HLA II genes distribution in Epstein–Barr virus-associated nasopharyngeal carcinoma and other tumors of the oral cavity patients in Russia

Background. It has been proved that for the nasopharyngeal carcinoma (NPC) the etiological agent is the Epstein–Barr virus (EBV). Being an ubiquitous infection, EBV, under certain conditions, is able to display its oncogenic potential. Among a wide range of tumors associated with EBV, the NPC occupies a special place because it is characterized by a geographically and ethnically heterogeneous distribution, suggesting that in the pathogenesis of NPC, in addition to EBV, an important role is played by other factors, such as genetic predisposition to this neoplasm. Among known genetic factors influencing the frequency of NPC development, the human leukocyte antigen (HLA) complex occupies an important place, as it plays a central role in the presentation of viral antigens to the immune system. In Russia, the association of HLA alleles with the risk of EBV associated forms of NPC development and with development of other oral cavity tumors (OOCT), not associated with the virus, has not been studied. In the literature there are contradictory information about HLA genes, which determine the predisposition to the emergence of these tumors, and their role in the initiation and formation an immune response to EBV proteins.

Objective: to study the distribution of the of DQA1-, DQB1-, DRB1-HLA class II gene variants associated with respectively the risk or resistance to the development of NPC and OOCT and with a high and low level of antibody response to EBV main proteins. A group of healthy persons served as a control.

Materials and methods. Blood samples from 62 patients with NPC, 44 patients with OOCT, and as control, 300 healthy individuals, were used in the study. The blood serum samples of NPC and OOCT patients were tested for the presence of immunoglobulin classes G and A antibodies to capsid and early EBV antigens by indirect immunofluorescence. All serum samples of patients and healthy individuals were genotyped on HLA-DQA1, -DQB1 and -DRB1 by the method of multi-primer amplification by sequence-specific primers by real-time polymerase chain reaction.

Results. In NPC patients, an increase in the frequency of HLA-DRB1*08 was found when compared with the frequency of a similar allele in healthy individuals (5.6 % vs 1.8 %; odds ratio (OR) 3.2; 95 % confidence interval (CI) 1.1–9.1; p = 0.02), and, on the contrary, a lower HLA-DQB1*0301 frequency was detected (16.1 % vs 25.3 %; p <0.05) than in healthy individuals. The data obtained suggest that the HLA-DRB1*08 gene is associated with an increased sensitivity to NPC.

In OOCT patients, HLA-DQB1*0502–4 and HLA-DRB1*16 variants were less common than in healthy individuals (1.1 % vs 6.8 %; p <0.05 and 1.1 % vs 6.7 %; OR 0.16; 95 % CI 0.01–1.08; p <0.05, respectively), suggesting that the HLA-DQB1*0301 gene is associated with resistance to NPC, and HLA-DQB1*0502–4 and HLA-DRB1*16 variants – with resistance to OOCT. It is interesting to note the difference in the frequency of HLA-DRB1*13 between NPC and OOCT patients (17.7 % vs 6.8 %; OR 2.9; 95 %

CI 1.1–8.6; p <0.05). One can suggest that this difference is related to the proven involvement of EBV in the NPC development. There were no other differences in the frequencies of class II HLA genes between the groups of NPC and OOCT patients. For the first time in Russia the importance of alleles DQA1, DQB1 and DRB1 of the HLA gene for the NPC and OOCT development, malignant tumors, respectively associated and non-associated with EBV, was studied. The results of the investigation completed together with known literature data allow us to conclude that the above alleles of the HLA class II gene can serve as a factor predisposing to the development of NPC in Russia.

Conclusion. However, in order to establish a strict association between a specific HLA haplotype and the NPC and OOCT incidence, the information obtained is insufficient due to the complexity and variability of the genetic control of immune responses controlling the tumor process. A comprehensive study of this issue using different immune response genes and populations of different ethnic origins will probably help to elucidate the effect of genetic polymorphism on the risk of NPC and OOCT development in Russia.

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