Sarah Jafrin1,2, Md Abdul Aziz1,2, Mohammad Safiqul Islam1,2. 1. Department of Pharmacy, 378872Noakhali Science and Technology University, Faculty of Science, Noakhali Science and Technology University, Noakhali, Bangladesh. 2. Laboratory of Pharmacogenomics and Molecular Biology, Department of Pharmacy, 378872Noakhali Science and Technology University, Noakhali Science and Technology University, Noakhali, Bangladesh.
Abstract
OBJECTIVE: Oxidative stress caused by the pro-inflammatory cytokine interleukin (IL)-1β has been widely investigated for cancer risk. In this study, we focused on the role of IL-1β rs1143634 polymorphism to reveal its impact on cancer development. METHODS: Related studies with fixed inclusion criteria were selected from electronic databases to May 2021. This meta-analysis was performed with odds ratios and 95% confidence intervals. Heterogeneity, publication bias and sensitivity analyses were also conducted. Trial sequential analysis (TSA) and in-silico gene expression analysis were performed. RESULTS: Forty-four case-control studies involving 18,645 patients with cancer and 22,882 controls were included. We observed a significant association of this single nucleotide polymorphism with overall cancer risk in the codominant model 3 (1.13-fold), recessive model (1.14-fold) and allelic model (1.08-fold). Subgroup analysis revealed that rs1143634 elevated the risk of gastric cancer, breast cancer and multiple myeloma. In addition, Asian and mixed populations and hospital-based controls had a significantly higher risk of cancer development. TSA confirmed our findings. CONCLUSION: Our meta-analysis revealed that the presence of IL-1β rs1143634 polymorphism increases the risk of cancer development. Among polymorphism carriers, the Asian population has a higher risk than other ethnic populations.This meta-analysis was registered retrospectively at INPLASY (https://inplasy.com/, INPLASY2021100044).
OBJECTIVE: Oxidative stress caused by the pro-inflammatory cytokine interleukin (IL)-1β has been widely investigated for cancer risk. In this study, we focused on the role of IL-1β rs1143634 polymorphism to reveal its impact on cancer development. METHODS: Related studies with fixed inclusion criteria were selected from electronic databases to May 2021. This meta-analysis was performed with odds ratios and 95% confidence intervals. Heterogeneity, publication bias and sensitivity analyses were also conducted. Trial sequential analysis (TSA) and in-silico gene expression analysis were performed. RESULTS: Forty-four case-control studies involving 18,645 patients with cancer and 22,882 controls were included. We observed a significant association of this single nucleotide polymorphism with overall cancer risk in the codominant model 3 (1.13-fold), recessive model (1.14-fold) and allelic model (1.08-fold). Subgroup analysis revealed that rs1143634 elevated the risk of gastric cancer, breast cancer and multiple myeloma. In addition, Asian and mixed populations and hospital-based controls had a significantly higher risk of cancer development. TSA confirmed our findings. CONCLUSION: Our meta-analysis revealed that the presence of IL-1β rs1143634 polymorphism increases the risk of cancer development. Among polymorphism carriers, the Asian population has a higher risk than other ethnic populations.This meta-analysis was registered retrospectively at INPLASY (https://inplasy.com/, INPLASY2021100044).
Currently, cancer is a leading cause of death worldwide. Oxidative stress induced by
chronic inflammation plays a vital role in cancer development. Although inflammation
is necessary for the immune system to protect the body against foreign infections,
the overstimulation of inflammatory cytokines has been identified to be responsible
for cancer progression.[1-6] Cancer cells often increase the
release of cytokines that stimulate the activation of multiple genes involved in
cellular migration, proliferation and survival. These cytokines help establish a
favorable microenvironment for neoplastic initiation and DNA damage.[7,8] Interleukin-1 (IL-1) is a
pro-inflammatory cytokine that exerts a wide range of biological actions, and
several case–control studies have shown that IL-1 polymorphisms are
significantly associated with different cancers .The IL-1β gene encodes IL-1β, which is one of the most potent
pro-inflammatory cytokines that initiates and amplifies both acute and chronic
inflammation and is involved in various cellular actions, such as proliferation,
differentiation and apoptosis. Upon stimulation, blood monocytes and tissue
macrophages produce IL-1β proprotein, which is cleaved and
activated by caspase 1.[10-15] According to genome-wide
association studies, patients with three common characteristic polymorphisms of this
gene, including rs16944, rs1143627 and rs1143634, are highly susceptible to cancer
development.[16-18]rs1143634, also known as +3954C>T, is a silent coding sequence polymorphism
located in exon 5 of chromosome 2. This single nucleotide polymorphism (SNP) showed
a significant association with increased IL-1β release from
lipopolysaccharide-induced cells in previous in vitro
studies.[19-21] Silent SNPs
tend to produce truncated proteins that remain inactive or degrade faster than
active proteins. This occurs when a silent SNP inactivates the splicing site and
causes premature termination of mRNA transcription.
