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Erschienen in: International Journal of Colorectal Disease 1/2010

01.01.2010 | Original Article

CTLA-4 +49A>G polymorphism is associated with the risk but not with the progression of colorectal cancer in Chinese

verfasst von: Peng Qi, Can-ping Ruan, Hao Wang, Fei-guo Zhou, Xin-yun Xu, Xing Gu, Yun-peng Zhao, Tong-hai Dou, Chun-fang Gao

Erschienen in: International Journal of Colorectal Disease | Ausgabe 1/2010

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Abstract

Purpose

Colorectal cancer (CRC) is one of the most common malignancies in the world and a multipathway disease. Cytotoxic T-lymphocyte antigen-4 (CTLA-4) is a potent immunoregulatory molecule that suppresses antitumor response by down-regulating T-cell activation. The most studied +49A>G polymorphism of CTLA-4 gene has been associated with several autoimmune or cancer diseases. Our aim was to investigate the association between this genetic variant and the risk as well as progression of colorectal cancer in Chinese.

Methods

We conducted a case–control study of 124 colorectal cancer cases and 407 healthy controls. DNA was extracted from blood specimens, and +49A>G polymorphism in the CTLA-4 gene was genotyped by polymerase chain reaction–ligation detection reaction (PCR–LDR).

Results

In our study group, the frequency of AG or GG or carrying at least one G allele at position +49 was significantly different in colorectal cancer patients and the control group, indicating that the risk of CRC was significantly higher among subjects with the AG or GG genotype or carrying at least one G allele at position +49 than among the subjects with the AA genotype. However, we observed no association between CTLA-4 +49A>G polymorphism and the progression of CRC. Interestingly, the CTLA-4 +49A allele was in non-significantly higher numbers in CRC patients with distant metastasis.

