The molecular causes of low ATM protein expression in breast carcinoma; promoter methylation and levels of the catalytic subunit of DNA-dependent protein kinase.

AIMS: To investigate whether aberrant methylation of the ATM promoter or loss of the catalytic subunit of DNA-dependent protein kinase (DNA-PKcs) may be the underlying causes of reduced ATM protein levels often seen in breast tumours. METHODS AND RESULTS: Methylation-specific polymerase chain reaction was used to determine the ATM promoter status and DNA-PKcs levels were measured by immunohistochemistry. None of the 74 invasive carcinomas (ICs) studied showed ATM promoter hypermethylation, whereas promoter methylation of CDKN2A/p16 (1.8%) and GSTP1 (15.8%) was detected. Of 92 ICs examined, 68 had reduced DNA-PKcs levels, supporting previous findings that alterations in double-strand break repair are associated with breast cancer pathogenesis. Although no association was found between the DNA-PKcs and ATM scores for the series of 92 tissues and 22/24 tissues with normal DNA-PKcs had reduced ATM, 29 tumours showed low expression of both DNA-PKcs and ATM compared with normal tissues. CONCLUSIONS: No evidence was found that the reduction in ATM protein levels seen in breast carcinoma is the result of epigenetic silencing. However, cross-regulation between DNA-PKcs and ATM may be a possible cause in a subset of tumours and warrants further investigation.

ATM polymorphisms as risk factors for prostate cancer development.

The risk of prostate cancer is known to be elevated in carriers of germline mutations in BRCA2, and possibly also in carriers of BRCA1 and CHEK2 mutations. These genes are components of the ATM-dependent DNA damage signalling pathways. To evaluate the hypothesis that variants in ATM itself might be associated with prostate cancer risk, we genotyped five ATM variants in DNA from 637 prostate cancer patients and 445 controls with no family history of cancer. No significant differences in the frequency of the variant alleles at 5557G>A (D1853N), 5558A>T (D1853V), ivs38-8t>c and ivs38-15g>c were found between the cases and controls. The 3161G (P1054R) variant allele was, however, significantly associated with an increased risk of developing prostate cancer (any G vs CC OR 2.13, 95% CI 1.17-3.87, P=0.016). A lymphoblastoid cell line carrying both the 3161G and the 2572C (858L) variant in the homozygote state shows a cell cycle progression profile after exposure to ionising radiation that is significantly different to that seen in cell lines carrying a wild-type ATM gene. These results provide evidence that the presence of common variants in the ATM gene, may confer an altered cellular phenotype, and that the ATM 3161C>G variant might be associated with prostate cancer risk.

Environmental and genetic determinants of aflatoxin-albumin adducts in the Gambia.

Aflatoxins together with chronic hepatitis B virus (HBV) infection contribute to the high incidence of hepatocellular carcinoma in developing countries. An understanding of the mechanism of interaction between these factors would provide a strong rationale for developing effective prevention strategies. In this study in The Gambia we examined the effect of environmental (place of residence and timing of sample collection) and host factors (age, sex, HBV status and interindividual variations in carcinogen metabolising enzymes) in determining blood aflatoxin-albumin adduct levels in 357 individuals of whom 181 were chronic HBV carriers. Samples were analysed for aflatoxin-albumin adducts, HBV status and genotypes of glutathione S-transferase (GST) M1, GSTT1, GSTP1 and epoxide hydrolase (EPXH). Urine samples were analysed for 6beta-hydroxycortisol:cortisol ratio as a marker of cytochrome P450 (CYP) 3A4 activity. Adduct levels were significantly higher in subjects resident in rural [geometric mean adduct level 34.9 pg aflatoxin B1-lysine equivalent (28.5-42.8; 95%CI)/mg albumin] than in periurban areas [22.2 pg (14.9-33.4)/mg] and were approximately twice as high in the dry season [mid-February to March; 83.2 pg (53.3-130.8)/mg] than the wet [July to August; 34.9 pg (28.5-42.8)/mg]. In contrast, HBV status, CYP3A4 phenotype, GSTT1, GSTP1 and EPXH genotypes were not associated with aflatoxin-albumin adduct level. However, mean adduct levels were significantly higher in non-HBV infected subjects with GSTM1 null genotype. The main factors which affect aflatoxin-albumin adduct levels in this population are environmental, notably place of residence and timing of sample collection. This study further emphasises the priority to reduce aflatoxin exposure in these communities by primary prevention measures.