In the case of rs1143634, the presence of this polymorphism increases active
IL-1β rather than inactive protein.[19-21] Excess IL-1β concentrations
facilitate a suitable environment for cancer development by increasing the rate of
uncontrolled cellular proliferation and differentiation and interfering with
apoptosis. Over the past decades, several individual case–control studies on
IL-1β rs1143634 polymorphism and cancer susceptibility have
been conducted in different ethnic groups. Although some studies reported a
significant link between this variant and different cancers, others failed to
establish any significant association.
In this meta-analysis, we summarized previous studies to investigate the
connection between IL-1β rs1143634 polymorphism and cancers and
provide comprehensive outcomes.
Materials and methods
Literature search strategy
Multiple authorized electronic databases (PubMed, Google Scholar, CNKI, Web of
Science and EMBASE) were comprehensively searched for related literature using
specific key terms up to May 2021. The selected key terms included cancer,
interleukin-1 beta, rs1143634 (+3954C>T), IL-1β polymorphism
and cancer, link between IL-1β rs1143634 and carcinogenesis and
IL-1β polymorphism and cancer development in various ethnic
populations. Additional studies were extracted from the references and citations
of the selected studies and the ‘similar studies’ option of the respected
websites. We selected published studies without restricting available
languages.
Publication screening
The eligibility of the publications was determined based on the previously
selected key terms, and the overall selection process was completed using a
protocol designed by the authors. The authors (SJ and MAA) selected the eligible
studies containing the related data and organized the extracted data for the
meta-analysis by comprehensive screening. The overall study selection protocol
was designed as a PRISMA flow diagram
using Review Manager (RevMan), Version 5.4 (The Cochrane Collaboration,
2020). The overall process was revised through final screening by another author
(MSI).This meta-analysis was retrospectively registered at INPLASY (https://inplasy.com/, INPLASY2021100044). Because no patients or
controls were directly involved in this meta-analysis, patient consent and
ethical approval were not necessary.
Inclusion and exclusion criteria
The main inclusion criteria of the selected studies were that they must contain
comparative genotypic information and detailed data regarding
IL-1β rs1143634 (+3954C>T) polymorphism in both patients
with cancer and control populations. If the selected studies contained genotypic
data on other SNPs, we only extracted the IL-1β rs1143634
(+3954C>T) data to include in this meta-analysis. We excluded studies without
IL-1β rs1143634 genotypic data in patients with cancer as
they were not eligible for this study. Publications containing incomplete
genotypic data on rs1143634 were also excluded. Studies lacking control
population data and those with incomplete information were avoided for further
comparison in this meta-analysis.
Extraction and quality assessment of data
The study ID, publication year, country and ethnic background of the study
population, cancer type, control type, genotypic method, sample and control
size, clinical histories and basic characteristics, genotypic data for the
selected SNP, Hardy–Weinberg equilibrium (HWE) p-value and
Newcastle–Ottawa Scale (NOS) score were collected from each selected study by
the authors.
Two authors (SJ and MAA) screened and processed the data using a
previously designed protocol, and another author (MSI) reviewed the organized
data by conducting the final screening.
Statistical analysis
We performed statistical analysis by comparing the frequency of
IL-1β rs1143634 polymorphism among patients with different
cancers and control populations to determine the connection between
IL-1β rs1143634 variants and cancer development
susceptibility. The meta-analysis used hospital-based (HB) and population-based
(PB) control populations as the control arms and patients with various cancers
carrying the IL-1β rs1143634 polymorphism as the experimental
arm. We used Review Manager (RevMan 5.4) to perform the overall statistical data
analysis. Estimation of cancer susceptibility was pooled as odds ratios (ORs)
with 95% confidence intervals (CIs). Based on heterogeneity, both the
fixed-effect model and the random-effects model were used (Q-test). If
heterogeneity was significant (p-value <0.10), a
random-effect model was applied, and when heterogeneity was not significant, the
fixed-effect model (Mantel–Haenszel) was applied.The Begg & Mazumdar test and Egger’s regression test were carried out to
estimate publication biases. Sensitivity analysis was also performed to assess
the reliability of the results by excluding individual studies one at a time.
Ethnicity-based sub-group analyses (White, Asian, African and mixed) were
conducted to analyze the role of IL-1β rs1143634 in patients
with cancer among different ethnic populations. Cancer types with less than two
studies were sub-grouped into ‘other cancers’ for further subgroup analysis.We applied seven common genetic models, including the association-allele model
(AM: T vs. C), codominant model 1 (COD1: TC vs. CC), codominant model 2 (COD2:
TT vs. CC), codominant model 3 (COD3: TT vs. TC), dominant model (DM: TT+ TC vs.
CC), recessive model (RM: TT vs. TC + CC) and over-dominant model (OD: TC vs.
TT+ CC). TT, TC and CC indicate normal homozygotes, heterozygotes and mutant
homozygotes, respectively.