Conclusions

Our results suggested that CTLA-4 +49A>G polymorphism was associated with an increased risk of colorectal cancer, but this polymorphism did not play an important role in the progression of CRC in Chinese.
Literatur
1.
2.
Zurück zum Zitat Jass JR (2006) Colorectal cancer: a multipathway disease. Crit Rev Oncol 12:273–287 Jass JR (2006) Colorectal cancer: a multipathway disease. Crit Rev Oncol 12:273–287
3.
Zurück zum Zitat Hurwitz AA, Kwon ED, van Elsas A (2000) Costimulatory wars: the tumor menace. Curr Opin Immunol 12:589–596CrossRefPubMed Hurwitz AA, Kwon ED, van Elsas A (2000) Costimulatory wars: the tumor menace. Curr Opin Immunol 12:589–596CrossRefPubMed
4.
Zurück zum Zitat Chen L (2004) Co-inhibitory molecules of the B7-CD28 family in the control of T-cell immunity. Nat Rev Immunol 4:336–347CrossRefPubMed Chen L (2004) Co-inhibitory molecules of the B7-CD28 family in the control of T-cell immunity. Nat Rev Immunol 4:336–347CrossRefPubMed
5.
Zurück zum Zitat Burnet FM (1970) The concept of immunological surveillance. Prog Exp Tumor Res 13:1–27PubMed Burnet FM (1970) The concept of immunological surveillance. Prog Exp Tumor Res 13:1–27PubMed
6.
Zurück zum Zitat Tivol EA, Schweitzer AN, Sharpe AH (1996) Costimulation and autoimmunity. Curr Opin Immunol 8:822–830CrossRefPubMed Tivol EA, Schweitzer AN, Sharpe AH (1996) Costimulation and autoimmunity. Curr Opin Immunol 8:822–830CrossRefPubMed
7.
Zurück zum Zitat Thompson CB, Allison JP (1997) The emerging role of CTLA4 as an immune attenuator. Immunity 7:445–450CrossRefPubMed Thompson CB, Allison JP (1997) The emerging role of CTLA4 as an immune attenuator. Immunity 7:445–450CrossRefPubMed
8.
Zurück zum Zitat Tivol EA, Borriello F, Schweitzer AN, Lynch WP, Bluestone JA, Sharpe AH (1995) Loss of CTLA-4 leads to massive lymphoproliferation and fatal multiorgan tissue destruction, revealing a critical negative regulatory role of CTLA-4. Immunity 3:541–547CrossRefPubMed Tivol EA, Borriello F, Schweitzer AN, Lynch WP, Bluestone JA, Sharpe AH (1995) Loss of CTLA-4 leads to massive lymphoproliferation and fatal multiorgan tissue destruction, revealing a critical negative regulatory role of CTLA-4. Immunity 3:541–547CrossRefPubMed
9.
Zurück zum Zitat Leach DR, Krummel MF, Allison JP (1996) Enhancement of antitumor immunity by CTLA-4 blockade. Science 271:1734–1736CrossRefPubMed Leach DR, Krummel MF, Allison JP (1996) Enhancement of antitumor immunity by CTLA-4 blockade. Science 271:1734–1736CrossRefPubMed
10.
Zurück zum Zitat Hurwitz AA, Foster BA, Kwon ED et al (2000) Combination immunotherapy of primary prostate cancer in a transgenic mouse model using CTLA-4 blockade. Cancer Res 60:2444–2448PubMed Hurwitz AA, Foster BA, Kwon ED et al (2000) Combination immunotherapy of primary prostate cancer in a transgenic mouse model using CTLA-4 blockade. Cancer Res 60:2444–2448PubMed
11.
Zurück zum Zitat van Elsas A, Hurwitz AA, Allison JP (1999) Combination immunotherapy of B16 melanoma using anti-cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and granulocyte/macrophage colony-stimulating factor (GM-CSF)-producing vaccines induces rejection of subcutaneous and metastatic tumors accompanied by autoimmune depigmentation. J Exp Med 190:355–366CrossRefPubMed van Elsas A, Hurwitz AA, Allison JP (1999) Combination immunotherapy of B16 melanoma using anti-cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) and granulocyte/macrophage colony-stimulating factor (GM-CSF)-producing vaccines induces rejection of subcutaneous and metastatic tumors accompanied by autoimmune depigmentation. J Exp Med 190:355–366CrossRefPubMed
12.
Zurück zum Zitat Ligers A, Teleshova N, Masterman T, Huang WX, Hillert J (2001) CTLA-4 gene expression is influenced by promoter and exon 1 polymorphisms. Genes Immun 2:145–152CrossRefPubMed Ligers A, Teleshova N, Masterman T, Huang WX, Hillert J (2001) CTLA-4 gene expression is influenced by promoter and exon 1 polymorphisms. Genes Immun 2:145–152CrossRefPubMed
