Effects of TNFα, NOS3, MDR1 Gene Polymorphisms on Clinical Parameters, Prognosis and Survival of Multiple Myeloma Cases

Effects of the SLCO1B1 A388G single nucleotide polymorphism on the development, clinical parameters, treatment, and survival of multiple myeloma cases in a Polish population

BACKGROUND

Multiple myeloma is one of the most common hematological malignancies worldwide. Genetic alterations may lead to the progression from monoclonal gammopathy to multiple myeloma. Additionally, the genetic background of the disease might influence therapy outcomes, including survival time. SLCO1B1, belonging to the OATPs family, is a membrane protein that mediates the uptake of a wide range of endogenous and exogenous (including drugs) compounds.

METHODS AND RESULTS

In this study, the A388G single nucleotide polymorphism in the SLCO1B1 gene in Polish multiple myeloma patients was determined. This polymorphism affects the amino acid change of the protein, so it may be responsible for treatment effectiveness or risk of disease development. A388G was evaluated by the PCR-RFLP method. The presented study showed a statistically significant association between the GG genotype with longer survival of patients with multiple myeloma with Melphalan-Prednisone therapy compared to other treatment regimens (p = 0.0271). There was no statistically significant association in the frequency of genotypes (p = 0.8211) and alleles: allele A (p = 0.5442); allele G (p = 0.8020) between multiple myeloma patients and a control group.

CONCLUSIONS

The A388G polymorphism does not seem to affect the increased risk of the development of multiple myeloma. However, the occurrence of the GG genotype may prolong of patients overall survival in the case of Melphalan-Prednisone therapy.

Association Of -308G/A, -238G/A TNF-α Polymorphisms with Multiple Myeloma Risk and Survival: A Systematic Review and Meta-Analysis

INTRODUCTION

Tumor necrosis factor alpha (TNF-α) is a cytokine with a key role in proinflammation and multiple diseases, including cancer. The gene encoding TNF-α is located within a highly polymorphic region on chromosome 6p21.3; two polymorphisms -308G/A (rs1800629) and -238G/A (rs361525) have been associated with occurrence of human diseases. There is a debate in recent meta-analyses that reached discrepant conclusions regarding the potential role of TNF-α polymorphisms in multiple myeloma (MM) risk. The aim of this systematic review and meta-analysis is to investigate the association between the aforementioned two polymorphisms with the risk and survival of MM.

MATERIALS AND METHODS

Eligible articles were identified through an extensive search in PubMed database (end of search: June 18, 2020). The pooled effect estimates were calculated following the random-effects models by Der Simonian and Laird. Separate analyses were conducted by ethnicity. Between-study heterogeneity was quantified, and the deviation of genotype frequencies in controls from the Hardy-Weinberg equilibrium was evaluated.

RESULTS

Eighteen studies (2934 cases, 4291 controls) have been included in the quantitative synthesis examining risk and 5 studies for survival (557 cases). No association was found between -308G/A and -238G/A TNF-α polymorphisms and MM susceptibility in all genetic models for both Caucasian and East Asian populations. There was no association between -308G/A and -238G/A TNF-α polymorphisms and survival (overall or progression-free) of MM.

CONCLUSION

This systematic review and meta-analysis did not reveal a significant effect of -308G/A and -238G/A TNF-α polymorphisms upon risk or survival of MM.

Incidence and Risk Factors of Osteonecrosis of Femoral Head in Multiple Myeloma Patients Undergoing Dexamethasone-Based Regimens

Objectives

To investigate the incidence and risk factors for osteonecrosis of femoral head (ONFH) in multiple myeloma (MM) patients undergoing dexamethasone-based regimens (DBRs).

Methods

A retrospective study was conducted in MM patients administered DBRs between December 2012 and April 2015. Demographic, clinical, and laboratory data were extracted to compare between two groups. Incidence of ONFH were calculated and risk factors identified by both univariate and multivariate analysis.

Results

The study group comprised 105 patients undergoing DBRs. Seven patients with ONFH after DBRs were classified as the ONFH group, and the other 98 patients without ONFH were included in the non-ONFH group. Incidence of ONFH was 6.7%. Median age of developing ONFH was 51 years (45-64), and the male to female ratio was 6 : 1. A total of 12 femoral heads were involved, including unilateral in 2 patients and bilateral in 5 patients. After the multivariate analysis, four risk factors were confirmed including male, younger age, cumulative dose of dexamethasone, and hyperlipidemia.