Trial sequential analysis (TSA)
TSA was performed to reduce the random error risk. We first determined the
required information size (RIS) and defined the monitoring boundaries by setting
the following criteria: 1) 95% CI with a p-value <0.05, 2)
20% relative risk reduction, 3) 80% statistical power and 4) 5% type I error. We
used TSA software (version 0.9.5.10 beta)
for conducting TSA. The statistical summary (Z values) was plotted on the
Z-curve, which showed the TSA boundary. If the cumulative Z-curve crossed the
TSA boundary or RIS, this meta-analysis was considered to have achieved a
reasonable and sufficient degree of evidence, confirming that no additional
studies are required.
In silico gene expression analysis
To evaluate the overall impact of rs1143634 polymorphism on the
IL-1β gene expression level, we conducted an important
in silico gene expression analysis termed expression
quantitative trait loci (eQTL) analysis through the GTEx portal website
(http://www.gtexportal.org/). Two skin samples from the GTEx
database were analyzed, including sun-exposed skin samples and non-sun exposed
skin samples (suprapubic). Sun-exposed skin samples were taken from the lower
leg, and non-sun-exposed skin samples were taken from the suprapubic area. The
skin samples were obtained as slices with the subcutaneous fat removed, avoiding
pubic hair in the suprapubic region.
Results
Selection of the individual studies
Figure 1 outlines the
complete study selection process in this meta-analysis. Forty-four
studies[17,25-67] were selected from 970
primary studies acquired from the searched databases following the eligibility
criteria. Comprehensive screening of the titles, abstracts and full texts for
each study was conducted to include or exclude the studies. The quality of the
studies was determined using the NOS quality assessment score, and low-quality
studies (score <6) were excluded. Among the 44 studies, there were 18 on
gastric cancer (GC), 8 on lung cancer (NSCLC), 7 on breast cancer (BC), 4 on
colorectal cancer (CRC), 3 on prostate cancer (PCa) and 4 on other cancers.
Figure 1.
PRISMA flow diagram for study selection.
IL-1β: interleukin-1 beta.
PRISMA flow diagram for study selection.IL-1β: interleukin-1 beta.
Study characteristics
The basic demographic information of the 44 selected case–control studies
involving 18,645 patients with cancer and 22,882 controls is summarized in Table 1. Among them,
16 studies were from the Asian population, 23 studies were from the White
population, 2 studies were from the African population, and the other 5 studies
were from mixed populations. One association study recruited both African and
White populations for the IL-1β rs1143634 polymorphism. Most
studies reported the HWE p-value.
Table 1.
Baseline characteristics of all studies evaluating IL-1β
rs1143634 included in this meta-analysis.[17,24–66]
The overall meta-analysis of the total study population showed a significantly
elevated risk in patients with cancer carrying the IL-1β
rs1143634 variant in three different genetic models, including COD3 (TT vs. TC:
OR = 1.13, 95% CI = 1.02–1.25, p = 0.016), RM (TT vs. TC + CC:
OR = 1.14, 95% CI = 1.04–1.25, p = 0.006) and AM (T vs. C:
OR = 1.08, 95% CI = 1.0–1.17, p = 0.039). According to the
ethnicity-based subgroup analysis, the White population did not show any
significant link between rs1143634 and cancer risk. In contrast, the Asian
population showed a significantly increased risk of cancer among the variant
carriers in several genetic models, including COD1 (TC vs. CC: OR = 1.54, 95%
CI = 1.12–2.11, p = 0.008), DM (TT + TC vs. CC: OR = 1.54, 95%
CI = 1.14–2.09, p = 0.005), OD (TC vs. TT+CC: OR = 1.48, 95%
CI = 1.07–2.03, p = 0.017) and AM (T vs. C: OR = 1.50, 95%
CI = 1.15–1.95, p = 0.003). In the African population, there
was no significant association between cancer risk and the rs1143634 variant.
Other studies with mixed populations showed a significant risk in COD2 (TT vs.
CC: OR = 1.22, 95% CI = 1.07–1.40, p = 0.004), COD3 (TT vs. TC:
OR = 1.22, 95% CI = 1.06–1.40, p = 0.006), RM (TT vs. TC + CC:
OR = 1.22, 95% CI = 1.07–1.39, p = 0.004) and AM (T vs. C:
OR = 1.05, 95% CI = 1.0–1.11, p = 0.050) genetic models.In the sub-group analysis of different cancer types, patients with
IL-1β rs1143634 polymorphism showed a significant risk of
GC in COD1 (TC vs. CC: OR = 1.25, 95% CI = 1.00–1.56,
p = 0.048), DM (TT + TC vs. CC: OR = 1.25, 95% CI = 1.01–1.56,
p = 0.039), OD (TC vs. TT+CC: OR = 1.25, 95%
CI = 1.00–1.55, p = 0.045) and AM (T vs. C: OR = 1.21, 95%
CI = 1.00–1.46, p = 0.044) models. For BC, patients with this
polymorphism showed a significantly increased cancer risk in two genetic models,
including COD2 (TT vs. CC: OR = 1.31, 95% CI = 1.03–1.67,
p = 0.029) and RM (TT vs. TC + CC: OR = 1.35, 95%
CI = 1.08–1.67, p = 0.008). The carriers of
IL-1β rs1143634 polymorphism showed a significant risk for
multiple myeloma (MM) in the RM model (TT vs. TC + CC: OR = 2.64, 95%
CI = 1.25–5.57, p = 0.011). No significant association was
found for the other types of cancers. Sub-group analysis of HB control
populations showed a significantly increased risk in two genetic models: DM
(TT + TC vs. CC: OR = 1.18, 95% CI = 1.00–1.40, p = 0.049) and
AM (T vs. C: OR = 1.17, 95% CI = 1.02–1.35, p = 0.030). PB
controls with rs1143634 polymorphism did not show any association with cancer
risk. The overall findings were summarized in Table 2 and Figure 2.