13.
Zurück zum Zitat Ghaderi A, Yeganeh F, Kalantari T et al (2004) Cytotoxic T lymphocyte antigen-4 gene in breast cancer. Breast Cancer Res Treat 86:1–7CrossRefPubMed Ghaderi A, Yeganeh F, Kalantari T et al (2004) Cytotoxic T lymphocyte antigen-4 gene in breast cancer. Breast Cancer Res Treat 86:1–7CrossRefPubMed
14.
Zurück zum Zitat Ueda H, Howson JM, Esposito L et al (2003) Association of the T-cell regulatory gene CTLA4 with susceptibility to autoimmune disease. Nature 423:506–511CrossRefPubMed Ueda H, Howson JM, Esposito L et al (2003) Association of the T-cell regulatory gene CTLA4 with susceptibility to autoimmune disease. Nature 423:506–511CrossRefPubMed
15.
Zurück zum Zitat Johnson GC, Esposito L, Barratt BJ et al (2001) Haplotype tagging for the identification of common disease genes. Nat Genet 29:233–237CrossRefPubMed Johnson GC, Esposito L, Barratt BJ et al (2001) Haplotype tagging for the identification of common disease genes. Nat Genet 29:233–237CrossRefPubMed
16.
Zurück zum Zitat Deichmann K, Heinzmann A, Bruggenolte E, Foster J, Kuehr J (1996) A Mse I RFLP in the human CTLA4 promoter. Biochem Biophys Res Commun 225:817–818CrossRefPubMed Deichmann K, Heinzmann A, Bruggenolte E, Foster J, Kuehr J (1996) A Mse I RFLP in the human CTLA4 promoter. Biochem Biophys Res Commun 225:817–818CrossRefPubMed
17.
Zurück zum Zitat Donner H, Rau H, Walfish PG et al (1997) CTLA4 alanine-17 confers genetic susceptibility to Graves' disease and to type 1 diabetes mellitus. J Clin Endocrinol Metab 82:143–146CrossRefPubMed Donner H, Rau H, Walfish PG et al (1997) CTLA4 alanine-17 confers genetic susceptibility to Graves' disease and to type 1 diabetes mellitus. J Clin Endocrinol Metab 82:143–146CrossRefPubMed
18.
Zurück zum Zitat Polymeropoulos MH, Xiao H, Rath DS, Merril CR (1991) Dinucleotide repeat polymorphism at the human CTLA4 gene. Nucleic Acids Res 19:4018 Polymeropoulos MH, Xiao H, Rath DS, Merril CR (1991) Dinucleotide repeat polymorphism at the human CTLA4 gene. Nucleic Acids Res 19:4018
19.
Zurück zum Zitat Pullmann R Jr, Lukác J, Skerenová M et al (1999) Cytotoxic T lymphocyte antigen 4 (CTLA-4) dimorphism in patients with systemic lupus erythematosus. Clin Exp Rheumatol 17:725–729PubMed Pullmann R Jr, Lukác J, Skerenová M et al (1999) Cytotoxic T lymphocyte antigen 4 (CTLA-4) dimorphism in patients with systemic lupus erythematosus. Clin Exp Rheumatol 17:725–729PubMed
20.
Zurück zum Zitat Zaletel K, Krhin B, Gaberscek S, Hojker S (2006) Thyroid autoantibody production is influenced by exon 1 and promoter CTLA-4 polymorphisms in patients with Hashimoto's thyroiditis. Int J Immunogenet 33:87–91CrossRefPubMed Zaletel K, Krhin B, Gaberscek S, Hojker S (2006) Thyroid autoantibody production is influenced by exon 1 and promoter CTLA-4 polymorphisms in patients with Hashimoto's thyroiditis. Int J Immunogenet 33:87–91CrossRefPubMed
21.
Zurück zum Zitat Kouki T, Sawai Y, Gardine CA, Fisfalen ME, Alegre ML, DeGroot LJ (2000) CTLA-4 gene polymorphism at position 49 in exon 1 reduces the inhibitory function of CTLA-4 and contributes to the pathogenesis of Graves' disease. J Immunol 165:6606–6611PubMed Kouki T, Sawai Y, Gardine CA, Fisfalen ME, Alegre ML, DeGroot LJ (2000) CTLA-4 gene polymorphism at position 49 in exon 1 reduces the inhibitory function of CTLA-4 and contributes to the pathogenesis of Graves' disease. J Immunol 165:6606–6611PubMed
22.
Zurück zum Zitat Gunesacar R, Erken E, Bozkurt B et al (2007) Analysis of CD28 and CTLA-4 gene polymorphisms in Turkish patients with Behcet's disease. Int J Immunogenet 34:45–49CrossRefPubMed Gunesacar R, Erken E, Bozkurt B et al (2007) Analysis of CD28 and CTLA-4 gene polymorphisms in Turkish patients with Behcet's disease. Int J Immunogenet 34:45–49CrossRefPubMed
23.
