Genetic anti-inflammatory defect predisposes children to lymphoma

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DustyKat

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At least forewarned is forearmed:

New research shows that children with an inherited genetic defect in a critical anti-inflammatory pathway have a genetic predisposition to lymphoma. Results of the study, published online today in Blood, the Journal of the American Society of Hematology (ASH), reveal an important association between the genetic defect, which causes chronic intestinal inflammation and early onset inflammatory bowel disease, and its role in cancer development in infants and children.

Among the hundreds of signaling pathways in the human immune system that guide the body's defense against infection, inflammation, and trauma, the interleukin-10 (IL-10) pathway plays a substantial role in regulating and safeguarding the intestinal tract. In rare cases, a genetic defect can appear in the IL-10 or in one of its receptors (IL-10R1 and IL-10R2) that turns off the pathway's normal protective function, resulting in the development of very-early-onset inflammatory bowel diseases (VEO-IBD) in children as young as two weeks old.

While chronic intestinal inflammation is a known risk factor for cancer, until this study no formal connection had been made between IL-10 deficiency, VEO-IBD, and the development of certain malignancies. Researchers began to investigate this potential linkage when five children between 5.5 and 6.5 years of age being monitored for VEO-IBD at the Necker Children's Hospital in Paris and the Munich Children's Hospital developed highly proliferative and severe cancer very similar to diffuse large B-cell lymphoma (DLBCL), an extremely rare form of blood cancer in children.

"When one VEO-IBD patient with an IL-10R deficiency developed diffuse large B-cell lymphoma, we suspected it might be an unfortunate circumstance. However, when the second, third, fourth, and fifth child were diagnosed, it was clear that this was not a chance occurrence," said lead study author Alain Fischer, MD, PhD, of the Imagine Institute, French National Institute of Health and Medical Research and Assistance Publique - Hôpitaux de Paris in Paris.

To explore the subset and type of the children's lymphomas, investigators performed several analyses to characterize their molecular composition, identify chromosomal abnormalities, and examine their genetic expression profiles. Following these analyses, the research team observed that all five children exhibited sub-types of DLBCL so extraordinarily similar that the similarity could not be atrributed to random occurrence, but rather reflected consequences of the defective IL-10 pathway.

In confirming their discovery, researchers considered that the predisposition to lymphoma in the five children with IL-10 deficiency could have been related to the immunosuppressive therapy that four of them received for VEO-IBD. However, of the 53 children being monitored at the Necker Children's Hospital and the Munich Children's Hospital for VEO-IBD who received the same therapy, the children with IL-10 deficiency were the only ones who developed lymphoma.

While this finding confirms an association between a nonfunctioning IL-10 pathway and lymphoma, the mechanism by which this genetic deficiency activates cancer development has not yet been identified. One hypothesis considers the IL-10 pathway's role in regulating the proliferation of B cells in the body and proposes that an IL-10 deficiency may lead to uncontrolled cell activity and ultimately cancer. Another potential explanation contends that IL-10 deficiency may impair the disease-fighting ability of local T cells, a type of white blood cell.

Given the established protective effects of the IL-10 pathway and the elevated risk of lymphoma observed in these IL-10-deficient children, these findings may lead researchers to develop a more complete understanding of how the IL-10 pathway may be manipulated to aid in cancer prevention.

"The confirmed association between the IL-10 pathway and this rare pediatric lymphoma provides a valuable tool to predict cancer risk in children with VEO-IBD so that doctors can take preventive action that may prevent the occurrence or reoccurrence of lymphoma," said Dr. Fischer.

http://www.medicalnewstoday.com/releases/266956.php
 
Recombinant human IL-10 has been produced and is currently being tested in clinical trials. This includes rheumatoid arthritis, inflammatory bowel disease, psoriasis, organ transplantation, and chronic hepatitis C. The results are heterogeneous. They give new insight into the immunobiology of IL-10 and suggest that the IL-10/IL-10 receptor system may become a new therapeutic target.

http://pharmrev.aspetjournals.org/content/55/2/241.full



I see that's from 2003. What, if any treatments, are a result of this "new insight"?
 
So how can doctors use this info for kids with ibd? Is there something we should do with this info? Or is there even a test that is possible?
 
My son's IL-10 level was tested last year so there is a test for that. The result for him was normal.
 
Our gi said the the IL-10 isn't something she can just order in a test. Is mostly kids with crohns onset 5 and under. That's most kids on here... She said its really expensive and our children's hospital is doing clinical trials on it...but its full...
Don't know what to think of all that.

She also said if a child has this 'kind of crohns' you're treated thru bone marrow, etc. And then its gone....the crohns GONE!!

But...consider our source:
Our GI is ....well...you know! She's just young...and we feel like she hasn't had any tough cases. We're in process of trying to change. It's been really tricky. Took first steps today.
 
I guess the IL-10 deficiency causes very severe form of VEO-IBD and the symptoms start during the first months of life. Below the link to the study:

http://www.mh-hannover.de/fileadmin...nde_haematologie/download/aktuelles/beier.pdf

My son's doctors didn't believe that he would have IL-10 deficiency, but still they organised the test upon our request. When the test is done, the child should not be on biologics, otherwise the result may not be reliable.

At the moment I am trying to find more iformation about the ROS deficiency mentioned in case 2 in the slides of the previous post. There they say: > 35% of VEO-IBD patients have variants/mutations in the components of the NADPH oxidase complex compared to < 15% in controls

But there is only little information about this deficiency. Until now I have found only these mentioning IBD in this context:

http://onlinelibrary.wiley.com/stor...3083.2010.02501.x.pdf?v=1&t=hmkzrpwn&71afeef4

http://www.doria.fi/handle/10024/88972

http://www.ncbi.nlm.nih.gov/pubmed/21900546

http://neopics.org/uploads/NEOPICS_CGD_genes.pdf
 

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