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Genetic polymorphisms in the Toll-like receptor signalling pathway in Helicobacter pylori infection and related gastric cancer
Authors:Natalia Castaño-Rodríguez  Nadeem O Kaakoush  Aryce L Pardo  Khean-Lee Goh  Kwong Ming Fock  Hazel M Mitchell
Institution:1. School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, NSW 2052, Australia;2. School of Statistics, National University of Colombia, Medellin, Colombia;3. Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;4. Division of Gastroenterology, Department of Medicine, Changi General Hospital, Singapore, Singapore
Abstract:

Background

Gastric cancer (GC) is a progressive process initiated by Helicobacter pylori-induced inflammation. Initial recognition of H. pylori involves Toll-like receptors (TLRs), central molecules in the host inflammatory response. Here, we investigated the association between novel polymorphisms in genes involved in the TLR signalling pathway, including TLR2, TLR4, LBP, MD-2, CD14 and TIRAP, and risk of H. pylori infection and related GC.

Methods

A case-control study comprising 310 ethnic Chinese individuals (87 non-cardia GC cases and 223 controls with functional dyspepsia) was conducted. Twenty-five polymorphisms were detected by MALDI-TOF mass spectrometry, PCR, PCR–RFLP and real-time PCR.

Results

Seven polymorphisms showed significant associations with GC (TLR4 rs11536889, TLR4 rs10759931, TLR4 rs1927911, TLR4 rs10116253, TLR4 rs10759932, TLR4 rs2149356 and CD14 −260 C/T). In multivariate analyses, TLR4 rs11536889 remained a risk factor for GC (OR: 3.58, 95% CI: 1.20–10.65). TLR4 rs10759932 decreased the risk of H. pylori infection (OR: 0.59, 95% CI: 0.41–0.86). Statistical analyses assessing the joint effect of H. pylori infection and the selected polymorphisms revealed strong associations with GC (TLR2, TLR4, MD-2, LBP and TIRAP polymorphisms).

Conclusions

Novel polymorphisms in TLR2, TLR4, MD-2, LBP, CD14 and TIRAP, genes encoding important molecules of the TLR signalling pathway, showed clear associations with H. pylori-related GC in Chinese.
Keywords:CTLs  C-type lectin receptors  CI  95% confidence intervals  DAMPs  damage-associated molecular patterns  ELISA  enzyme-linked immunosorbent assay  EM  Expectation-Maximization  FOXP3  forkhead box protein P3  FD  functional dyspepsia  GC  gastric cancer  HWE  Hardy&ndash  Weinberg equilibrium  HREC  Human Ethics Committee  LD  linkage disequilibrium  LPS  lipopolysaccharide  LR  logistic regression  MALDI-TOF  matrix assisted laser desorption ionisation time-of-flight  NCBI  National Center for Biotechnology Information  NHMRC  National Health and Medical Research Council  NSAIDs  non-steroidal anti-inflammatory drugs  NLRs  nucleotide-binding oligomerization domain-like receptors  OR  odds ratios  PAMPs  pathogen-associated molecular patterns  PCR  polymerase chain reaction  PCR&ndash  RFLP  polymerase chain reaction&ndash  restriction fragment length polymorphism  PRRs  pattern-recognition receptors  RLRs  retinoic acid-inducible gene-I-like receptors  Treg  natural regulatory T  TLRs  Toll-like receptors  UTR  untranslated region  χ2  chi-square goodness-of-fit test  
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