet to be widely incorporated into translational research and clinical practice in child health. In this review, the author re-examines some of the long-held assumptions that mold CPET in children. In particular, the author suggests that current testing strategies that rely predominantly on maximal exercise may, inadvertently, obfuscate novel and clinically useful insights that can be gleaned from more comprehensive data analytics. New pathways to discovery may emanate from the simple recognition that the physiological journey that human beings undertake in response to the challenge of exercise may be far more important than the elusive destination of maximal or peak effort.

Insights into Pathogenic Interactions Among Environment, Host, and Tumor at the Crossroads of Molecular Pathology and Epidemiology

Evidence indicates that diet, nutrition, lifestyle, the environment, the microbiome, and other exogenous factors have pathogenic roles and also influence the genome, epigenome, transcriptome, proteome, and metabolome of tumor and nonneoplastic cells, including immune cells. With the need for big-data research, pathology must transform to integrate data science fields, including epidemiology, biostatistics, and bioinformatics. The research framework of molecular pathological epidemiology (MPE) demonstrates the strengths of such an interdisciplinary integration, having been used to study breast, lung, prostate, and colorectal cancers. The MPE research paradigm not only can provide novel insights into interactions among environment, tumor, and host but also opens new research frontiers. New developments-such as computational digital pathology, systems biology, artificial intelligence, and in vivo pathology technologies-will further transform pathology and MPE. Although it is necessary to address the rarity of transdisciplinary education and training programs, MPE provides an exemplary model of integrative scientific approaches and contributes to advancements in precision medicine, therapy, and prevention.