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Genetic polymorphisms in the Toll-like receptor signalling pathway in Helicobacter pylori infection and related gastric cancer
Authors:Natalia Castañ  o-Rodrí  guez,Nadeem O. Kaakoush,Aryce L. Pardo,Khean-Lee Goh,Kwong Ming Fock,Hazel M. Mitchell
Affiliation: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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