Genetic variation in TGF-beta 1 gene promoter and risk of gestational trophoblastic disease.

OBJECTIVE: To examine the relationship of transforming growth factor beta 1 (TGF-beta 1) gene polymorphisms at promoter positions -509 (C/T) and -800 (G/A) with the risk of gestational trophoblastic disease (GTD) as compared to normal controls STUDY DESIGN: Polymerase chain reaction-restriction fragment length polymorphism was performed on peripheral blood of 102 patients with GTD and 124 normal, healthy, pregnant women as the control group. RESULTS: In this study, TGF-beta 1 gene polymorphisms at positions -509 (C/T) and -800 (G/A) failed to correlate with GTD. CONCLUSION: Our findings suggest that promoter gene polymorphisms of TGF-beta 1 do not play major roles in GTD and may not be risk factors for this disease.

Investigation of soluble HER2 and transforming growth factor Beta-1 serum levels in gestational trophoblastic disease.

HER2/neu and TGF-beta1 are over-expressed in various types of malignancies. It appears that they play an important role in the biologic behavior of tumors and have prognostic value. Gestational tropoblastic diseases (GTDs) comprise of a heterogeneous group characterized by abnormally proliferating trophoblastic tissues, ranging from benign to malignant. The objective of this study was to measure and compare the serum levels of s-HER2 and TGF-beta between patients with GTDs and pregnant and non-pregnant controls. Serum levels of s-HER2 and TGF-beta1 were determined by ELISA method in 95 GTD patients (55 complete moles, 32 persistent moles, and 8 choriocarcinoma), 30 normal pregnant controls, and 22 normal non-pregnant controls. Mean serum level of s-HER2 did not differ significantly between patients and controls. TGF-beta1 serum level was significantly higher in GTD patients (20.29 +/- 10.68 pg/ml with 95% confidence interval (CI) of 18.10-22.48 pg/ml) compared with pregnant controls (10.26 +/- 11.84 pg/ml with 95% CI of 5.75-14.76 pg/ml) and non-pregnant controls (7.27 +/- 9.61 pg/ml with 95% CI of 3.01-11.53 pg/ml) (P < 0.001). Our findings suggest that TGF-beta1 serum levels in GTD patients may represent a potential prognostic marker. Further investigations with larger sample size and more frequent sampling are required to elucidate this issue.

PDCD1, CTLA-4 and p53 gene polymorphism and susceptibility to gestational trophoblastic diseases.

OBJECTIVE: Gestational trophoblastic neoplasms (also termed gestational trophoblastic diseases [GTDs]) encompass a spectrum of interrelated tumors originating from trophoblasts. The search is ongoing for identification of the culpable gene defects in GTDs. Considering the role of PDCD1, CTLA-4 and p53 genes in immune regulation and tumor progression, we explored the association of single-nucleotide polymorphisms (SNPs) corresponding to each gene and GTDs. STUDY DESIGN: In a genetic association study, PD1.5 (7785) C/T, CTLA-4 +49 A/G, and p53 codon 72 Arg/Pro SNPs were genotyped in case-control groups with patient/control ratios of 92:295, 83:84 and 85:150, respectively. RESULTS: The C/T genotype of the PDCD1 gene was significantly more prevalent among patients with GTDs (40.2%) than controls (19%) (odds ratio [OR] = 2.87; 95% CI = 1.72, 4.77; p < 0.001). Moreover, the C allele was present in 65.8% of patients and 49.5% of controls (OR = 1.96; 95% CI = 1.38, 2.76; p < 0.001). There was no difference in the distribution of each genotype or allele between patients with GTDs and controls considering other studied SNPs. CONCLUSION: The results of the current study demonstrate that SNPs in the PDCD1 gene confer susceptibility to GTDs, while there is no association between CTLA-4 and p53 gene polymorphisms and GTDs in an Iranian population.

Interleukin-18 gene promoter polymorphisms in women with gestational trophoblastic diseases.

OBJECTIVE: Gestational trophoblastic diseases (GTDs) consist of a spectrum of disorders characterized by an abnormal proliferation of trophoblastic tissue. IL-18 is a pleiotropic cytokine with a capacity for both ThI and Th2 polarization. Considering the association of IL-18 promoter polymorphisms at positions -607 (A/C) and -137 (C/G) with pregnancy events and some cancers, we sought to examine these polymorphisms in Iranian patients with GTD, their association with disease subtypes, and IL-18 serum level. STUDY DESIGN: Single nucleotide polymorphisms (SNPs) were analyzed by allele-specific polymerase chain reaction in 92 patients with GTDs and 103 healthy pregnant controls. IL-18 serum level was determined using ELISA method. RESULTS: No significant association was found between the allele, genotype, genotype combination and haplotype distribution of these SNPs and GTDs or its subgroups. Mean IL-18 serum level was significantly higher in patients with choriocarcinoma and pregnant controls compared with nonpregnant controls (p = 0.04, 0.04 and 0.001, respectively). -137 GG genotype pregnant controls had a significantly higher IL-18 serum level compared with CC genotype. CONCLUSION: IL-18 promoter polymorphisms do not confer susceptibility to GTDs or its variants; however, their functional significance is demonstrated in this study. Furthermore, IL-18 serum level increases in GTDs and in normal pregnancy.