Table 2.
Meta-analysis of the association between IL-1β rs1143634
polymorphisms and cancer susceptibility.
Meta-analysis of the association between IL-1β rs1143634
polymorphisms and cancer susceptibility.OR: odds ratio, 95% CI: 95% confidence interval, COD1: codominant
model 1, COD2: codominant model 2, COD3: codominant model 3, DM:
dominant model, RM: recessive model, OD: over-dominant model, AM:
allelic model; GC: gastric cancer; BC: breast cancer; LC: lung
cancer; CRC: colorectal cancer; PCa: prostate cancer; MM: multiple
myeloma; HB: hospital-based; PB: population-based. Bold values
indicate statistically significant differences
(p < 0.05).Forest plots describing the association between IL-1β
rs1143634 (+3954C>T) polymorphism and cancer susceptibility.IL-1β: interleukin-1 beta, OR: odd’s ratio, CI:
confidence interval, COD1: codominant model 1, COD2: codominant model 2,
COD3: codominant model 3, DM: dominant model, RM: recessive model, OD:
over-dominant model, AM: allelic model.
Heterogeneity
The Q-test was performed to determine the degree of
heterogeneity (Table
2). Heterogeneity was significant in maximum subgroup analysis models
(p-value <0.1), and random-effect models were applied
for these analyses. All subgroup analyses showed significant heterogeneity
(p-value < 0.1), except the subgroup analysis with the
mixed population and patients with PCa. The overall analysis with the total
study population did not show significant heterogeneity in COD3
(I2 = 19.52) and RM
(I2 = 22.46) genetic models.
Sensitivity and publication bias analyses
To confirm the reliability of the outcomes, we performed a sensitivity analysis
by the sequential omission of each study. The influence of each included study
on the final outcome of this meta-analysis was analyzed, and none of the studies
interfered with the pooled ORs. The sensitivity analysis revealed the stability
and robustness of this meta-analysis (Table 3).
Table 3.
Sensitivity analysis of the meta-analysis.
Study ID
COD1 (TC vs. CC)
COD2 (TT vs. CC)
COD3 (TT vs. TC)
DM (TT + TC vs. CC)
RM (TT vs. TC + CC)
OD (TC vs. TT + CC)
AM (T vs. C)
Overall
1.08(0.98–1.18)
1.10(0.95–1.27)
1.13(1.02–1.25)
1.09(1.00–1.19)
1.14(1.04–1.25)
1.06(1.00–1.16)
1.08(1.00–1.17)
Abazis-Stamboulieh et al.
1.06(0.97–1.16)
1.08(0.95–1.23)
1.12(1.02–1.24)
1.07(0.98–1.16)
1.13(1.02–1.24)
1.05(0.96–1.14)
1.06(0.99–1.14)
AL-Eitan et al.
1.08(0.98–1.18)
1.09(0.94–1.26)
1.11(1.00–1.23)
1.09(0.99–1.19)
1.12(1.01–1.23)
1.07(0.98–1.17)
1.07(1.00–1.16)
Al-Moundhri et al.
1.08(0.98–1.18)
1.11(0.96–1.29)
1.14(1.03–1.26)
1.09(1.00–1.20)
1.15(1.04–1.26)
1.06(0.97–1.16)
1.09(1.01–1.18)
Alpízar-Alpízar et al.
1.06(0.97–1.16)
1.1(0.95–1.27)
1.13(1.02–1.25)
1.08(0.99–1.18)
1.14(1.04–1.25)
1.05(0.96–1.14)
1.07(1.00–1.16)
Balasubramanian et al.
1.09(0.99–1.20)
1.1(0.95–1.29)
1.13(1.02–1.25)
1.1(1.00–1.21)
1.14(1.04–1.26)
1.07(0.98–1.17)
1.09(1.01–1.18)
Burada et al.
1.09(0.99–1.19)
1.11(0.95–1.29)
1.13(1.02–1.25)
1.1(1.00–1.20)
1.14(1.04–1.26)
1.07(0.98–1.17)
1.09(1.01–1.18)
Chen et al.
1.07(0.98–1.18)
1.1(0.95–1.27)
1.13(1.02–1.25)
1.09(0.99–1.19)
1.14(1.04–1.25)
1.06(0.97–1.15)
1.08(1.00–1.16)
Cigrovski Berković et al.
