Discovering Infection-mediated Pathways of Glioma Etiology and Prognosis by Leveraging Multiplex Serology and Immunogenomics

项目总结 胶质瘤占所有恶性脑肿瘤的80%，预后极差，长达5年。 存活率为5.1%。胶质瘤的病因仍然知之甚少，几乎没有确定的可改变的危险因素。 多项研究表明，感染与胶质瘤的发生有关，然而，其潜在的机制 推定的致病原因仍不清楚。除了风险，还有越来越多的证据来自 调查新疗法的研究表明，对感染的免疫反应可能预示着 神经胶质瘤患者。以前的流行病学研究调查了数量有限的病原体，使用 只允许检测的血清学检测。我们试图进行一项大型的血清学研究，测量41 使用提供定量测量的分析方法检测与胶质瘤有关的所有12种感染的抗原 抗体反应。我们的研究将包括1000对脑胶质瘤病例对照，具有广泛的临床和 流行病学数据。在目标1中，我们将评估每个个体感染对胶质瘤风险和存活率的影响。 并检查联合感染的分组模式。在目标2中，我们将采用创新的长读测序 在同一套人类白细胞抗原(人类白细胞抗原)I和II类基因中详细说明所有多态性的技术 研究对象。人类白细胞抗原基因变异在调节对病毒攻击的免疫应答中起着关键作用 以前曾被认为与神经胶质瘤的风险和进展有关。我们将研究一系列功能性的人类白细胞抗原 与胶质瘤相关的基因多态，包括抗原呈递的经典等位基因和氨基酸残基 风险和生存。在目标3中，我们将结合血清学和人类白细胞抗原测序数据来描绘宿主基因 感染的免疫反应机制及其对胶质瘤终点的后续影响。这将使我们能够 开发全面的免疫基因组学模型来预测神经胶质瘤的风险和存活率。总而言之， 拟议中的研究将提供新的、高质量的数据，这些数据将显著促进我们对胶质瘤的理解 以及为预防和改善脑胶质瘤患者的预后提供信息。

PROJECT SUMMARY Gliomas account for 80% of all malignant brain tumors and have an extremely poor prognosis, with a 5-year survival of 5.1%. The etiology of glioma remains poorly understood, with few established modifiable risk factors. Multiple studies have implicated infections in the development of glioma, however the underlying mechanisms and putative causal pathogens remain unclear. In addition to risk, there is also accumulating evidence from studies investigating novel therapeutics suggesting that immune response to infection may be prognostic in glioma patients. Previous epidemiologic studies have investigated a limited number of pathogens using serological assays that only allowed detection. We seek to conduct a large serologic study measuring 41 antigens from all 12 infections previously associated with glioma using assays that provide quantitative measures of antibody response. Our study will include 1000 glioma case-control pairs with extensive clinical and epidemiologic data. In Aim 1 we will estimate the effect of each individual infection on glioma risk and survival and also examine grouped patterns of co-infections. In Aim 2, we will employ innovative long read sequencing technology to detail all polymorphisms in human leukocyte antigen (HLA) class I and II genes in the same set of subjects. Genetic variation in the HLA region plays a pivotal role in regulating immune response to viral challenge and has been previously linked to glioma risk and progression. We will investigate a range of functional HLA polymorphisms, including antigen-presenting classical alleles and amino acid residues, with respect to glioma risk and survival. In Aim 3, we will integrate serological and HLA sequencing data to delineate host genetic mechanisms of immune response to infection and subsequent effects on glioma endpoints. This will allow us to develop comprehensive immunogenomic models for predicting glioma risk and survival. Taken together, the proposed study will contribute new, high-quality data that will significantly advance our understanding of glioma pathogenesis, as well as inform avenues for prevention and improvement of outcomes in glioma patients.