Clinical value of tumor markers in gestational trophoblastic diseases.

OBJECTIVE: To determine the clinical importance of serum biomarkers in diagnosis of gestational trophoblastic disease (GTD). STUDY DESIGN: Sixty-nine pregnant women with molar pregnancy and 19 healthy pregnant women with corresponding age, gravity, parity and gestational age were matched. Serum levels of human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP), CA 125, CA 19-9, CA 15-3, CA 242 and carcinoembryonic antigen (CEA) were measured using enzyme-linked immunosorbent assay (ELISA). Mean serum values were compared between the groups using Mann-Whitney, chi2 and paired t tests. RESULTS: AFP levels were higher in the control group. CA 19-9 serum values are increased in patients with GTD. Comparing mean CA 19-9 serum levels between the groups demonstrated a meaningful relation (p = 0.012). CA 125, CA 15-3, CA 242 and CEA are not affected by molar pregnancy, and no significant difference was observed between the groups. CONCLUSION: Low AFP levels and increased CA 19-9 levels can be used as tumor markers in diagnosis of molar pregnancies in conjunction with clinical and sonographic findings and serum levels of hCG. Serum levels of CA 125, CA 15-3, CA 242 and CEA did not provide reliable information in diagnosis of GTD.

Polymorphism of TP53 codon 72 showed no association with breast cancer in Iranian women.

Breast cancer is the most common female malignancy worldwide. Despite the high incidence of sporadic cases, the rate of familial breast cancer is low. The tumor suppressor gene TP53 (alias p53), located on chromosome 17, has been involved in various malignancies. Mutations in codon 72 of TP53 have been studied in breast cancer and most solid tumors. For study of polymorphisms and allele frequency, 221 female patients with sporadic breast cancer and 205 healthy blood donors as control group were recruited. DNA from peripheral blood mononuclear cells was extracted and amplified using allele-specific polymerase chain reaction. Frequency of homozygotic arginine at codon 72 was 37.6% in patients and 36.6% in controls, for homozygotic proline it was 13.1 and 19.5%, and for heterozygotic Arg/Pro it was 49.3 and 43.9%, respectively. No significant difference was found between patients and controls regarding allele frequencies. Mutation in codon 72 of TP53 gene was not associated with breast cancer in Iranian patients.

Factors influencing serum concentration of CA125 and CA15-3 in Iranian healthy postmenopausal women.

Screening for breast and ovarian cancers are required due to the late stage at diagnosis and poor survival. Serum CA125 and CA15-3 are important cancerdetecting agents in patients with ovarian and breast cancers, respectively. Elevation of CA125 and CA15-3 level correlates with malignant and non-malignant conditions. Moreover, a series of individual characteristics affect the serum level of these markers. The objective of the present study was to evaluate CA125 and CA15-3 levels in cancer-free postmenopausal women to investigate the impacts of patient parameters on the serum level of these markers. 203 subjects were studied prospectively. Serum CA125 and CA15-3 assessment was done subsequent to the direct interview. The associations between marker levels and presenting features were examined. CA125 and CA15-3 levels were elevated in 35 (17.2%) and 12 (5.9%) of persons, respectively. A higher CA125 level was associated with advanced age (p = 0.046), while a lower level was correlated with hormone replacement therapy (HRT) and having smoking habits (p = 0.000 and p = 0.01, respectively). CA15-3 level was remarkably lower amongst oral contraceptive (OCP) users (p = 0.03). Serum marker levels were not significantly related to menarche age, age at menopause, height, weight, BMI and parity. Serum CA125 is imperative indicator for malignancies of the ovary; however, personal and medical factors influence its serum level. A fair interpretation of results must be due to an accurate attention to the individual characteristics.

Interleukin-18 gene promoter polymorphisms and recurrent spontaneous abortion.

BACKGROUND: IL-18 is a multifunctional cytokine capable of inducing either Th1 or Th2 polarization depending on the immunologic milieu. IL-18 is detected at the materno-fetal interface very soon in early pregnancy. Two polymorphisms in the promoter region of the IL-18 gene at positions of -607 and -137 appear to have functional impacts. OBJECTIVE: This study attempts to evaluate the frequency of these two polymorphisms in the IL-18 gene promoter in patients with recurrent spontaneous abortion (RSA) and normal pregnant women. SUBJECTS AND METHODS: One hundred and two RSA patients and 103 healthy pregnant women were enrolled in this study. Single nucleotide polymorphisms of the IL-18 gene at positions -607 (C/A) and -137 (G/C) were analyzed by the sequence-specific PCR method. RESULTS: There was no significant association between the allele, genotype, and haplotype frequencies of the two single nucleotide polymorphisms (SNPs) in the IL-18 gene promoter and RSA. CONCLUSION: The results of this study showed that IL-18 gene promoter polymorphisms at positions -607 and -137 did not confer susceptibility to RSA in southern Iranian patients.

