Polymorphisms within autophagy‐related genes as susceptibility biomarkers for pancreatic cancer: A meta‐analysis of three large European cohorts and functional characterization
Authors: Gálvez‐Montosa Fernando , Peduzzi Giulia , Sanchez‐Maldonado José Manuel , ter Horst Rob , Cabrera‐Serrano Antonio J. , Gentiluomo Manuel , Macauda Angelica , Luque Natalia , Ünal Pelin , García‐Verdejo Francisco José , Li Yang , López López José Antonio , Stein Angelika , Bueno‐de‐Mesquita H. Bas , Arcidiacono Paolo Giorgio , Zanette Dalila Luciola , Kahlert Christoph , Perri Francesco , Soucek Pavel , Talar‐Wojnarowska Renata , Theodoropoulos George E. , Izbicki Jakob R. , Tamás Hussein , Van Laarhoven Hanneke , Nappo Gennaro , Petrone Maria Chiara , Lovecek Martin , Vermeulen Roel C. H. , Adamonis Kestutis , Reyes‐Zurita Fernando Jesus , Holleczek Bernd , Sumskiene Jolanta , Mohelníková‐Duchoňová Beatrice , Lawlor Rita T. , Pezzilli Raffaele , Aoki Mateus Nobrega , Pasquali Claudio , Petrenkiene Vitalija , Basso Daniela , Bunduc Stefania , Comandatore Annalisa , Brenner Hermann , Ermini Stefano , Vanella Giuseppe , Goetz Mara R. , Archibugi Livia , Lucchesi Maurizio , Uzunoglu Faik Guntac , Busch Olivier , Milanetto Anna Caterina , Puzzono Marta , Kupcinskas Juozas , Morelli Luca , Sperti Cosimo , Carrara Silvia , Capurso Gabriele , van Eijck Casper H. J. , Oliverius Martin , Roth Susanne , Tavano Francesca , Kaaks Rudolf , Szentesi Andrea , Vodickova Ludmila , Luchini Claudio , Schöttker Ben , Landi Stefano , Dohan Orsolya , Tacelli Matteo , Greenhalf William , Gazouli Maria , Neoptolemos John P. , Cavestro Giulia Martina , Boggi Ugo , Latiano Anna , Hegyi Péter , Ginocchi Laura , Netea Mihai G. , Sánchez‐Rovira Pedro , Canzian Federico , Campa Daniele , Sainz Juan 
Published: September 2024

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with patients having unresectable or metastatic disease at diagnosis, with poor prognosis and very short survival. Given that genetic variation within autophagy‐related genes influences autophagic flux and susceptibility to solid cancers, we decided to investigate whether 55,583 single nucleotide polymorphisms (SNPs) within 234 autophagy‐related genes could influence the risk of developing PDAC in three large independent cohorts of European ancestry including 12,754 PDAC cases and 324,926 controls. The meta‐analysis of these populations identified, for the first time, the association of the BIDrs9604789 variant with an increased risk of developing the disease (ORMeta = 1.31, p = 9.67 × 10−6). We also confirmed the association of TP63rs1515496 and TP63rs35389543 variants with PDAC risk (OR = 0.89, p = 6.27 × 10−8 and OR = 1.16, p = 2.74 × 10−5). Although it is known that BID induces autophagy and TP63 promotes cell growth, cell motility and invasion, we also found that carriers of the TP63rs1515496G allele had increased numbers of FOXP3+ Helios+ T regulatory cells and CD45RA+ T regulatory cells (p = 7.67 × 10−4 and p = 1.56 × 10−3), but also decreased levels of CD4+ T regulatory cells (p = 7.86 × 10−4). These results were in agreement with research suggesting that the TP63rs1515496 variant alters binding sites for FOXA1 and CTCF, which are transcription factors involved in modulating specific subsets of regulatory T cells. In conclusion, this study identifies BID as new susceptibility locus for PDAC and confirms previous studies suggesting that the TP63 gene is involved in the development of PDAC. This study also suggests new pathogenic mechanisms of the TP63 locus in PDAC.