Zurück zum Zitat Monne M, Piras G, Palmas A et al (2004) Cytotoxic T-lymphocyte antigen-4 (CTLA-4) gene polymorphism and susceptibility to non-Hodgkin's lymphoma. Am J Hematol 76:14–18CrossRefPubMed Monne M, Piras G, Palmas A et al (2004) Cytotoxic T-lymphocyte antigen-4 (CTLA-4) gene polymorphism and susceptibility to non-Hodgkin's lymphoma. Am J Hematol 76:14–18CrossRefPubMed
24.
Zurück zum Zitat Piras G, Monne M, Uras A et al (2005) Genetic analysis of the 2q33 region containing CD28-CTLA4-ICOS genes: association with non-Hodgkin's lymphoma. Br J Haematol 129:784–790CrossRefPubMed Piras G, Monne M, Uras A et al (2005) Genetic analysis of the 2q33 region containing CD28-CTLA4-ICOS genes: association with non-Hodgkin's lymphoma. Br J Haematol 129:784–790CrossRefPubMed
25.
Zurück zum Zitat Seidl C, Donner H, Fischer B et al (1998) CTLA4 codon 17 dimorphism in patients with rheumatoid arthritis. Tissue Antigens 51:62–66CrossRefPubMed Seidl C, Donner H, Fischer B et al (1998) CTLA4 codon 17 dimorphism in patients with rheumatoid arthritis. Tissue Antigens 51:62–66CrossRefPubMed
26.
Zurück zum Zitat Abe T, Takino H, Yamasaki H et al (1999) CTLA4 gene polymorphism correlates with the mode of onset and presence of ICA512 Ab in Japanese type 1 diabetes. Diabetes Res Clin Pract 46:169–175CrossRefPubMed Abe T, Takino H, Yamasaki H et al (1999) CTLA4 gene polymorphism correlates with the mode of onset and presence of ICA512 Ab in Japanese type 1 diabetes. Diabetes Res Clin Pract 46:169–175CrossRefPubMed
27.
Zurück zum Zitat Agarwal K, Jones DE, Daly AK et al (2000) CTLA-4 gene polymorphism confers susceptibility to primary biliary cirrhosis. J Hepatol 32:538–541CrossRefPubMed Agarwal K, Jones DE, Daly AK et al (2000) CTLA-4 gene polymorphism confers susceptibility to primary biliary cirrhosis. J Hepatol 32:538–541CrossRefPubMed
28.
Zurück zum Zitat van Veen T, Crusius JB, van Winsen L et al (2003) CTLA-4 and CD28 gene polymorphisms in susceptibility, clinical course and progression of multiple sclerosis. J Neuroimmunol 140:188–193CrossRefPubMed van Veen T, Crusius JB, van Winsen L et al (2003) CTLA-4 and CD28 gene polymorphisms in susceptibility, clinical course and progression of multiple sclerosis. J Neuroimmunol 140:188–193CrossRefPubMed
29.
Zurück zum Zitat Teutsch SM, Booth DR, Bennetts BH, Heard RN, Stewart GJ (2004) Association of common T cell activation gene polymorphisms with multiple sclerosis in Australian patients. J Neuroimmunol 148:218–230CrossRefPubMed Teutsch SM, Booth DR, Bennetts BH, Heard RN, Stewart GJ (2004) Association of common T cell activation gene polymorphisms with multiple sclerosis in Australian patients. J Neuroimmunol 148:218–230CrossRefPubMed
30.
Zurück zum Zitat Solerio E, Tappero G, Iannace L et al (2005) CTLA4 gene polymorphism in Italian patients with colorectal adenoma and cancer. Dig Liver Dis 37:170–175CrossRefPubMed Solerio E, Tappero G, Iannace L et al (2005) CTLA4 gene polymorphism in Italian patients with colorectal adenoma and cancer. Dig Liver Dis 37:170–175CrossRefPubMed
31.
Zurück zum Zitat Hadinia A, Hossieni SV, Erfani N, Saberi-Firozi M, Fattahi MJ, Ghaderi A (2007) CTLA-4 gene promoter and exon 1 polymorphisms in Iranian patients with gastric and colorectal cancers. J Gastroenterol Hepatol 22:2283–2287CrossRefPubMed Hadinia A, Hossieni SV, Erfani N, Saberi-Firozi M, Fattahi MJ, Ghaderi A (2007) CTLA-4 gene promoter and exon 1 polymorphisms in Iranian patients with gastric and colorectal cancers. J Gastroenterol Hepatol 22:2283–2287CrossRefPubMed
32.
Zurück zum Zitat Dilmec F, Ozgonul A, Uzunkoy A, Akkafa F (2008) Investigation of CTLA-4 and CD28 gene polymorphisms in a group of Turkish patients with colorectal cancer. Int J Immunogenet 35:317–321CrossRefPubMed Dilmec F, Ozgonul A, Uzunkoy A, Akkafa F (2008) Investigation of CTLA-4 and CD28 gene polymorphisms in a group of Turkish patients with colorectal cancer. Int J Immunogenet 35:317–321CrossRefPubMed
33.
