
POLYMORPHISM OF THE IL13 GENE MAY BE
ASSOCIATED WITH UTERINE LEIOMYOMAS
IN SLOVENIAN WOMEN Krsteski J, Jurgec S, Pakiž M, But I, Potočnik U, *Corresponding Author: Professor Uroš Potočnik, Ph.D., Centre for Human Molecular Genetics and Pharmacogenomics,
Faculty of Medicine, University of Maribor, Taborska Ulica 8, 2000 Maribor, Slovenia. Tel: +386-2-2345-854, Fax: +386-2-
2345-820, E-mail: uros.potocnik@um.si page: 51
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MATERIALS AND METHODS
Study Subjects. In this study, we recruited 181 ULM
patients and 41 women without ULM as a control group at
the Department of General Gynecology and Gynecological
Urology (University Medical Centre Maribor, Maribor,
Slovenia) as described previously [17]. Additionally, 92
subjects were included to represent the general population.
Uterine leiomyomas patients were divided into two subgroups:
85 were patients with solitary ULM and 96 were
patients with multiple ULM, with a mean age at diagnosis
of 46 ± 11 years. Controls were also divided into two
subgroups. The first group (healthy control) consisted of
41 women without ULM but diagnosed with pelvic organ
prolapse as described previously [17], with a mean age of
60 ± 11 years, and the second group (normal population)
consisted of 92 healthy individuals, with a mean age of
43 ± 12 years. Demographic and clinical parameters of
ULM patients analyzed in this study have been described
previously [17]. Additionally, quantitative measurements
of the 17β-estradiol levels in serum were performed using
ARCHITECT i2000SR Immunoassay Analyzer (Abbott
Laboratories, Abbott Park, IL, USA) according to the manufacturer’s
instructions. The study protocol was approved
by the Slovenian National Committee for Medical Ethics
and the Institutional Review Board (KME 43/10/15).
Selection and Genotyping of IL4 (rs2070874), IL4R
(rs1801275), IL12B (rs6887695), IL12RB1 (rs11575934)
and IL23R (rs7517847) Single Nucleotide Polymorphisms.
The rs2070874 (IL4) and rs1801275 (IL4R) SNPs
were selected according to their known functional role
in IL expression. Single nucleotide polymorphisms rs
11575934 (IL12RB1), rs6887695 (IL12B), rs20541 (IL13)
and rs7517847 (IL23R) were previously reported to be
associated with other ULM-related immune-mediated
diseases, such as inflammatory bowel disease [22], glioblastoma
[23], cervical adenocarcinoma and an increased
risk of tuberculosis [24].
Genotyping of IL4 (rs2070874), IL4R (rs1801275),
IL12B (rs6887695, located ~60 kb upstream of the IL12B
coding region), IL12RB1 (rs11575934) and IL23R (rs
7517847) SNPs was performed by polymerase chain reaction
(PCR) followed by the restriction fragment length
polymorphism (RFLP) technique. The PCR primers and
restriction enzymes were selected using the GeneRunner
program (Hastings Software Inc., Hastings, NY, USA).
A total of 50 ng of genomic DNA was mixed with oligonucleotide primers in a final volume of 10 μL containing 2
mM MgCl2, 0.2 mM dNTP mix, 10 mM Tris-HCl and 0.25
U Taq polymerase (Fermentas, Waltham, MA, USA). The
PCR conditions, primer sequences and the concentration
of each primer are shown in Table 1. Polymerase chain
reaction amplification was performed in a Professional
Standard PCR Thermocycler (TProfessional Basic; Biometra
GmbH, Göttingen, Germany). The PCR products were
digested with a restriction enzyme at 37 °C overnight. The
PCR products were electrophoresed on a 2.0% agarose
gel stained with ethidium bromide, and visualized on an
ultraviolet transilluminator. Restriction enzymes and fragment
sizes after digestion are listed in Table 1.
Genotyping of the IL13 (rs20541) Single Nucleotide
Polymorphism. Genotyping of the IL13 (rs20541)
SNP was performed by high resolution melting (HRM)
curve analysis following touchdown PCR amplification.
Primers were designed using Primer3 (http://simgene.com/
Primer3), and manufactured by Sigma-Aldrich Produktions
GmbH, Steinheim, Germany. Primer sequences were
as follows: forward 5’-CTG CAA ATA ATG ATG CTT
TCG-3’ and reverse 5’-ACC TGC TCT TAC ATT TAA
AGA AAC TT-3’. The touchdown PCR amplification
was performed on a LightCycler®480 detection system
(Roche Applied Science, Mannheim, Germany). Samples
were amplified in reactions containing 2 μL DNA (2.5
ng/μL), 3 μL of 2X LightCycler® 480 High Resolution
Melting Master Mix (Roche Applied Science), 200 nM of
each primer, 0.8 μL of MgCl2 (2 mM final concentration)
and RNase-free water in a final reaction volume of 10
μL. The touchdown PCR program was as follows: initial
denaturation at 95 °C for 10 min., followed by 45 cycles
of 10 seconds at 95 °C, 15 seconds at 65 °C (secondary
target temperature 53 °C, with 0.5 °C/step) and 10 seconds
at 72 °C. The HRM curve analysis was performed with
temperature ranges used for the melting curve generation
from 65 °C to 95 °C with 25 signal acquisitions per °C.
Statistical Analysis. All statistical analyses were
performed with the Statistical Package for the Social Sciences
(SPSS), version 23 (IBM Corporation, Armonk,
NY, USA). Genetic polymorphisms were expressed as
bivariate descriptive parameters, either by each of the two
SNP alleles or by either of two genetic models assuming a
dominant/recessive influence of the non-ancestral allele on
a particular phenotype. Appropriate statistical techniques
and methods were used, depending on properties of the
measured parameter. Association analyses were done by
either the two-sided Fisher’s exact test, risk determination,
Mann-Whitney test or Independent Samples t-test. Predictive
models for bivariate variables describing phenotype
groups were constructed using logistic regression with a
stepwise exclusion of parameters (backward: Wald exclusion
method with parameter exclusion criteria at p >0.05).
Initially included parameters were: all SNPs, adenomyosis,
age at diagnosis, family predisposition, menarche, number
of pregnancies, parity, body mass index, intake of oral
contraceptives, intake of gestagenes, age at first sexual
intercourse, and smoking. We did not perform a Bonferroni
correction in our statistical analysis to avoid an unnecessary
increase of type II errors [25]. Power of statistical
association analysis (p) for dominant and recessive genetic
models was calculated using G*Power computer software (Heinrich Heine University, Dusseldorf, Germany). The
power of the study was calculated post hoc, using the
generally accepted standard error rate α = 0.05.
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