Evaluating the Causal Link Between Malaria Infection and Endemic Burkitt Lymphoma in Northern Uganda: A Mendelian Randomization Study

• Published in: EBioMedicine Vol. 25; no. C; pp. 58 - 65
• Main Authors: Legason, Ismail D., Pfeiffer, Ruth M., Udquim, Krizia-Ivana, Bergen, Andrew W., Gouveia, Mateus H., Kirimunda, Samuel, Otim, Isaac, Karlins, Eric, Kerchan, Patrick, Nabalende, Hadijah, Bayanjargal, Ariunaa, Emmanuel, Benjamin, Kagwa, Paul, Talisuna, Ambrose O., Bhatia, Kishor, Yeager, Meredith, Biggar, Robert J., Ayers, Leona W., Reynolds, Steven J., Goedert, James J., Ogwang, Martin D., Fraumeni, Joseph F., Prokunina-Olsson, Ludmila, Mbulaiteye, Sam M.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01-11-2017; Elsevier
• Subjects: Adolescent; Burkitt Lymphoma; Burkitt Lymphoma - complications; Burkitt Lymphoma - epidemiology; Burkitt Lymphoma - genetics; Burkitt Lymphoma - parasitology; Child; Child, Preschool; Female; Genetic Association Studies; Genetic Predisposition to Disease; Genotype; Humans; Infant; Infant, Newborn; Malaria; Malaria resistance genes; Malaria, Falciparum - complications; Malaria, Falciparum - epidemiology; Malaria, Falciparum - genetics; Malaria, Falciparum - parasitology; Male; Mendelian randomization; Mendelian Randomization Analysis; Plasmodium falciparum; Plasmodium falciparum - pathogenicity; Research Paper; Sickle cell trait; Uganda - epidemiology; Sickle cell trait; Plasmodium falciparum; Malaria resistance genes; Burkitt Lymphoma; Mendelian randomization; Malaria
• ISSN: 2352-3964; 2352-3964
• DOI: 10.1016/j.ebiom.2017.09.037

Plasmodium falciparum (Pf) malaria infection is suspected to cause endemic Burkitt Lymphoma (eBL), but the evidence remains unsettled. An inverse relationship between sickle cell trait (SCT) and eBL, which supports that between malaria and eBL, has been reported before, but in small studies with low power. We investigated this hypothesis in children in a population-based study in northern Uganda using Mendelian Randomization.
Malaria-related polymorphisms (SCT, IL10, IL1A, CD36, SEMA3C, and IFNAR1) were genotyped in 202 eBL cases and 624 controls enrolled during 2010–2015. We modeled associations between genotypes and eBL or malaria using logistic regression.
SCT was associated with decreased risk of eBL (adjusted odds ratio [OR] 0·37, 95% CI 0·21–0·66; p=0·0003). Decreased risk of eBL was associated with IL10 rs1800896-CT (OR 0·73, 95% CI 0·50–1·07) and -CC genotypes (OR 0·53, 95% CI 0·29–0·95, ptrend=0·019); IL1A rs2856838-AG (OR 0·56, 95% CI 0·39–0·81) and -AA genotype (OR 0·50, 95% CI 0·28–1·01, ptrend=0·0016); and SEMA3C rs4461841-CT or -CC genotypes (OR 0·57, 95% CI 0·35–0·93, p=0·0193). SCT and IL10 rs1800896, IL1A rs2856838, but not SEMA3C rs4461841, polymorphisms were associated with decreased risk of malaria in the controls.
Our results support a causal effect of malaria infection on eBL.
•Mendelian randomization analysis was done to assess a causal relationship between malaria infection and endemic Burkitt lymphoma in Uganda•Carriage of the sickle cell trait was associated with decreased risk of endemic Burkitt lymphoma•Heterozygous or homozygous minor alleles of IL10 rs1800896, IL1A rs2856838, and SEMA3C rs4461841 were associated with decreased risk of endemic Burkitt lymphoma•The inverse association between sickle cell trait and endemic Burkitt lymphoma supports a causal role of malaria in endemic Burkitt lymphoma