Haematologica
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Haematologica, Vol 92, Issue 8, 1145-1146 doi:10.3324/haematol.11053
Copyright © 2007 by Ferrata Storti Foundation
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Malignant Lymphomas

Vitamin D receptor gene polymorphisms and risk of non-Hodgkin’s lymphoma

Mark P. Purdue*,, Qing Lan*, Anne Kricker°, Claire M. Vajdic#, Nathaniel Rothman*, Bruce K. Armstrong°

* Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
° The University of Sydney, Sydney, AUS
# National Centre for HIV Epidemiology and Clinical Research, Sydney, Australia

Correspondence: Mark Purdue, PhD, Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, EPS 8121, MSC 7240, Rockville, MD, 20892-7240, USA. Phone: international +001.301.4515036. Fax: international +001.301.4021819. E-mail purduem{at}mail.nih.gov


    ABSTRACT
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We studied three vitamin D receptor gene (VDR) polymorphisms (BsmI, TaqI, FokI) in a case-control study of non-Hodgkin’s lymphoma. The BsmI B and TaqI t alleles were associated with an increased risk of diffuse large B-cell lymphoma. These findings suggest that variants in VDR may influence lymphomagenesis.

Key words: vitamin D receptor, case-control study, non-Hodgkin’s lymphoma, polymorphisms, Australia.

Recent epidemiologic findings suggesting an inverse association between sunlight exposure and risk of non-Hodgkin lymphoma (NHL) have generated interest in whether vitamin D, a photosynthesized hormone with anti-neoplastic properties, inhibits NHL development.13 Vitamin D has been reported to inhibit proliferation and induce differentiation in lymphocytes4 and lymphoma cell lines.5 In an early-phase trial of a vitamin D analog, 24% of 34 treated patients with progressive low-grade lymphoma experienced regression.6

Investigations of single-nucleotide polymorphisms (SNPs) in the vitamin D receptor gene (VDR) may offer an insight into the etiologic relevance of vitamin D. Three SNPs, located in FokI, BsmI and TaqI restriction sites, have been extensively studied as possible susceptibility factors for different diseases. The FokI (rs10735810) polymorphism, located at the 5' end of VDR, alters the transcription initiation site, resulting in a protein three amino acids shorter in length with higher activity as a transcription factor. 7 The BsmI (rs1544410) and TaqI (rs731236) polymorphisms are located close to one another at the 3' end. While these SNPs are unlikely to have functional relevance, they may be in linkage disequilibrium with other functionally relevant variants.7,8 We investigated the relationship between FokI, BsmI and TaqI and NHL risk within a population-based case-control study conducted in New South Wales, Australia. This study was approved by the human research ethics committee at each participating institution. Detailed descriptions of the study design and methods have been published previously.9 Briefly, 704 cases of NHL (86% of 819 eligible and contactable individuals) and 694 controls (61% of 1,136 eligible and contactable individuals) were interviewed. Of the 597 cases and 525 controls who provided blood, genotyping was successfully performed for 584 cases (83% of participants, 69% of eligible contactable individuals) and 518 controls (75% and 46%). Genotyping was carried out at the National Cancer Institute Core Genotyping Facility (http://cgf.nci.nih.gov) using TaqMan® assays (Applied Biosystems Inc., Foster City, CA, USA). The concordance rates for 95 duplicate samples were 100% for all assays. All SNPs passed a Hardy-Weinberg equilibrium test. The analysis was restricted to individuals of European or Asian ethnicity (561 cases, 506 controls; 97% of subjects) and was performed using SAS Version 8.2 (SAS Institute, Cary, North Carolina, USA). Analyses restricted to individuals of European ancestry gave almost identical findings and are not presented. To estimate the relative risk of NHL according to SNP genotype, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression adjusted for sex, age, state and ethnicity. The most prevalent homozygous genotype among controls was selected as the referent group. We also calculated subtype-specific ORs by cell lineage (B-cell, n=542; T-cell, n=16) and for the two most prevalent B-cell subtypes: follicular lymphoma (FL, n=211) and diffuse large B-cell lymphoma (DLBCL, n=180). We express genotypes using restriction-fragment length polymorphism nomenclature. Upper-case letters (i.e., F,B,T) indicate alleles coding for the restriction sequence in question (FokI, BsmI, TaqI respectively), while lower case letters denote the absence of the sequence.