Zurück zum Zitat Wong YK, Chang KW, Cheng CY, Liu CJ (2006) Association of CTLA-4 gene polymorphism with oral squamous cell carcinoma. J Oral Pathol & Med 35:51–54CrossRef Wong YK, Chang KW, Cheng CY, Liu CJ (2006) Association of CTLA-4 gene polymorphism with oral squamous cell carcinoma. J Oral Pathol & Med 35:51–54CrossRef
34.
Zurück zum Zitat Hoeffel C, Mulé S, Romaniuk B, Ladam-Marcus V, Bouché O, Marcus C (2009) Advances in radiological imaging of gastrointestinal tumors. Crit Rev Oncol Hematol 69:153–167CrossRefPubMed Hoeffel C, Mulé S, Romaniuk B, Ladam-Marcus V, Bouché O, Marcus C (2009) Advances in radiological imaging of gastrointestinal tumors. Crit Rev Oncol Hematol 69:153–167CrossRefPubMed
35.
Zurück zum Zitat Sun T, Zhou Y, Yang M et al (2008) Functional genetic variations in cytotoxic T-lymphocyte antigen 4 and susceptibility to multiple types of cancer. Cancer Res 68:7025–7034CrossRefPubMed Sun T, Zhou Y, Yang M et al (2008) Functional genetic variations in cytotoxic T-lymphocyte antigen 4 and susceptibility to multiple types of cancer. Cancer Res 68:7025–7034CrossRefPubMed
36.
Zurück zum Zitat Marron MP, Raffel LJ, Garchon HJ et al (1997) Insulin-dependent diabetes mellitus (IDDM) is associated with CTLA4 polymorphisms in multiple ethnic groups. Hum Mol Genet 6:1275–1282CrossRefPubMed Marron MP, Raffel LJ, Garchon HJ et al (1997) Insulin-dependent diabetes mellitus (IDDM) is associated with CTLA4 polymorphisms in multiple ethnic groups. Hum Mol Genet 6:1275–1282CrossRefPubMed
37.
Zurück zum Zitat Dalgleish AG, O’Byrne KJ (2002) Chronic immune activation and inflammation in the pathogenesis of AIDS and cancer. Adv Cancer Res 84:231–276CrossRefPubMed Dalgleish AG, O’Byrne KJ (2002) Chronic immune activation and inflammation in the pathogenesis of AIDS and cancer. Adv Cancer Res 84:231–276CrossRefPubMed
38.
Zurück zum Zitat Li S, Nie Z, Li N et al (2003) Colorectal cancer screening for the natural population of Beijing with sequential fecal occult blood test: a multicenter study. Chin Med J (Engl) 116:200–202 Li S, Nie Z, Li N et al (2003) Colorectal cancer screening for the natural population of Beijing with sequential fecal occult blood test: a multicenter study. Chin Med J (Engl) 116:200–202
39.
Zurück zum Zitat Mapara MY, Sykes M (2004) Tolerance and cancer: mechanisms of tumor evasion and strategies for breaking tolerance. J Clin Oncol 22:1136–1151CrossRefPubMed Mapara MY, Sykes M (2004) Tolerance and cancer: mechanisms of tumor evasion and strategies for breaking tolerance. J Clin Oncol 22:1136–1151CrossRefPubMed
40.
Zurück zum Zitat Agarwal K, Czaja AJ, Jones DE, Donaldson PT (2000) Cytotoxic T lymphocyte antigen-4 (CTLA-4) gene polymorphisms and susceptibility to type 1 autoimmune hepatitis. Hepatology 31:49–53CrossRefPubMed Agarwal K, Czaja AJ, Jones DE, Donaldson PT (2000) Cytotoxic T lymphocyte antigen-4 (CTLA-4) gene polymorphisms and susceptibility to type 1 autoimmune hepatitis. Hepatology 31:49–53CrossRefPubMed
41.
Zurück zum Zitat Anjos S, Nguyen A, Ounissi-Benkalha H, Tessier MC, Polychronakos C (2002) A common autoimmunity predisposing signal peptide variant of the cytotoxic T-lymphocyte antigen 4 results in inefficient glycosylation of the susceptibility allele. J Biol Chem 277:46478–46486CrossRefPubMed Anjos S, Nguyen A, Ounissi-Benkalha H, Tessier MC, Polychronakos C (2002) A common autoimmunity predisposing signal peptide variant of the cytotoxic T-lymphocyte antigen 4 results in inefficient glycosylation of the susceptibility allele. J Biol Chem 277:46478–46486CrossRefPubMed
Metadaten
Titel
CTLA-4 +49A>G polymorphism is associated with the risk but not with the progression of colorectal cancer in Chinese
verfasst von
Peng Qi
Can-ping Ruan
Hao Wang
Fei-guo Zhou
Xin-yun Xu
Xing Gu
Yun-peng Zhao
Tong-hai Dou
Chun-fang Gao
Publikationsdatum
01.01.2010
Verlag
Springer-Verlag
Erschienen in
International Journal of Colorectal Disease / Ausgabe 1/2010
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-009-0806-z

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