1.07(0.98–1.18)
1.1(0.95–1.28)
1.13(1.03–1.25)
1.09(0.99–1.19)
1.14(1.04–1.26)
1.05(0.96–1.15)
1.08(1.00–1.17)
Crusius et al.
1.08(0.98–1.19)
1.11(0.95–1.29)
1.14(1.03–1.26)
1.09(1.00–1.20)
1.15(1.04–1.26)
1.06(0.97–1.16)
1.09(1.01–1.18)
Eaton et al.
1.08(0.98–1.18)
1.1(0.94–1.28)
1.14(1.03–1.26)
1.09(0.99–1.19)
1.14(1.04–1.26)
1.06(0.96–1.16)
1.08(1.00–1.17)
El-Omar et al.
1.08(0.98–1.19)
1.13(0.98–1.30)
1.15(1.04–1.27)
1.1(1.00–1.20)
1.16(1.05–1.27)
1.06(0.97–1.16)
1.09(1.01–1.18)
Glas et al.
1.08(0.99–1.19)
1.1(0.95–1.28)
1.13(1.02–1.25)
1.1(1.00–1.20)
1.14(1.04–1.25)
1.06(0.97–1.16)
1.09(1.01–1.18)
Gonzalez-Hormazabal et al.
1.09(0.99–1.19)
1.1(0.95–1.27)
1.13(1.02–1.24)
1.1(1.00–1.20)
1.14(1.04–1.25)
1.07(0.97–1.16)
1.09(1.01–1.17)
Gordeeva et al.
1.08(0.99–1.19)
1.12(0.97–1.30)
1.14(1.03–1.26)
1.1(1.00–1.20)
1.15(1.05–1.27)
1.06(0.97–1.16)
1.09(1.01–1.18)
Hartland et al.
1.07(0.97–1.17)
1.09(0.94–1.26)
1.13(1.02–1.25)
1.08(0.99–1.18)
1.14(1 .03–1.25)
1.05(0.96–1.15)
1.07(1.00–1.16)
He et al.
1.08(0.98–1.18)
1.09(0.94–1.27)
1.13(1.02–1.24)
1.09(1.00–1.19)
1.14(1.03–1.25)
1.06(0.97–1.16)
1.08(1.00–1.17)
Hefler et al.
1.09(0.99–1.19)
1.1(0.95–1.28)
1.13(1.02–1.24)
1.1(1.00–1.20)
1.14(1.04–1.25)
1.07(0.98–1.17)
1.09(1.01–1.18)
Kaarvatn et al.
1.08(0.98–1.18)
1.1(0.95–1.28)
1.13(1.03–1.25)
1.09(1.00–1.20)
1.14(1.04–1.26)
1.06(0.97–1.16)
1.09(1.01–1.17)
Kiyohara et al.
1.07(0.97–1.17)
1.09(0.94–1.26)
1.13(1.02–1.24)
1.08(0.99–1.18)
1.14(1.03–1.25)
1.05(0.96–1.15)
1.07(0.99–1.16)
Landvik et al.
1.07(0.98–1.18)
1.1(0.95–1.28)
1.14(1.03–1.26)
1.09(0.99–1.19)
1.15(1.04–1.26)
1.05(0.96–1.15)
1.08(1.00–1.17)
Lee et al.
1.08(0.98–1.18)
1.1(0.95–1.27)
1.13(1.02–1.25)
1.09(1.00–1.19)
1.14(1.04–1.25)
1.06(0.97–1.16)
1.08(1.00–1.17)
Michaud et al.
1.08(0.99–1.19)
1.09(0.94–1.27)
1.12(1.02–1.24)
1.09(1.00–1.20)
1.13(1.03–1.25)
1.06(0.97–1.17)
1.09(1.00–1.17)
Ohmiya et al.
1.08(0.98–1.18)
1.1(0.95–1.27)
1.13(1.02–1.25)
1.09(1.00–1.19)
1.14(1.04–1.25)
1.06(0.97–1.16)
1.08(1.00–1.17)
Palli et al.
1.08(0.99–1.19)
1.09(0.94–1.27)
1.13(1.02–1.24)
1.09(1.00–1.20)
1.14(1.03–1.25)
1.06(0.97–1.16)
1.09(1.00–1.17)
Pérez-Ramírez et al.
1.09(0.99–1.19)
1.12(0.98–1.29)
1.14(1.03–1.26)
1.1(1.01–1.21)
1.15(1.05–1.26)
1.07(0.98–1.17)
1.1(1.02–1.18)
Persson et al._HB
1.08(0.98–1.18)
1.1(0.95–1.28)
1.13(1.03–1.25)
1.09(1.00–1.19)
1.14(1.04–1.26)
1.06(0.97–1.16)
1.08(1.00–1.17)
Persson et al._PB
1.08(0.98–1.19)
1.1(0.95–1.28)
1.13(1.03–1.25)
1.09(1.00–1.20)
1.14(1.04–1.26)
1.06(0.97–1.16)
1.09(1.01–1.17)
Pooja et al.
