Educational attainment could be a protective factor against obstructive sleep apnea: a study based on Mendelian randomization.

BACKGROUND: Causality between education and obstructive sleep apnea (OSA) is not known. METHODS: Genetic variants, as instrumental variables for years of education, were derived from the Social Science Genetic Association Consortium. The outcome datasets related to OSA were from the FinnGen research project (www.finngen.fi/en/). Inverse variance-weighted, weighted-median, and Mendelian randomization-Egger analysis were used to estimate causal effects. To assess the robustness and horizontal pleiotropy of significant results, leave-one-out sensitivity analysis and Mendelian randomization-Egger regression analysis were conducted. The inverse variance-weighted method was undertaken to estimate the association between years of education and other known risk factors for OSA. Analyses were conducted using the Two Sample Mendelian Randomization package of R 4·0·3. RESULTS: Genetic predisposition towards 4.2 years of additional education was associated with a 27.8% lower risk of OSA [odds ratio (OR) =0.722, 95% confidence interval (CI): 0.566-0.921; P=0.009]. Sensitivity analyses were consistent with a causal interpretation in which a major bias from genetic pleiotropy was unlikely. The Mendelian randomization assumptions did not seem to be violated. Genetic predisposition towards longer education was associated with a lower body mass index, fewer cigarettes smoked per day, and greater alcohol intake per week. CONCLUSIONS: Our data indicated that education could be a protective factor against OSA. Potential mechanisms could include body mass index, tobacco smoking, and alcohol intake.

Inflammatory Bowel disease promote oral cancer and pharyngeal cancer: new evidence of Mendelian randomization.

BACKGROUND: Evidence from observational studies shows that inflammatory bowel disease (IBD) [comprising ulcerative colitis (UC) and Crohn's disease (CD)] is a risk factor to Oral cavity and pharyngeal cancer (OC&PC) [comprising Oral cavity cancer (OCC) and Oropharyngeal cancer (OPC)], but it is unclear whether these diseases have potential causality. OBJECTIVES: We aimed to explore the causal relationship between IBD and OC&PC. MATERIALS AND METHODS: A mendelian randomized (MR) study was performed to estimate the causal relationship between IBD and OC&PC. RESULTS: The potential causal relationship was statistically significant between IBD and OCC (OR = 1.14, 95% confidence interval (CI): 1.02-1.27, p = .02), UC and OCC (OR = 1.13, 95% CI: 1.01-1.27, p = .03), respectively. There was a universal null effect of IBD on OC&PC (IBD: OR = 1.01, 95%CI: 0.93-1.10, p = .74; UC: OR = 1.00, 95%CI: 0.92-1.10, p = .94; CD: OR = 1.02, 95%CI: 0.94-1.09, p = .69), and IBD on OPC (IBD: OR = 0.93, 95%CI: 0.81-1.06, p = 0.26; UC: OR = 0.90, 95%CI: 0.79-1.03, p = .12; CD: OR = 1.04, 95%CI: 0.94-1.15, p = .44). CONCLUSIONS AND SIGNIFICANCE: MR analyses support new evidence indicating there may be a positive causal effect of IBD (including UC) on OCC. Further investigation of the potential biological mechanisms is necessary.

Prognostic significance of tumor-infiltrating lymphocytes and macrophages in nasopharyngeal carcinoma: a systematic review and meta-analysis.

PURPOSE: Many studies have investigated the prognostic value of tumor-infiltrating lymphocytes (TILs) and tumor-infiltrating macrophages (TIMs) in patients with nasopharyngeal carcinoma (NPC), but the results remain controversial. Here, we performed a meta-analysis to evaluate the prognostic significance of TILs/TIMs in patients with NPC METHODS: The study was registered with PROSPERO (CRD42021234078). PubMed, Embase, and Web of Science databases were searched up to Dec 30, 2020. We reviewed studies that evaluated the relationship between TILs/TIMs and overall survival (OS), disease-free survival (DFS), or progression-free survival (PFS) in NPC. For TILs, CD3, CD4, CD8, and FOXP3 were searched as T-cell markers, CD19 and CD20 as B-cell markers, and CD56 as a natural killer cell marker. For TIMs, CD68 and CD163 were searched as total and M2 macrophage markers, respectively. RESULTS: In total, 19 studies with 3708 NPC were included in this meta-analysis. We found that high total numbers of TILs were significantly associated with favorable OS [hazard ratio (HR) 0.46, 95% confidence interval (CI) 0.38-0.57 and PFS (HR 0.48, 95% CI 0.38-0.62)]. In contrast, tumor infiltration by CD3+ T cells (HR 0.55, 95% CI 0.39-0.76), CD4+ T cells (HR 0.40, 95% CI 0.18-0.85), and CD8+ T cells (HR 0.56, 95% CI 0.34-0.93) correlated positively with OS. No significant relationship was found between survival and tumor infiltration by FOXP3+ T cells, CD68+ macrophages, or CD163+ macrophages. CONCLUSION: Our findings revealed that tumor infiltration by CD3+ , CD4+ , and CD8+ T cells could be prognostic biomarkers in NPC.

Serum EA-IgA and D-dimer, but not VCA-IgA, are associated with prognosis in patients with nasopharyngeal carcinoma: a meta-analysis.

BACKGROUND: Patients with nasopharyngeal cancer (NPC) differ in prognosis, even at the same stage; therefore, new biomarkers are urgently required to identify early-stage NPC patients at high risk of poor prognosis. Although Epstein-Barr virus (EBV) DNA has been used for prognosis, the value of many other biomarkers expressed during the infection cycle of EBV remains unclarified. This study aimed to evaluate the prognostic potential of EA-IgA, VCA-IgA and D-dimer in patients with NPC. METHODS: Electronic databases, including PubMed, Embase and Web of Science, were searched up to February 1, 2021. Pooled data were extracted from studies that evaluated the relationship between NPC and overall survival (OS), distant metastasis-free survival (DMFS) or disease-free survival (DFS) and then were subjected to a meta-analysis. RESULTS: Nine studies with 5729 patients were included in this meta-analysis. In patients with NPC, EA-IgA levels significantly predicted OS (HR = 1.63, 95% CI 1.07-2.48). D-Dimer levels significantly predicted OS (HR = 1.75, 95% CI 1.24-2.47) and DMFS (HR = 1.91, 95% CI 1.31-2.79). However, high levels of VCA-IgA were not associated with OS (HR = 1.24, 95% CI 0.95-1.60), DMFS (HR = 1.41, 95% CI 0.92-2.17) or DFS (HR = 2.39, 95% CI 0.78-7.26). CONCLUSIONS: The present findings reveal that EA-IgA and D-dimer, but not VCA-IgA, can be used as prognostic biomarkers in NPC.