Detecção de Epstein-Barr vírus e variantes genéticas nos receptores das imunoglobulinas G em linfomas não-Hodgkin
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2016-09-22
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O cancro é uma doença complexa e multifactorial, cuja incidência tem vindo a aumentar
ao longo dos anos nos diversos países, sendo por isso crucial a pesquisa de novos métodos de
prevenção, diagnóstico, prognóstico e tratamento.
A análise de polimorfismos genéticos (SNPs – “Single nucleotide polymorphisms”) ao
longo do genoma é uma das formas de avaliação dirigida dos vários tumores, podendo ser uma
ferramenta muito útil no estabelecimento de grupos de risco, escolha da terapia, previsão da
resposta, sobrevivência global dos pacientes, entre outros parâmetros. No caso dos linfomas não-Hodgkin, que envolvem células do sistema imunitário, o estudo dos polimorfismos genéticos
que ocorrem nos receptores das imunoglobulinas G, como é o caso do Fc RIIa-131H/R, pode
assim ser promissor. Neste estudo a avaliação do Fc RIIa-131H/R não detectou associações
estatisticamente significativas deste polimorfismo com o estadio clínico, IPI/FLIPI, resposta ao
1º tratamento e sobrevivência global. Contudo, a futura análise de outros parâmetros poderá
clarificar o papel deste polimorfismo neste grupo de tumores, uma vez que algumas associações
foram já descritas, embora os resultados permaneçam controversos.
Além dos factores intrínsecos a cada indivíduo, existem outros agentes que podem ter
influência na carcinogénese, de que são exemplo as infecções virais. Um dos primeiros vírus
associados a um processo tumoral (linfoma de Burkitt) foi o Epstein-Barr, tendo desde então sido
alvo de diversos estudos, que o relacionaram com outros tipos de tumor. Nos linfomas não-Hodgkin a infecção por este vírus pode ter um papel importante, uma vez que o estado
imunocomprometido normalmente associado a estes pacientes pode também implicar diferentes
capacidades de resposta, assim como distintos padrões de infecção, permitindo monitorizar a
patologia através da carga viral de EBV. Embora os resultados não tenham revelado diferenças
significativas na detecção e quantificação de EBV entre pacientes e grupo controlo, a futura
ampliação da amostragem poderá estabelecer novas associações, uma vez que o valor de p não se
encontra muito afastado do nível de significância (p < 0,05).
Os objectivos futuros em Oncologia passam, desta forma, pela pesquisa e compreensão
global dos factores que desencadeiam e condicionam o aparecimento destas patologias, bem
como do seu desenvolvimento e progressão, no sentido de minimizar ou mesmo anular as taxas de mortalidade.
Cancer is a complex and multi factorial disease, whose incidence has been increasing over the years in different countries, making it crucial to research new methods of prevention, diagnosis, prognosis and treatment. Analysis of genetic polymorphisms (SNPs – “Single nucleotide polymorphisms”) through the genome is one of the ways of directed evaluation of the various tumors and may be an important tool in the establishment of risk groups, choice of therapy, prediction of the outcome, overall survival, among other parameters. In non-Hodgkin lymphomas, which implicate immune system cells, the study of genetic polymorphisms which occur in the immunoglobulin G receptors, such as Fc RIIa-131H/R, might be promising. In this study the evaluation of Fc RIIa-131H/R did not reveal significant differences between this polymorphism and the clinical stage, IPI/FLIPI, response to first treatment and overall survival. However, future analysis of other parameters might clarify the role of this polymorphism in this type of tumors, since some associations have already been described, although the results are still controversial. Apart from the intrinsic factors inherent to each individual, there are other agents that may influence carcinogenesis, as is the case of viral infections. Epstein-Barr was one of the first viruses associated with a tumor process (Burkitt’s lymphoma), making it a subject of many studies since then and relating it to other tumors. In non-Hodgkin’s lymphomas, the infection by this virus might play an important role, since the immune compromised state of the individuals may result in different capacities of response, as well as patterns of infection, allowing the monitoring of the pathology through the EBV viral load. Even though the results show no significant differences in detection and quantification of EBV between patients and the control group, the future enlargement of the sample might establish new associations, since the p value is not so far from the significance level (p < 0,05). The future goals of Oncology will inevitably be focusing on the research and global comprehension of factors which trigger and condition the appearance of such pathologies, as well as their development and progression, so as to minimize or annul the associated mortality rates.
Cancer is a complex and multi factorial disease, whose incidence has been increasing over the years in different countries, making it crucial to research new methods of prevention, diagnosis, prognosis and treatment. Analysis of genetic polymorphisms (SNPs – “Single nucleotide polymorphisms”) through the genome is one of the ways of directed evaluation of the various tumors and may be an important tool in the establishment of risk groups, choice of therapy, prediction of the outcome, overall survival, among other parameters. In non-Hodgkin lymphomas, which implicate immune system cells, the study of genetic polymorphisms which occur in the immunoglobulin G receptors, such as Fc RIIa-131H/R, might be promising. In this study the evaluation of Fc RIIa-131H/R did not reveal significant differences between this polymorphism and the clinical stage, IPI/FLIPI, response to first treatment and overall survival. However, future analysis of other parameters might clarify the role of this polymorphism in this type of tumors, since some associations have already been described, although the results are still controversial. Apart from the intrinsic factors inherent to each individual, there are other agents that may influence carcinogenesis, as is the case of viral infections. Epstein-Barr was one of the first viruses associated with a tumor process (Burkitt’s lymphoma), making it a subject of many studies since then and relating it to other tumors. In non-Hodgkin’s lymphomas, the infection by this virus might play an important role, since the immune compromised state of the individuals may result in different capacities of response, as well as patterns of infection, allowing the monitoring of the pathology through the EBV viral load. Even though the results show no significant differences in detection and quantification of EBV between patients and the control group, the future enlargement of the sample might establish new associations, since the p value is not so far from the significance level (p < 0,05). The future goals of Oncology will inevitably be focusing on the research and global comprehension of factors which trigger and condition the appearance of such pathologies, as well as their development and progression, so as to minimize or annul the associated mortality rates.
Descrição
Dissertação de Mestrado em Genética Molecular Comparativa e Tecnológica
Palavras-chave
Linfoma não Hodgkin , Polimorfismo genético , Herpesvírus humano 4 , Carcinogénese , Recetores de imunoglobulinas G