Conclusion

The overall incidence of ONFH in MM patients treated with DBRs is 6.7%, and 4 risk factors are confirmed including male, younger age, cumulative dose of dexamethasone, and hyperlipidemia in our study.

Association between tumor necrosis factor alpha gene polymorphisms and multiple myeloma risk: an updated meta-analysis

OBJECTIVE

This study aimed to investigate the relationship between tumor necrosis factor alpha (TNFα) polymorphisms and multiple myeloma (MM) risk.

METHODS

Eligible studies were retrieved from PubMed, the Cochrane Library, Embase, CNKI and the Wanfang database. Polymorphisms of TNFα-308 G/A, TNFα-857 C/T, and TNFα-238 G/A were analyzed based on the allele, recessive, dominant, and additive-dominant models. The meta-analysis was conducted using R 3.12 software. Odds ratio (OR) and 95% confidence intervals (CI) were used as evaluation indicators. Heterogeneity among studies was detected. Publication bias was evaluated. Sensitivity and power analyses were also conducted.

RESULTS

Significant associations existed between 'TT vs. CC' (OR = 2.3752, 95% CI = 1.1342-4.9740) and 'TT vs. CC + TC' (OR = 2.0802, 95% CI = 1.0250-4.2218) models of the TNFα-857 C/T gene and MM risk. There were no significant differences in other genetic models of TNFα-857 C/T or any genetic models of TNFα-308 G/A and TNFα-238 G/A. No significant publication bias existed among the studies. In addition, sensitivity analyses showed that meta-analysis results of all genetic models of the TNFα-238 G/A gene did not change after omitting one of these studies, but most models of TNFα-857 C/T and TNFα-308 G/A exhibited significant changes.

CONCLUSION

Our findings indicate that the 'TT vs. CC' and 'TT vs. CC + TC' of TNFα-857 C/T are correlated with MM risk. TNFα-857 C/T may be a risk factor for MM development. There is no association between TNFα-238/-308 polymorphisms and MM risk.

Genetic polymorphisms and multiple myeloma risk: a meta-analysis

Previous researches exploring associations between multiple myeloma (MM) and genetic polymorphisms showed controversial results. In this investigation, we aimed to make a meta-analysis to assess the association between MM risk and genetic polymorphisms. We searched for articles on genetic polymorphism and MM risk in Web of Science and PubMed databases from 1951 to August 2019. We computed the odds ratio (OR) and 95% confidence intervals (CI) extracted from included articles. The meta-analysis showed no significant associations between MM risks and tumor necrosis factor (TNF)-α (rs1800629/rs361525/rs1799724), interleukin (IL)-6 (rs1800795), multidrug resistance 1 (MDR1) (rs1045642), Methylenetetrahydrofolate reductase (MTHFR) (rs1801131/rs1801133) polymorphisms. In summary, the study shows that the TNF-α (rs1800629/rs361525/rs1799724), IL-6 (rs1800795), MDR1 (rs1045642), and MTHFR (rs1801131/rs1801133) polymorphisms may not be associated with MM susceptibility. Thus, we do not need more expensive and useless studies to explore the associations between MM risks and these genetic polymorphisms.

NR3C1, ABCB1, TNF and CYP2C19 polymorphisms association with the response to the treatment of erythema nodosum leprosum

Aim: To evaluate the effects of gene polymorphisms in the treatment of erythema nodosum leprosum with prednisone/thalidomide. Patients & methods: A total of 152 patients from different regions of Brazil were included. Generalized estimating equation was used to evaluate the influence of polymorphisms and haplotypes on the drug dose variation throughout the treatment. Results: An association between the genotype tuberculoid of polymorphism ABCB1 3435C>T (rs1045642; p = 0.02) and prednisone dose was found in the recessive model. An association between the haplotypes 1031T/-863C/-857C/-308A/-238G (p = 0.006) and 1031T/-863C/-857T/-308A/-238G (p = 0.040) of the TNF gene and the CYP2C19*2 polymorphism were also identified, in relation to thalidomide dosage variation over the course of treatment. Conclusion: This work presents the first pharmacogenetic report of association between gene polymorphisms and erythema nodosum leprosum treatment with prednisone/thalidomide.

