Christina Persson

Plasma levels of carotenoids, retinol and tocopherol and the risk of gastric cancer in Japan: a nested case–control study

Fruits and vegetables have been suggested to confer protection against diseases such as cancer through the effects of antioxidants, often represented by carotenoids. We investigated the impact of carotenoids, retinol and tocopherol on gastric cancer development in a large nested case-control study among Japanese with known Helicobacter pylori infection status. A total of 36 745 subjects aged 40-69 in the Japan Public Health Center-based Prospective Study who responded to the baseline questionnaire and provided blood samples in 1990-1995 were followed until 2004. Plasma levels of carotenoids in 511 gastric cancer cases and 511 matched controls were measured by high-performance liquid chromatography. Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were estimated using conditional logistic regression models. Plasma level of beta-carotene was inversely associated with the risk of gastric cancer (compared with the lowest quartile: OR = 0.63, 95% CI = 0.31-0.75; OR = 0.48, 95% CI = 0.31-0.75 and OR = 0.46, 95% CI = 0.28-0.75, for quartile 2, 3 and 4, respectively, P(trend) < 0.01). Inverse associations were evident in men for alpha-carotene (P(trend) = 0.04) and beta-carotene (P(trend) < 0.01), but not in women, who had relatively higher plasma levels compared with men. We found no statistically significant association between plasma levels of lutein/zeaxanthin, lycopene, retinol, alpha- or gamma-tocopherol and gastric cancer risk. Our findings suggest that those who have very low plasma levels of alpha-carotene and beta-carotene are at a higher risk of gastric cancer.

Interleukin 1-β gene polymorphisms and risk of gastric cancer in Sweden

Objective. Helicobacter pylori (H. pylori) infection stimulates the production of interleukin (IL)-1β, a pro-inflammatory cytokine and suppressor of gastric acid secretion. As both inflammation and hypochlorhydria, which might facilitate proximal colonization of H. pylori and other bacterial species alike, have been implicated in gastric carcinogenesis, much attention has been directed to functional genetic polymorphisms that affect the production of IL-1β. The purpose of this study was to clarify the role of these polymorphisms. Material and methods. We analysed a population-based, case-control study in 5 Swedish counties and a hospital-based, case-control study conducted in 8 Swedish hospitals, with a total of 351 gastric cancer cases and 539 controls. The IL1B-31, IL1B-511 and IL1B+3954 biallelic polymorphisms were genotyped using pyrosequencing. The variable number of tandem repeats (VNTR) polymorphism of IL1-RN was analysed using polymerase chain reaction (PCR) followed by gel electrophoresis. Relative risks were estimated by odds ratios with 95% confidence intervals, derived from unconditional logistic regression. Results. The risk of gastric cancer was unrelated to genotype in all of the studied polymorphic loci, and the absence of any association was confirmed in both the population-based and hospital-based case-control studies. Analyses confined to histological subtypes (intestinal or diffuse) and site-specific tumours (cardia or distal stomach), as well as analyses stratified by H. pylori infection status and family history of gastric cancer, did not reveal any significant increases or decreases in risk. Conclusion. Our results do not lend support to the hypothesis that human genetic polymorphisms related to the production of IL-1β are associated with the risk of gastric cancer.

Female reproductive factors and the risk of gastric cancer in a large-scale population-based cohort study in Japan (JPHC study).

The incidence of gastric cancer is two-fold to three-fold greater in men than in women. We investigated the reasons for this discrepancy by evaluating the impact of female reproductive factors on gastric cancer risk in the Japan Public Health Center-based Prospective Study. Among the 44 453 women enrolled, 368 cases of gastric cancer were newly diagnosed during follow-up from 1990 to 2004. The influence of female reproductive factors on risk was estimated using a multivariable Cox proportional hazards model after adjustment for potential confounders. Participants were stratified by menopause and gastric cancer status and further subdivided by histological type and anatomic subsite. No statistically significant association between female reproductive factors and gastric cancer risk was seen in general. Compared with those in late menarche (≥15), however, women in early menarche (≤12) had a close to 50% decreased risk of stomach cancer (hazard ratio 0.65, 95% confidence interval 0.43–0.98; P trend <0.01). Similar results were obtained in subgroup analyses categorized by histological subtype and anatomic subsite. Although early estrogen exposure may have some protective effect, female reproductive factors may have no substantial influence on gastric cancer development.