Lack of association between the TGF-beta1 gene polymorphisms and recurrent spontaneous abortion.

Transforming growth factor-beta1 (TGF-beta1) is produced by T regulatory lymphocytes (Treg), which play an important role in the physiology of pregnancy. Several polymorphisms of the TGF-beta1 gene (TGFB1) have been reported, some with an important correlation with TGF-beta1 production and disease severity. We performed an association study between TGFB1 polymorphisms and recurrent spontaneous abortion (RSA). We first used a PCR-RFLP method to detect three known TGFB1 cSNPs (coding single nucleotide polymorphisms) among 111 RSA and 110 normal control women from Southern Iran, such as 29T-->C (Leu 10 Pro), 74G-->C (Arg 25 Pro) and 788C-->T (Thr 263Ile), and compared their frequencies between the two groups of subjects. To confirm results of the RFLP study and to identify new SNPs in the RSA women, we then sequenced their DNA samples for seven exons and adjacent intronic regions of TGFB1. Consequently, 10 SNPs were detected; one (-14G-->A) was located in the upstream region of exon 1, three in exons (two in exon 1 and one in exon 5) and six in intronic regions. Two (IVS5+18G-->C and IVS6+910G-->A) of the 10 SNPs were novel. Statistical analysis on the frequency of six most frequent SNPs, including the three cSNPs, as well as on the frequencies of genotypes and 13 haplotypes regarding the 6 SNPs, revealed no significant difference between RSA and control women. Therefore, this study concludes that there is no association between exonic and adjacent intronic polymorphisms of TGFB1 and RSA.

The promoter region (-800, -509) polymorphisms of transforming growth factor-beta1 (TGF-beta1) gene and recurrent spontaneous abortion.

Recurrent spontaneous abortion (RSA) is regarded as a common pregnancy complication in southern Iran. The exact causes of RSA are not yet known. Transforming growth factor-beta1 (TGF-beta1) is produced by T regulatory lymphocytes (Treg), which play an important role in the physiology of pregnancy. Several polymorphisms of the TGF-beta1 gene have been reported, some with important correlation with disease severity. In this investigation, the polymorphism of the TGF-beta1 gene at promoter region positions -800 (G/A) and -509 (C/T) was studied in 111 RSA and 110 normal female subjects from southern Iran by PCR-RFLP. Results indicated that at position -800 (G/A) polymorphism, 75.7% of RSA cases and 77.3% of normals were homozygote GG. In addition, 23.4% of cases and 22.7% of normal individuals were heterozygote AG. Only one of the patients appeared to be homozygote AA. None of the normal individuals were found to be homozygote AA at this position. In the case of the -509 (C/T) polymorphism, 38.7% of patients and 28.2% of controls were homozygote CC. While 40.6% of cases and 50.9% of normal individuals were heterozygote CT, 20.7% of RSA cases and 20.9% of controls were homozygote TT. The results indicate that there are no statistically significant differences of genotype distribution and allele frequency between RSA cases and controls at both polymorphic sites. In conclusion, the promoter region polymorphisms of TGF-beta1 at positions -800 (G/A) and -509 (C/T) may not be associated with RSA.

HLA-DQBl alleles and susceptibility to cervical squamous cell carcinoma in Southern Iranian patients.

The association of HLA class II with various autoimmune diseases has been extensively investigated. Despite the importance and functions of HLA genes in the evolution of cancer, the allele specific association of HLA molecules in cancer patients has not been well investigated. In this study the HLA-class II alleles frequency was investigated in Iranian patients with cervical squamous cell carcinoma. HLA typing was carried out by PCR amplification using sequence specific primers (PCR-SSP). DRB1, DQA1 and DQB1 typing was performed for 23 patients. The allele frequencies were calculated and compared with 36 healthy Iranian female controls. A positive association was observed between the existence of HLA-DQB1* 0601 and squamous cell carcinoma of the cervix (p<0.04, RR=1.94). Moreover, analysis of HLA-DRB1, DQA1 and DQB1 haplotypes indicated that none of the putative haplotypes were significantly associated with either patient or control group. Positive association of cervical carcinoma with a single allele of HLA-DQ provides evidence on the importance of HLA class II molecules and the immune response in squamous cell carcinoma of cervix.

IL-17A is elevated in sera of patients with poorly differentiated ovarian papillary serous cystadenocarcinoma.

