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Household endotoxin levels and the risk of non-Hodgkin lymphoma

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Abstract

Objective

Endotoxin, a component of the outer membrane of gram-negative bacteria, elicits a strong innate and inflammatory immune response associated with the secretion of proinflammatory cytokines, including tumor necrosis factor-alpha (TNF-α). Because TNF-α polymorphisms that increase TNF-α production are associated with an increased risk of non-Hodgkin lymphoma (NHL), we hypothesized that increased levels of household endotoxin would be associated with an increased NHL risk.

Methods

We evaluated this association in the National Cancer Institute/Surveillance, Epidemiology and End Results (NCI/SEER) NHL multicenter population-based case–control study. Used vacuum cleaner bags were collected from participants during a home interview. Dust samples from the bags of 594 cases and 442 controls were analyzed for endotoxin [endotoxin unit (EU)/mg of dust] using the kinetic chromogenic Limulus amebocyte lysate assay. Multivariable logistic regression was used to estimate the effect of endotoxin on NHL risk adjusted for age, sex, race, education, study center, and farm exposure.

Results

Endotoxin was not associated with NHL overall [odds ratio (OR) for highest quartile of endotoxin levels = 0.81, 95 % confidence interval (CI) = 0.55, 1.20; p for trend = 0.35] or with diffuse large B-cell lymphoma (OR = 0.63, 95 % CI = 0.34, 1.16; p = 0.31) or follicular lymphoma (OR = 1.07, 95 % CI = 0.61, 1.89; p = 0.73) subtypes. Both working and living on a farm were associated with higher household endotoxin levels compared to never working (p = 0.009) or living (p = 0.01) on a farm. Excluding farmers from the analysis did not change the results.

Conclusions

We found no evidence of a role for household endotoxin in NHL etiology.

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Abbreviations

LPS:

Lipopolysaccharide

TNF-α:

Tumor necrosis factor α

NCI:

National Cancer Institute

SEER:

Surveillance, Epidemiology and End Results program

NHL:

Non-Hodgkin lymphoma

EU/mg:

Endotoxin units per milligram

OR:

Odds ratio

CI:

Confidence interval

DLBCL:

Diffuse large B-cell lymphoma

PTF:

Pulmonary toxicology facility

Ln:

Natural logarithm

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Acknowledgments

This study was supported by the National Cancer Institute Division of Cancer Epidemiology and Genetics and the Surveillance, Epidemiology and End Results Program under contracts N01-PC-35139, N01 PC065064, NO1-PC-67008, N01-PC-71105, and N01-PC67009 awarded to the University of Southern California, Wayne State University, University of Washington and Mayo Clinic. This study was also supported by grants P01 CA17054, P30 ES07048, and the Norris Comprehensive Cancer Center Support Grant P30 CA014089, funded by the National Cancer Institute from the National Institutes of Health awarded to the University of Southern California. Additional funding from NIEHS supported exposure assessment at the University of Iowa (P30 ES005605). The collection of cancer incidence data in Los Angeles County was supported by the California Department of Health Services as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885 and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement #U55/CCR921930-02 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the authors and endorsement by the State of California, Department of Health Services, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Jun Wang, Wendy Cozen, Kiros Berhane & Leslie Bernstein

  2. Department of Pathology, USC Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Wendy Cozen

  3. Norris Comprehensive Cancer Center, USC Keck School of Medicine, University of Southern California, 1441 Eastlake Ave. MC 9175, Los Angeles, CA, 90089-9175, USA

    Wendy Cozen

  4. Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA, USA

    Peter S. Thorne

  5. Division of Epidemiology, College of Medicine, Mayo Clinic, Rochester, MN, USA

    James R. Cerhan

  6. Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Patricia Hartge, Mary H. Ward, Lindsay M. Morton, Martha S. Linet & Joanne S. Colt

  7. Division of Public Health Sciences, Department of Epidemiology, Fred Hutchinson Cancer Research Center and, School of Public Health, University of Washington, Seattle, WA, USA

    Anneclaire J. De Roos

  8. Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI, USA

    Richard K. Severson

  9. Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA

    Leslie Bernstein

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  1. Jun Wang
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  2. Wendy Cozen
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Correspondence to Wendy Cozen.

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Wang, J., Cozen, W., Thorne, P.S. et al. Household endotoxin levels and the risk of non-Hodgkin lymphoma. Cancer Causes Control 24, 357–364 (2013). https://doi.org/10.1007/s10552-012-0121-9

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  • DOI: https://doi.org/10.1007/s10552-012-0121-9

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