H. pylori Seropositivity before Age 40 and Subsequent Risk of Stomach Cancer: A Glimpse of the True Relationship?

Stomach carcinogenesis involves mucosal and luminal changes that favor spontaneous disappearance of Helicobacter pylori. Therefore, the association between the infection and cancer risk might typically be underestimated. As acquisition of the infection almost invariably occurs before adulthood, the serostatus at age 16–40 should best reflect the lifetime occurrence of the infection. We therefore conducted a case-control study nested within a historic cohort of about 400,000 individuals who donated sera before age 40 to either of two large Swedish Biobanks between 1968 and 2006, and whose records were linked to complete nationwide registers. For each stomach adenocarcinoma case occurring at least 5 years after serum donation 2 controls were selected matched on age, sex and year of donation and biobank. Serum immunoglobulin G antibodies against H. pylori cell-surface antigens (Hp-CSAs) were measured with an enzyme–linked immunosorbent assay and antibodies against CagA with an immunoblot assay. Conditional logistic regression models were used to estimate odds ratios (ORs) for stomach adenocarcinoma among H. pylori infected relative to uninfected. We confirmed 59 incident cases of stomach adenocarcinoma (41 non-cardia tumors) during follow-up. ORs for non-cardia stomach adenocarcinoma among subjects with Hp-CSA antibodies (regardless of CagA serostatus), antibodies against CagA (regardless of Hp-CSA serostatus), and antibodies to both, relative to those who were seronegative to both, were 17.1 (95% confidence interval [CI] 4.0–72.9), 10.9 (95% CI 3.2–36.9), and 48.5 (95% CI 5.8–407.4), respectively. H. pylori infection is a much stronger risk factor for non-cardia stomach adenocarcinoma than initially realized. However, further studies are needed to answer whether it is a necessary cause, as the possibility of misclassification of H. pylori status could not be ruled out in our study.

Analyses of functional antibody responses in HIV-1-infected individuals after vaccination with rgp160

BACKGROUND The immune response to HIV infection has been extensively studied and the antibody response against the virus has been characterized in detail. It is, however, still unclear which immune function it is most important to stimulate when administering a vaccine against HIV. OBJECTIVES To analyze the functional antibody responses in asymptomatic HIV-1-infected individuals after vaccination with rgp160. STUDY DESIGN Forty-nine asymptomatic HIV-1-infected individuals were followed for 9 months and analyzed for changes in functional antibody responses. Forty of them received HIV-1 envelope rgp160 injections and nine did not. RESULTS Increased levels of antibodies mediating neutralization and cellular cytotoxicity (ADCC) could be seen in subjects who also showed a better CD4 development compared with the patients without increased levels of functional antibodies. Out of nine matched HIV-infected and influenza-immunized controls, none had increased neutralizing activity and only one had an increased ADCC titer. An increased capacity to block soluble CD4 binding to gp120 occurred in 10 immunized patients. Seroreactivity and avidity maturation were detectable to peptides representing consensus HIV-1 envelope regions, indicating an anamnestic response to the patients own virus. CONCLUSIONS The humoral immune response in HIV-1-infected individuals was moderately influenced by repeated gp160 immunizations, while previous studies have shown that HIV-specific T-cell reactivity was strongly increased.

Enzyme immunoassay (ELISA) for the evaluation of antibodies directed to the CD4 receptor-binding site of the HIV gp120 molecule

The interaction between the HIV envelope glycoprotein gp120 and the CD4 molecule is probably the most important primary event determining HIV infection. Reactivity with the native viral envelope has been difficult to measure due to the lack of gp120 ligand purified directly from primary virus cultures. We have developed an ELISA, utilizing Galanthus nivalis agglutinin (GNA) which selectively binds native HIV envelope gp120 in culture medium. The GNA-based ELISA eliminates the need for isotope-labelled reagents, live cells and recombinant non-natively glycosylated envelope proteins and offers an easy way of using gp120 directly from crude HIV culture medium. The reactivities of sera from several categories of HIV infected individuals were assayed for inhibition of the HIV-1 gp120-CD4 binding. 19/32 (59.3%) sera from asymptomatic individuals and 7/10 (70%) sera from ARC/AIDS patients blocked the CD4-gp120 binding. 20 serum samples from uninfected individuals showed a gp120-CD4 interaction blocking capacity of 0-15%. Two monoclonal antibodies, T4.2 directed to CD4 and 1171 directed to the CD4 binding site of gp120 were used as positive controls. Both Mabs inhibited CD4-gp120 binding by 66-90%.

Genetic Variation in A4GNT in Relation to Helicobacter pylori Serology and Gastric Cancer Risk

Background:  Helicobacter pylori, a known risk factor of gastric cancer, rarely colonize the deeper portion of normal gastric glands, where the mucus is rich in α‐1,4‐linked N‐acetylglucosamine capped O‐glycans, that strongly inhibit H. pylori growth in vitro.