BACKGROUND: IL-17A a member of IL-17 family of cytokines is an inflammatory cytokine produced by a subset of CD4+ T cells that links innate and adaptive immunity. IL-17A has been shown to be a key mediator of inflammation in autoimmune diseases, transplant rejection and cancers. OBJECTIVE: To investigate the level of IL-17A in sera of southern Iranian patients with papillary serous cystadenocarcinoma of ovary and compare it with age-matched women of the same region. METHODS: In this study we investigated IL-17A and CA125 levels in sera of 26 patients with ovarian serous cystadenocarcinoma and 62 healthy age matched women by commercial ELISA assays. RESULTS: Fifteen (58%) and 16 (61.5%) out of 26 patients showed elevated IL-17A (1.25 ± 2.25 pg/ml) and CA125 (218 ± 224.69 IU/ml) in their sera, respectively. No healthy individual had detectable IL-17A or elevated CA125 in their sera (8.85 ± 2.86 IU/ml). The mean IL-17A levels in poorly differentiated tumors (3.33 ± 2.36 pg/ml) was significantly higher than that of well differentiated (0.14 ± 0.38 pg/ml) and moderately differentiated (undetectable) tumors. There was also a positive correlation between IL-17A and CA125 in sera of patients and controls when grouped together (r=0.37, p=0.005). CONCLUSION: Elevation of IL-17A in a high percentage of ovarian serous cystadenocarcinoma and lack of this cytokine in healthy individuals makes it a specific candidate in diagnosis, follow up or immunotherapy.

Coding region polymorphisms in the indoleamine 2,3-dioxygenase (INDO) gene and recurrent spontaneous abortion.

Indoleamine 2,3-dioxygenase (INDO) catalyzes degradation of the indole ring of indoleamines and locally depletes tryptophan. INDO expression suppresses T cell proliferation and activation. Genetic variation in the INDO gene may contribute to the variable INDO enzyme expression, activity and severity of some diseases. Recurrent spontaneous abortion (RSA) is a common pregnancy complication and the exact causes of RSA are not yet known. We performed an association study between INDO single nucleotide polymorphisms (SNPs) and RSA. To identify INDO SNPs we sequenced DNA samples for ten exons and adjacent intronic regions from 111 RSA patients. Consequently 10 SNPs were detected; four in exons (one in exon 4, two in exon 9 and one in exon 10) and six in intronic regions (one in intron 3, three in intron 6, one in intron 8 and one in intron 9). Three (IVS3+562 del C, IVS8+116 T→G and IVS9+2431 G→A) of these ten SNPs have been registered at the NCBI SNP database. Statistical analysis of allele, genotype and haplotype frequency distribution in the three most frequent SNPs (IVS3+562 del C, IVS6+61 G→A and IVS9+2431 G→A) showed no significant differences between the 111 RSA and 105 matched control women. CGA and CGG were the most frequent haplotypes in both the RSA and control groups. We conclude that there is no association between INDO polymorphisms and susceptibility of Iranian women to RSA.

Determination of antiovarian antibodies after laparoscopic ovarian electrocauterization in patients with polycystic ovary syndrome.

OBJECTIVE: To determine whether ovarian damage consequent to laparoscopic ovarian electrocauterization may result in the development of humoral autoimmunity and production of antiovarian antibodies (AOA). DESIGN: Prospective study. SETTING: Infertility and gynecologic endoscopy units of one of the medical university hospitals. PATIENT(S): Sixty-four reproductive-age infertile women (

Cytotoxic T lymphocyte antigen-4 gene in breast cancer.

The exon 1 polymorphism (49A/G) of ctla-4 gene corresponds to an amino acid exchange (threonine to alanine) in the leader peptide of the expressed protein. There are reports concerning the higher level of G allele in subjects with various autoimmune diseases, which has resulted in the hypothesis that CTLA-4 may play a role in regulating self-tolerance by the immune system and in the pathogenesis of autoimmune disorders. This study was undertaken to investigate the correlation of exon 1 (49A/G) polymorphism in the ctla-4 gene and breast cancer. The ctla-4 49A/G polymorphism was studied in 197 women with primary breast cancer and 151 age/sex matched normal individuals. The results indicated a significant difference between frequency of ctla-4 genotypes in patients and controls. The frequency of GG genotype was significantly decreased in breast cancer patients compared to controls (4.6% v.s. 12.6%, P = 0.012). There was also a significant positive correlation between tumor size and the existence of AA genotype in patients (P = 0.016). In addition, a positive correlation between AA genotype and lymph node involvement was observed (P = 0.042). The observed decrease in the frequency of GG genotype in the breast cancer patients is contrary to the frequently reported increase of GG genotype in autoimmune diseases. In addition, the data implies that polymorphism of ctla-4 exon 1 contributes in tumor progression.