Autoimmune Conditions, Genetic Variations, and Lymphoma Etiology

描述(申请人提供)：非霍奇金淋巴瘤(NHL)几乎没有确定的危险因素，这是一种免疫细胞癌，发病率经历了最大的-但仍未解释-的增加之一。长期以来，免疫失调一直被认为是非霍奇金淋巴瘤病因所必需的，但这种失调的本质仍然知之甚少。免疫失调的相反光谱--免疫抑制和免疫激活--被认为是NHL的危险因素。临床和流行病学研究已证实自身免疫性疾病是非霍奇金淋巴瘤的危险因素。最近流行病学研究的联合努力进一步确定了特定的免疫基因变异，包括肿瘤坏死因子(TNF)和人类白细胞抗原(HLA)I类和II类基因，作为NHL的危险因素。我们假设，由自身免疫条件引起的慢性炎症以及引发的炎症类型，可以通过增加NHL风险的遗传易感基因和影响NHL亚型或细胞谱系的出现而复杂化。这项应用的总体目标是在国际淋巴瘤流行病学(InterLymph)联合会的参与研究中，评估遗传易感基因对NHL风险的贡献，以及自身免疫条件下的慢性炎症对NHL风险的贡献，特别是B细胞NHL和弥漫性大B细胞淋巴瘤。在目标1中，我们将确定来自淋巴间联盟全基因组关联研究(GWAS)的确认的易感基因与自身免疫条件与NHL风险的联合关联。我们将对GWAS确认的基因座进行病例对照分析，这将在8,188例病例和7,084名欧洲血统对照中获得。这一目的将告知确认的易感基因是否与自身免疫条件协同作用来改变NHL的风险。没有相互作用的证据表明，替代途径可能导致相同的疾病实体，这是一个重要的概念，将有助于针对潜在疾病生物学的治疗干预。在目标2中，我们将采用一种仅病例的方法，在自身免疫疾病的背景下，在具有Gwas数据的6,068例NHL病例中识别与NHL相关的新基因变异。这一目标的基本原理是基于这样一个假设，即存在对慢性炎症和NHL风险施加影响的遗传易感基因仅在 存在适当的环境触发因素。综上所述，我们建议通过生物驱动和严格应用互补统计方法来评估非霍奇金淋巴瘤的基因-环境相互作用，从而确定遗传易感基因是否与免疫条件一致或独立于免疫条件。

DESCRIPTION (provided by applicant): There are few established risk factors for non-Hodgkin lymphoma (NHL), a cancer of immune cells which has experienced one of the largest - and still unexplained - increases in incidence. Immune dysregulation has long been recognized as necessary for non-Hodgkin lymphoma etiology, but the nature of that dysregulation is still poorly understood. Opposite spectrums of immune dysregulation - immune suppression and immune activation - are implicated as NHL risk factors. Clinical and epidemiologic studies have established autoimmune disorders collectively as a risk factor for NHL. More recent consortial efforts among epidemiologic studies have further identified specific immune gene variations, including the tumor necrosis factor (TNF) and human leukocyte antigen (HLA) Class I and Class II genes, as NHL risk factors. We hypothesize that the chronic inflammation that results from autoimmune conditions, and the type of inflammation elicited, can be compounded by genetic susceptibility loci to increase NHL risk and influence which NHL subtype or cell lineage emerges. The overall objective of this application is to evaluate the contributions of genetic susceptibility loci to NHL risk jointly with chronic inflammation from autoimmune conditions on risk of NHL - and particularly B-cell NHLs and diffuse large B-cell lymphoma - among participating studies in the International Lymphoma Epidemiology (InterLymph) Consortium. In Aim 1, we will determine the joint associations of confirmed susceptibility loci from the InterLymph Consortium genome-wide association study (GWAS) and autoimmune conditions on risk of NHL. We will conduct a case-control analysis of GWAS- confirmed loci, which will be available on 8,188 cases and 7,084 controls of European ancestry. This aim will inform whether confirmed susceptibility loci act in concert with autoimmune conditions to alter NHL risk. No evidence of an interaction would suggest that alternative pathways might lead to the same disease entity, an important concept that would aid in therapeutic interventions aimed at the underlying disease biology. In Aim 2, we will conduct a case-only approach to identify new gene variants associated with NHL, in the context of autoimmune conditions, among the 6,068 NHL cases with GWAS data. The rationale for this aim is based on the hypothesis that there are genetic susceptibility loci that exert their influence on chronic inflammation and NHL risk only in the presence of the appropriate environmental trigger. In summary, we propose to determine whether genetic susceptibility loci act in concert with or independent from immune conditions by conducting a biologically-driven and rigorous application of complementary statistical approaches for assessing gene- environment interaction in NHL.