1.05(0.96–1.14)
1.11(0.95–1.28)
1.15(1.04–1. 27)
1.07(0.98–1.16)
1.15(1.04–1.26)
1.03(0.95–1.12)
1.07(0.99–1.15)
Qian et al.
1.09(0.99–1.20)
1.13(0.98–1.30)
1.14(1.03–1.26)
1.1(1.01–1.21)
1.16(1.05–1.27)
1.07(0.98–1.17)
1.1(1.02–1.18)
Sakuma et al.
1.07(0.97–1.17)
1.1(0.95–1.27)
1.13(1.02–1.25)
1.08(0.99–1.18)
1.14(1.04–1.25)
1.05(0.96–1.14)
1.08(1.00–1.16)
Sanabria-Salas et al.
1.08(0.98–1.19)
1.09(0.94–1.26)
1.12(1.02–1.24)
1.09(1.00–1.20)
1.14(1.03–1.25)
1.06(0.97–1.16)
1.08(1.00–1.17)
Schonfeld et al.
1.08(0.98–1.19)
1.08(0.93–1.25)
1.12(1.01–1.24)
1.09(0.99–1.19)
1.12(1.02–1.24)
1.06(0.97–1.16)
1.08(1.00–1.17)
Sicinschiet al.
1.08(0.98–1.18)
1.09(0.94–1.27)
1.13(1.02–1.24)
1.09(1.00–1.19)
1.14(1.03–1.25)
1.06(0.97–1.16)
1.08(1.00–1.17)
Snoussi et al.
1.07(0.98–1.18)
1.08(0.93–1.25)
1.12(1.02–1.24)
1.08(0.99–1.18)
1.13(1.03–1.24)
1.05(0.96–1.15)
1.07(1.00–1.16)
Song et al.
1.07(0.97–1.17)
1.1(0.95–1.27)
1.13(1.02–1.25)
1.08(0.99–1.18)
1.14(1.04–1.25)
1.05(0.96–1.14)
1.07(1.00–1.15)
Sousa et al.
1.09(0.99–1.19)
1.12(0.97–1.29)
1.13(1.03–1.25)
1.1(1.01–1.21)
1.15(1.04–1.26)
1.07(0.98–1.17)
1.09(1.01–1.18)
Ter-Minassian et al.
1.09(0.99–1.20)
1.1(0.94–1.28)
1.13(1.01–1.25)
1.1(1.00–1.21)
1.14(1.03–1.26)
1.07(0.97–1.17)
1.09(1.01–1.18)
Truong et al.
1.09(0.99–1.21)
1.09(0.93–1.29)
1.09(0.96–1.24)
1.11(1.00–1.22)
1.12(0.99–1.26)
1.07(0.97–1.18)
1.1(1.01–1.19)
Wang et al. (2007)
1.07(0.98–1.18)
1.1(0.95–1.27)
1.13(1.02–1.25)
1.09(0.99–1.19)
1.14(1.04–1.25)
1.05(0.97–1.15)
1.08(1.00–1.17)
Wang et al. (2015)
1.07(0.98–1.17)
1.1(0.95–1.27)
1.13(1.02–1.25)
1.08(0.99–1.18)
1.14(1.04–1.25)
1.05(0.96–1.15)
1.08(1.00–1.16)
Wen et al.
1.07(0.98–1.17)
1.1(0.95–1.27)
1.13(1.02–1.25)
1.08(0.99–1.18)
1.14(1.04–1.25)
1.05(0.96–1.15)
1.08(1.00–1.16)
Zabaleta et al._AF
1.08(0.99–1.19)
1.1(0.94–1.27)
1.13(1.02–1.24)
1.1(1.00–1.20)
1.14(1.04–1.25)
1.06(0.97–1.16)
1.09(1.01–1.17)
Zabaleta et al._Cau
1.08(0.98–1.19)
1.11(0.95–1.29)
1.14(1.03–1.26)
1.09(1.00–1.20)
1.15(1.04–1.26)
1.06(0.97–1.16)
1.09(1.01–1.18)
Zeng et al.
1.08(0.99–1.19)
1.1(0.95–1.27)
1.13(1.02–1.25)
1.1(1.00–1.20)
1.14(1.04–1.25)
1.06(0.97–1.16)
1.09(1.01–1.17)
Zhang et al. (2000)
1.08(0.98–1.18)
1.1(0.94–1.27)
1.13(1.02–1.25)
1.09(1.00–1.19)
1.14(1.04–1.25)
1.06(0.97–1.16)
1.08(1.00–1.17)
Zhang et al. (2005)
1.05(0.96–1.14)
1.1(0.95–1.27)
1.13(1.02–1.25)
1.06(0.98–1.15)
1.14(1.04–1.25)
1.03(0.95–1.12)
1.06(0.99–1.14)
COD1: codominant model 1, COD2: codominant model 2, COD3: codominant
model 3, DM: dominant model, RM: recessive model, OD: over-dominant
model, AM: allelic model.
Sensitivity analysis of the meta-analysis.COD1: codominant model 1, COD2: codominant model 2, COD3: codominant
model 3, DM: dominant model, RM: recessive model, OD: over-dominant
model, AM: allelic model.Publication bias was tested using Egger’s test and Begg & Mazumdar’s test.