Effects of eNOS gene polymorphisms on individual susceptibility to cancer: A meta-analysis

BACKGROUND

Whether endothelial nitric oxide synthase (eNOS) polymorphisms are implicated in cancer development remains controversial. Therefore, we performed this study to obtain a more conclusive result on associations between eNOS polymorphisms and cancer.

METHODS

Literature retrieve was conducted in PubMed, Medline and Embase. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

RESULTS

Forty-one studies were enrolled for analyses. Pooled overall analyses showed that rs1799983 (dominant model: p = 0.01; recessive model: p = 0.007; allele model: p = 0.005), rs2070744 (recessive model: p = 0.004) and rs869109213 (recessive model: p < 0.0001; allele model: p = 0.02) polymorphisms were all significantly associated with individual susceptibility to cancer. Further subgroup analyses revealed that rs2070744 and rs869109213 polymorphisms were only significantly associated with individual susceptibility to cancer in Caucasians, whereas the rs1799983 polymorphism was significantly associated with individual susceptibility to cancer in both Caucasians and Asians.

CONCLUSIONS

Our findings indicated that rs1799983, rs2070744 and rs869109213 polymorphisms may serve as genetic biomarkers of cancer in certain ethnicities.

Multidrug resistance 1 (MDR1/ABCB1) gene polymorphism (rs1045642 C > T) and susceptibility to multiple myeloma: a systematic review and meta-analysis

INTRODUCTION

Several studies have evaluated the association between the multidrug resistance 1 (MDR1) polymorphism (rs1045642 C > T) and multiple myeloma (MM). However, the results were not consistent. Therefore, to reach a comprehensive and reliable answer we determined the association of the MDR1 (rs1045642 C > T) polymorphism and MM in the context of meta-analysis.

METHODS

All eligible studies published in EMBASE, PubMed, and Web of Science databases before July 2017 were reviewed. Subsequently, to assess the strength of association in the dominant model, recessive model, allelic model, homozygotes contrast, and heterozygotes contrast, pooled odds ratios and 95% confidence intervals (CIs) were calculated by the fixed effects model.

RESULTS

A total of four case-control studies with 395 MM cases and 418 healthy controls were included in the meta-analysis. The overall results showed no significant association between the MDR1 (rs1045642 C > T) polymorphism and the risk of MM in genetic models (dominant model: OR = 1.04, 95% CI = 0.78-1.38; recessive model: OR = 0.74, 95% CI = 0.52-1.06; allelic model: OR = 0.90, 95% CI = 0.73-1.11; TT vs. CC: OR = 0.80, 95% CI = 0.51-1.25; and CT vs. CC: OR = 1.12, 95% CI = 0.77-1.62). No evidence of publication bias was detected except for the analysis of the recessive model.

CONCLUSION

This meta-analysis suggests that the MDR1 C > T polymorphism was not associated with the risk of MM. To confirm these findings, further comprehensive and well-designed studies are needed.

Inflammatory and Anti-Inflammatory Equilibrium, Proliferative and Antiproliferative Balance: The Role of Cytokines in Multiple Myeloma

Multiple myeloma (MM) is typically exemplified by a desynchronized cytokine system with increased levels of inflammatory cytokines. We focused on the contrast between inflammatory and anti-inflammatory systems by assessing the role of cytokines and their influence on MM. The aim of this review is to summarize the available information to date concerning this equilibrium to provide an overview of the research exploring the roles of serum cytokines in MM. However, the association between MM and inflammatory cytokines appears to be inadequate, and other functions, such as pro-proliferative or antiproliferative effects, can assume the role of cytokines in the genesis and progression of MM. It is possible that inflammation, when guided by cancer-specific Th1 cells, may inhibit tumour onset and progression. In a Th1 microenvironment, proinflammatory cytokines (e.g., IL-6 and IL-1) may contribute to tumour eradication by attracting leucocytes from the circulation and by increasing CD4 ⁺ T cell activity. Hence, caution should be used when considering therapies that target factors with pro- or anti-inflammatory activity. Drugs that may reduce the tumour-suppressive Th1-driven inflammatory immune response should be avoided. A better understanding of the relationship between inflammation and myeloma will ensure more effective therapeutic interventions.