The FokI, BsmI and TaqI polymorphisms were not clearly associated with all NHL in our population (Table 1). We did observe an excess risk of DLBCL with carriage of BsmI B and TaqI t alleles, but no evidence of a dose-response relationship was observed (Table 2). Experimental studies of functional activity and association studies involving these SNPs have not provided consistent findings,7 although these variants have been fairly consistently linked to shorter adult height.10 These SNPs, located close to one another at the 3' end of VDR, are unlikely to have direct functional effects, although they are in linkage disequilibrium with variants in the nearby 3'-UTR that may affect mRNA stability and VDR transcriptional activity. BsmI and TaqI are also situated within the block B linkage disequilibrium block spanning exons 3 to 9,8 and may be linked to other functional variants residing within this region. Further research is needed to identify possible underlying causal variants.


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Table 1. Associations between FokI, BsmI and TaqI VDR polymorphisms and risk of all NHL.

 

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Table 2. Associations between FokI, BsmI and TaqI VDR polymorphisms and NHL subtypes (B-cell- and T-cell lymphoma; follicular- and diffuse large B-cell lyphoma).

 
We also found the FokI f allele to be associated with an increased risk of T-cell lymphoma. This is linked to decreased VDR transactivation activity in vitro7 and is consistent with the hypothesis that vitamin D inhibits lymphomagenesis. However, given the small number of T-cell lymphomas in our study, we cannot rule out the possibility that this is due to chance.

In conclusion, our findings suggest that the FokI, BsmI and TaqI polymorphisms in VDR may be associated with some NHL subtypes. However, these findings must be confirmed in further studies if meaningful conclusions are to be drawn.


    Footnotes
 
Funding: the NSWNHL study was funded by the National Health and Medical Research Council of Australia, The Cancer Council NSW, and The University of Sydney Medical Foundation. The genotyping project was funded by the Intramural Research Program at the NIH (National Cancer Institute).


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  1. Hughes AM, Armstrong BK, Vajdic CM, Turner J, Grulich A, Fritschi L, et al. Sun exposure may protect against non-Hodgkin lymphoma: a case-control study. Int J Cancer 2004;112:865-71.[CrossRef][Web of Science][Medline]
  2. Smedby KE, Hjalgrim H, Melbye M, Torrang A, Rostgaard K, Munksgaard L, et al. Ultraviolet radiation exposure and risk of malignant lymphomas. J Natl Cancer Inst 2005;97:199-209.[Abstract/Free Full Text]
  3. Hartge P, Lim U, Freedman DM, Colt J, Cerhan JR, Cozen W, et al. Ultraviolet radiation, dietary vitamin D, and risk of non-Hodgkin’s lymphoma (United States). Cancer Causes Control 2006;17:1045-52.[CrossRef][Web of Science][Medline]
  4. Provvedini DM, Tsoukas CD, Deftos LJ, Manolagas SC. 1,25-dihydroxyvitamin D3 receptors in human leukocytes. Science 1983;221:1181-3.[Abstract/Free Full Text]
  5. Hickish T, Cunningham D, Colston K, Millar BC, Sandle J, Mackay AG, et al. The effect of 1,25-dihydroxyvitamin D3 on lymphoma cell lines and expression of vitamin D receptor in lymphoma. Br J Cancer 1993;68:668-72.[Web of Science][Medline]
  6. Raina V, Cunningham D, Gilchrist N, Soukop M. Alfacalcidol is a nontoxic, effective treatment of follicular small-cleaved cell lymphoma. Br J Cancer 1991;63:463-5.[Web of Science][Medline]
  7. Uitterlinden AG, Fang Y, van Meurs JB, Pols HA, Van Leeuwen JP. Genetics and biology of vitamin D receptor polymorphisms. Gene 2004;338:143-56.[CrossRef][Web of Science][Medline]
  8. Nejentsev S, Godfrey L, Snook H, Rance H, Nutland S, Walker NM, et al. Comparative high-resolution analysis of linkage disequilibrium and tag single nucleotide polymorphisms between populations in the vitamin D receptor gene. Hum Mol Genet 2004;13:1633-9.[Abstract/Free Full Text]
  9. Purdue MP, Lan Q, Kricker A, Grulich A, Vajdic C, Turner J, et al. Polymorphisms in immune function genes and risk of non-Hodgkin’s lymphoma: findings from the New South Wales non-Hodgkin’s lymphoma study. Carcinogenesis 2007;28:704-12.[Abstract/Free Full Text]
  10. Xiong DH, Xu FH, Liu PY, Shen H, Long JR, Elze L, et al. Vitamin D receptor gene polymorphisms are linked to and associated with adult height. J Med Genet 2005;42:228-34.[Abstract/Free Full Text]




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