The funnel plots are shown in Figure 3, and the bias parameters are presented in Table 4. The bias
analysis was conducted for overall studies, and no visual asymmetry was found
for COD2, COD3 and RM, indicating the absence of publication bias. The rest of
the analysis model showed potential publication biases (p-value
<0.05).
Figure 3.
Funnel plots indicating publication bias.
COD1: codominant model 1, COD2: codominant model 2, COD3: codominant
model 3, DM: dominant model, RM: recessive model, OD: over-dominant
model, AM: allelic model.
Table 4.
Outcome of publication bias analysis.
Study population and cancer
Comparison type
Egger’s test
Begg & Mazumdar’s Test
t
p
Z
p
Overall
COD1 (TC vs. CC)
2.44
0.019
2.96
0.003
COD2 (TT vs. CC)
0.25
0.805
0.71
0.478
COD3 (TT vs. TC)
−0.90
0.374
−0.24
0.813
DM (TT + TC vs. CC)
2.22
0.027
2.96
0.003
RM (TT vs. TC + CC)
−0.07
0.947
0.60
0.551
OD (TC vs. TT + CC)
2.42
0.020
2.83
0.005
AM (T vs. C)
2.08
0.044
2.49
0.013
COD1: codominant model 1, COD2: codominant model 2, COD3: codominant
model 3, DM: dominant model, RM: recessive model, OD: over-dominant
model, AM: allelic model.
Funnel plots indicating publication bias.COD1: codominant model 1, COD2: codominant model 2, COD3: codominant
model 3, DM: dominant model, RM: recessive model, OD: over-dominant
model, AM: allelic model.Outcome of publication bias analysis.COD1: codominant model 1, COD2: codominant model 2, COD3: codominant
model 3, DM: dominant model, RM: recessive model, OD: over-dominant
model, AM: allelic model.
TSA results
TSA plots revealed that the cumulative Z-curve for rs1143634 crossed conventional
and/or trial sequential monitoring boundaries and achieved the RIS in the
overall analysis, GC, BC and HB controls, demonstrating that an adequate level
of evidence was achieved, and no further studies are required to confirm the
results of the present meta-analysis (Figure 4 A–F). For the Asian subgroup of
overall cancer, the Z-curve surpassed the trial sequential monitoring boundary
but failed to attain the RIS.
Figure 4.
Trial sequential analysis for IL-1β rs1143634 in allele
models. (a) Overall, (b) White, (c) Asian, (d) Gastric cancer, (e)
Breast cancer and (f) Hospital-based controls. The blue line represents
the cumulative Z curve, and the red lines indicate the futility
boundaries.
Trial sequential analysis for IL-1β rs1143634 in allele
models. (a) Overall, (b) White, (c) Asian, (d) Gastric cancer, (e)
Breast cancer and (f) Hospital-based controls. The blue line represents
the cumulative Z curve, and the red lines indicate the futility
boundaries.TSA: trial sequential analysis, IL-1β: interleukin-1
beta.
IL-1β gene expression
The eQTL analysis from GTEx revealed that the mutant allele of
IL-1β rs1143634 leads to increased IL-1β
mRNA expression in the colon (p = 0.00095) and skin
(p = 0.0032) (Figure 5A & B).
Figure 5.
In silico expression analysis of IL-1β
in relation to different variants of the rs1143634 polymorphism. (a)
There was a significant difference in the expression of
IL-1β mRNA in colon tissues depending on the three
genotypes, and the variant allele showed higher expression. (b) There
was a significant difference in the expression of IL-1β
mRNA in the non-sun exposed skin samples, and the variant allele showed
lower expression. The values in the brackets represent the frequency of
different genotype carriers.
IL-1β: interleukin-1 beta.
In silico expression analysis of IL-1β
in relation to different variants of the rs1143634 polymorphism. (a)
There was a significant difference in the expression of
IL-1β mRNA in colon tissues depending on the three
genotypes, and the variant allele showed higher expression. (b) There
was a significant difference in the expression of IL-1β
mRNA in the non-sun exposed skin samples, and the variant allele showed
lower expression. The values in the brackets represent the frequency of
different genotype carriers.IL-1β: interleukin-1 beta.
Discussion
Previous reports suggest that cancer and inflammatory cytokines are closely related.
For example, the elevated expression of IL-1β in most human cancer
types indicates its crucial impact on carcinogenesis. In addition, the increased
level of IL-1β restricts improvement in many cancer
cases.[35,68,69] Because some previous studies provided controversial reports,
we attempted to collect and analyze all evidence to understand the role of
IL-1β rs1143634 in different cancers.IL-1β inhibits gastric acid secretion and potentiates chronic inflammation in GC,
worsening the disease.[70,71] As IL-1β rs1143634 polymorphism increases the
production of active IL-1β, this SNP is thought to play a critical role in GC. Zhang
et al. showed that the heterozygote model of IL-1β +3954C>T was
related to a significantly increased risk of GC.
