Nohelia Cajas-Salazar

Myeloperoxidase G-463A polymorphism and lung cancer: A HuGE Genetic Susceptibility to Environmental Carcinogens pooled analysis

Myeloperoxidase is a phase I metabolic enzyme that converts the metabolites of benzo[a]pyrene from tobacco smoke into highly reactive epoxides. A polymorphism in the promoter region of myeloperoxidase (463G→A) has been found to be inversely associated with lung cancer; differences in the association with age and gender have been suggested. We conducted a pooled analysis of individual data from 10 studies (3688 cases and 3874 controls) from the Genetic Susceptibility to Environmental Carcinogens database. The odds ratio for lung cancer was 0.88 (95% confidence interval: 0.80–0.97) for the AG variant of myeloperoxidase G-463A polymorphism, and 0.71 (95% confidence interval: 0.57–0.88) for the AA variant after adjusting for smoking, age, gender, and ethnicity. The inverse association between lung cancer and myeloperoxidase G-463A polymorphism was equally found in males and females (odds ratio for the AA genotype 0.73 [95% confidence interval: 0.56–0.96] and 0.67 [95% confidence interval: 0.46–0.98], respectively), without differences in the association according to age in the two genders. The myeloperoxidase G-463A polymorphism was significantly protective in “ever” smokers but not in “never” smokers. Myeloperoxidase is a key enzyme in tobacco-induced carcinogenesis.

Effect of epoxide hydrolase polymorphisms on chromosome aberrations and risk for lung cancer

Microsomal epoxide hydrolase (mEH) gene is polymorphic and its enzyme is involved in the activation and subsequent detoxification of several tobacco carcinogens, for example polycyclic aromatic hydrocarbons. Therefore, we have investigated the association of two polymorphisms at exons 3 and 4 of the mEH gene with the development of lung cancer in 110 patients and 119 matched controls. In addition, we have investigated the relationship between the different mEH alleles and the frequency of chromosome aberrations (CA), as an approach to understand the role of genetic susceptibility on cancer risk. Our results show that only the homozygous exon 4 fast genotype is significantly associated with increased risk for lung cancer (odds ratio [OR]=6.26; 95% confidence interval [CI]=1.02-38.3). When the exons 3 and 4 polymorphisms are considered together, patients carrying the high enzyme activity genotype have a significantly increased risk for lung cancer (OR=2.46; 95% CI=1.06-5.68). More importantly, the increased risk for this group is confirmed by their having the highest frequency of CA compared to any other genotype groups. In addition, genotypes with higher risk had consistently more CA than those with lower risk. Our CA data also indicates that the low activity genotype may exert a protective role in cigarette smokers, as it was associated with a significant decrease in CA compared to the high and intermediate activity genotypes. In conclusion, the CA data provides evidence to support that susceptibility mEH alleles are significantly involved with the development of lung cancer from cigarette smoking.

Factors contributing to discrepancies in population monitoring studies

A review of the scientific literature on population monitoring studies (on non-accidentally exposed populations) frequently show that many of these studies using similarly exposed populations and the same laboratory techniques do not produce consistent results. To illustrate the problem, a brief review of studies using well validated techniques (chromosome aberrations and hprt gene mutation) to elucidate genotoxic effects of cigarette smoking is presented. Although many factors can contribute to the generation of discrepant results, two obvious factors are small sample sizes and inadequate experimental data. In addition, a new factor on genetic susceptibility should be considered in population studies whenever appropriate. The new factor is based on recent data showing the influence of polymorphic metabolizing genes on response to environmental mutagens towards biological effects and disease outcome. The common ones include the cytochrome P450 and the glutathione S-transferase genes. The inclusion of susceptibility factors in population monitoring may revolutionize the approach for health risk assessment and for environmental regulations.

Chromosome aberrations in workers exposed to organic solvents: Influence of polymorphisms in xenobiotic-metabolism and DNA repair genes.

Organic solvents are widely used as diluents or thinners for oil-paints, gasoline and other organic mixtures. We evaluated chromosome aberrations (CAs) in lymphocytes of 200 workers exposed to organic solvents and 200 referents and the influence of polymorphisms in xenobiotic-metabolism (CYP2E1, GSTM1 and GSTT1) and in DNA repair genes (XRCC1(194) Arg/Trp, XRCC1(280) Arg/His, XRCC1(399) Arg/Gln and XRCC3(241) Thr/Met). Polymorphisms were determined by PCR-RFLP. Poisson regression analysis indicates a significant CA frequency increase in exposed workers, representing a higher risk in relation to the matched referent (RR 2.15, 95% CI 1.21-1.53, p<0.001). The CA frequency in exposed workers was influenced by the polymorphic genotypes: GSTM1 null (RR 1.33, 95% CI 1.31-1.69, p<0.001), XRCC1(194) Arg/Trp, Trp/Trp (RR 1.23, 95% CI 1.08-1.40, p<0.001) and by the wild genotypes CYP2E1 C1/C1 (RR 1.20, 95% CI 1.05-1.37, p<0.001), GSTT1 positive (RR 1.49, 95% CI 1.31-1.69, p<0.001), XRCC1(280) Arg/Arg (RR 1.44, 95% CI 1.26-1.64, p<0.001) and XRCC1(241) Thr/Thr (RR 1.54, 95% CI 1.34-1.76, p=0.001). We contribute to the follow-up predictive value of individual susceptibility biomarkers and their CA frequency influence during occupational organic solvent exposure. We provide tools for surveillance and prevention strategies to reduce potential health risks in countries with a large population of car painters not using protection devices and limited organic solvents use control.