Another study also demonstrated that C>T genotype carriers showed a
significantly increased risk of this cancer.
Wen et al. reported an elevated risk and added that environmental factors
potentiated the chance of cancer development.
Similarly, Sakuma et al. provided evidence that polymorphism carriers in the
Japanese population might have an increased risk of GC development in the corpus.
In contrast, a number of studies showed that the IL-1β
rs1143634 variant is not associated with an elevated risk of GC.[27,28,40,47,60,67] Moreover,
El-Omar et al. stated that this variant might have a protective effect against GC,
although the result was statistically non-significant.
Persson et al. conducted both PB and HB case–control studies but did not find
any connection.IL-1β binds to the estrogen receptor of BC cells and activates transcription. Pooja
et al. reported that variant alleles of IL-1β rs1143634 elevated
the risk of BC
, whereas other previous studies did not find any significant
correlations.[32,33,63] Two case–control studies reported that this variant might not
be related to lung cancer,[26,54] whereas Kiyohara et al. and Ter-Minassian et al. indicated that
smokers who are mutant T allele carriers of rs1143634 might have a higher risk of
lung cancer.[34,53] This SNP did not show any association with NSCLC and small cell
lung cancer in men.[29,35,41] For CRC, only polymorphism carriers among the Chinese Han
population showed an increased risk,
but other studies reported a negative association.[44,64] Patients with MM carrying CT
and TT alleles of the IL-1β +3954C>T polymorphism exhibited
improved survival rates and survival conditions compared with the CC allele carriers.
However, another study in patients with MM did not find any possible
association with this polymorphism.
Excess IL-1β potentiates inflammation caused by oxidative stress in cancerous
pancreatic beta cells, leading to cell destruction and restricted insulin release.
It also controls adhesion, invasion and chemoresistance by triggering various
signaling pathways, such as nuclear factor kappa B and extracellular
signal-regulated kinase.[72-75] Cigrovsk Berkovic et al.
found a possible association between rs1143634 variant and pancreatic neuroectoderm
tumors, although the results were not statistically significant.
This SNP did not show a significant association with PCa,[38,59] and prior
studies[31,65] reported no risk for other cancer types. This polymorphism was
found to have varied relationships with malignancies in different ethnic
populations.[9,39]In this meta-analysis, the IL-1β rs1143634 variant showed a
significantly elevated association with cancers in three genetic models, COD3
(1.13-fold), RM (1.14-fold) and AM (1.08-fold). The Asian population showed a
significantly enhanced risk of cancer in various genetic models, such as COD1
(1.54-fold), DM (1.54-fold), OD (1.48-fold) and AM (1.50-fold). African and White
populations did not show any connection between the IL-1β rs1143634
variant and cancer susceptibility. Populations with other mixed ethnicities were
significantly associated with cancer risk in COD2 (1.22-fold), COD3 (1.22-fold), RM
(1.22-fold) and AM (1.05-fold) models.We also performed a subgroup analysis with different cancer types.
IL-1β rs1143634 polymorphism showed a significant risk
association with GC in COD1, DM, OD and AM (1.25-, 1.25-, 1.25-, and 1.21-fold,
respectively), BC in COD2 and RM (1.31- and 1.35-fold, respectively) and MM in RM
(2.64-fold) models. We found no significant association for the other types of
cancers. The selection of controls slightly affected the outcomes according to our
sub-group analysis with HB and PB control populations. The analysis with HB controls
showed a significantly increased risk in DM (1.18-fold) and AM (1.17-fold) models.
No risk association was revealed for the IL-1β rs1143634 variant
with cancers in the case of PB controls. The presence of variant alleles of
IL-1β rs1143634 might increase the risk of various cancers.The analysis of sensitivity confirmed the stability and robustness of the present
meta-analysis. Moreover, TSA demonstrated that the cumulative Z-curve for the
rs1143634 SNP crossed the conventional monitoring boundaries and achieved the RIS,
demonstrating that adequate evidence was achieved for this meta-analysis and that no
additional studies are needed to verify the results. However, in the Asian
population, the Z-curve surpassed the trial sequential monitoring boundary but
failed to attain the RIS. Furthermore, we conducted IL-1β gene
expression analysis through eQTL, which revealed that mutant alleles of
IL-1β rs1143634 lead to increased IL-1β mRNA
expression in both colon tissues.Our meta-analysis had some limitations that could not be avoided. Some of the
subgroup analyses showed significant heterogeneity based on the
Q-test analysis. Visual asymmetry, Egger’s and Begg &
Mazumdar’s tests reported the presence of possible publication bias in a few models.
Finally, because of missing information, we failed to provide additional data for
individuals, such as their age, sex or disease duration, that may have enriched the
quality of the investigation.
Conclusions
Our meta-analysis revealed that the presence of IL-1β rs1143634
variant might elevate the cancer risk in the overall population. Among rs1143634
polymorphism carriers, the Asian population has a greater risk than other ethnic
populations. Further studies with larger sample sizes, specific ethnicities and
unbiased populations with detailed individual information should be conducted to
confirm our findings.
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