Combined effect of MPO, GSTM1 and GSTT1 polymorphisms on chromosome aberrations and lung cancer risk.

The role of myeloperoxidase (MPO), and glutathione S-transferase mu and theta (GSTM1 and GSTT1) genetic polymorphisms on lung cancer risk was investigated in 110 Caucasian patients and 119 matched controls. Single genotype variants were not significantly associated with lung cancer risk. However, inheritance of the combined GSTM1 and GSTT1 null genotypes showed a significant increase in risk (crude OR = 2.32, 95% CI = 1.01-6.04). Based on adjustment by age, gender and smoking history, the MPO GA interacted with the presence of GSTM1 and GSTT1 genotypes to significantly reduce the risk (OR = 0.17, 95% CI = 0.03-0.98). From the chromosome aberration (CA) study in a subgroup of 79 patients and 69 matched controls, patients had significantly more CA than the controls. Among the patients, GSTM1 null was associated with a significant increase of CA and MPO AA was associated with a significant decrease of CA compared to their respective wild-type genotypes. After stratifying by smoking history (< or = and > 40 pack-years) and genotype, patients still had significantly more CA than the respective controls in most genotype categories. This indicates that the patients had additional contributing factors such as other susceptibility genes and/or different styles of smoking compared with the controls. In conclusion, our study indicates that CA is a useful biomarker to show the functional characteristics of genotypes and the interactive effects from combined genotypes. Therefore, our study strengthens the combined use of genotype and biomarkers for genetic susceptibility to environmental cancer.

Inheritance of polymorphic metabolizing genes on environmental disease and quality of life.

From investigations based on the human genome and the environmental genome programs, genetic basis for individual differences in response to environmental mutagens is being characterized. Inheritance of variant versions of certain polymorphic genes is frequently associated with the development of environmental disease, such as lung cancer from cigarette smoking. Inheritance of these alleles may also affect the quality of life such as longevity. Evidence in support of these possibilities is presented. It is obvious that through the understanding of susceptibility, more precise disease prevention strategies can be implemented which will not only reduce the disease burden but also improve the quality of life.

CYP2E1 Polymorphism, Cigarette Smoking, p53 Expression, and Survival in Non-small Cell Lung Cancer A Long Term Follow-up Study

The expression of selected gene products involved in cell differentiation and cell growth and genetic polymorphism of detoxifying genes was examined in 105 surgically resected nonsmall cell lung cancer (NSCLC) patients, and the relationship of these factors was correlated with cigarette smoking and patient survival. Genotyping of peripheral blood lymphocytes from 87 patients was performed for CYP2E1, GSTM1, GSTT1, mEH, and MPO detoxifying genes using polymerase chain reaction. Formalin-fixed, paraffin-embedded tissue was immunostained with antibodies to p53, p27, phospho-AKT, and bcl-2 using the avidin–biotin–peroxidase method and tissue microarray technique. Tumors were assigned a positive or negative score based on more than 10% of tumor cells staining positive with the antibody. The subtypes of NSCLC included 48 adenocarcinomas, 47 squamous cell carcinomas, and 10 large cell undifferentiated carcinomas. A total of 54 tumors were pathologic stage I, 23 were stage II, and 26 were stage III. All subjects smoked (range, 10–175 pack-years; mean, 60 pack-years). The mean overall survival was 112 weeks (median, 129 weeks). Patients with p53-positive tumors had significantly fewer pack-years of smoking (52 pack-years vs 72 pack-years; P = 0.021), smoked fewer years (34 years vs 40 years; P = 0.018), and had significantly better survival compared with those with p53-negative tumors (P = 0.045). When smoking history was further analyzed, the authors found that p53 expression was associated with the number of years smoked and not the number of packs smoked per day. Patients with squamous cell carcinoma had smoked longer compared with those with adenocarcinoma (P = 0.011). Significant association was seen between the CYP2E1 wild-type allele and better survival (P = 0.016). Patients with stage I tumors had better survival compared with stages II and III (P = 0.032). No association was found between survival and tumor type; tumor differentiation; expression of phospho-AKT, p27, and bcl-2; and polymorphic metabolizing genes other than CYP2E1. The significant association of long duration of smoking (>40 years) with loss of p53 expression and poor survival suggests inactivation of the protective p53 pathway in those who had a history of more than 40 years of smoking.

The effect of genetic admixture in an association study: genetic polymorphisms and chromosome aberrations in a Colombian population exposed to organic solvents.

The human population is heterogeneous in genetic susceptibility, chromosomal instability and disease risk; all factors which depend on inherited genetic constitution and acquired nongenetic environmental and occupational factors. Recently, special attention has been directed to the identification of sources of potential bias in population studies of gene–environment interactions including genetic admixture. The aim of this study was to evaluate the effect of genetic admixture in the association of genetic polymorphisms and chromosome aberrations (CA) in a population exposed to organic solvents. We assessed genetic admixture via 34 genetic ancestry informative markers (AIMs) in 398 Colombian individuals. We report a statistically significant difference of higher CA frequency in individuals’ below‐average European component, and in individuals’ above‐average Native American component after adjusting for covariates. In addition, the confounding risk ratio values are ≥10% than the adjusted risk ratio, suggesting that population stratification is a confounding factor in this gene–environment association study. Furthermore, after adjusting for individual admixture proportions and covariates, the results demonstrate that glutathione‐S‐transferase M1 (GSTM1)‐null is associated with CA frequency increase. These results suggest that gene–environment association studies that involve recently admixed populations should take into consideration population stratification as a confounding factor and suggest GSTM1‐null as a genetic marker associated with CA frequency increase.