Aflatoxin-albumin adducts: a basis for comparative carcinogenesis between animals and humans.

The study objectives were (a) to correlate AFB1 serum albumin adduct levels with AFB1-DNA adduct levels in liver in different rodent species to determine whether the former could serve as a marker of hepatic DNA adduct levels irrespective of species, and (b) to relate the levels of both adducts to differences in susceptibility to tumor induction by AFB1 in the different species. Finally, an attempt was made to compare the dose response for AFB1-albumin adduct formation in the rodent species with that in human populations exposed environmentally to AFB1. Three strains of rat (Fischer 344, Wistar, and Sprague-Dawley), and one strain each of guinea pig (Hartley), hamster (Syrian golden), and mouse (C57BL) were treated by gavage with up to 14 daily doses of between 1 and 80 mug AFB1/kg body weight. Animals were killed 24 h after 1, 3, 7, or 14 days treatment. A dose response in both AFB1-albumin and AFB1-DNA adducts was seen for all species and strains with steady-state adduct levels at 14 days. In rat strains at 14 days after treatment with 20 mu g/kg, the mean AFB1-albumin levels were between 24 and 26 pg AFB1-lysine equivalent/mg albumin, and the mean AFB1-DNA adduct levels were between 1.5 and 2.5 pmol (8, 9-dihydro-8- (2, 6-diamino-4-oxo-3, 4-dihydro-pyrimid-5-ylforamido-)- 9-hydroxy) AFB1/mg DNA. The level of both adducts was in the following order: rat > guinea pig > hamster > mouse. In the case of AFB1-albumin, the mean adduct level at 14 days in the three rat strains was approximately 1.5, 3.0, and 8-fold higher than in the guinea pig, hamster, and mouse, respectively. When the levels of the albumin and DNA adducts at 14 days were plotted against each other for all species and strains, a correlation was observed (r = 0.83; P = < 0.0001; n = 57; two-tailed test) suggesting a constant relationship between the level of binding of AFB1 to serum albumin and liver DNA. The levels of AFB1-albumin adduct also reflect at least qualitatively the relative susceptibility of the different species to AFB1 carcinogenesis; the rat is sensitive and the hamster and mouse are resistant. The level of AFB1-albumin adduct formed as a function of a single dose of AFB1 in rodents was compared to data from humans exposed environmentally to AFB1. This comparison yielded a value for the three rat strains of between 0.3 and 0.51 pg AFB1-lysine equivalent/mg albumin/1 mu g AFB1/kg body weight and a value for the mouse of <0.025. The best estimate for people from The Gambia and southern China was 1.56 pg/mg albumin for the same exposure. These data suggest that humans exposed to AFB1 form amounts of albumin addducts, and by extrapolation amounts of DNA adducts, closer to those observed in AFB1-sensitive species and 1-2 orders of magnitude higher levels than the AFB1-resistant species.

Aflatoxin exposure and cytogenetic alterations in individuals from the Gambia, West Africa.

Aflatoxin-albumin adducts in peripheral blood provide a measure of exposure to aflatoxin over the previous 2-3 months. In the present study, the levels of these adducts were determined in a group of individuals from The Gambia, West Africa and were compared in a cross-sectional study to the levels of various cytogenetic alterations (chromosomal aberrations, micronuclei, sister chromatid exchanges) in the same individuals to test whether an increase in genetic damage is associated with an increased exposure in this population. Of 35 subjects tested for aflatoxin-albumin adducts, all but 3 were positive. There were no correlations between the adduct level and the number of cytogenetic abnormalities at the individual level. A comparison of the cytogenetic alterations was made between Gambian individuals and a group of 22 healthy people from Italy where aflatoxin exposure is expected to be low. The levels of structural chromosomal aberrations, sister chromatid exchanges and micronuclei were all higher in the former group. Overall, these data are indicative of a higher exposure to genotoxins in Gambian subjects, one of which are aflatoxins, but suggest that more specific genetic markers of aflatoxin exposure are required to further examine the link between aflatoxin exposure and genetic alterations.

Dietary intake of aflatoxins and the level of albumin-bound aflatoxin in peripheral blood in The Gambia, West Africa.

Aflatoxin is implicated as a risk factor for hepatocellular carcinoma in areas of the world with a high incidence of this tumor. The present study was designed to validate the use of aflatoxin-albumin adducts in peripheral blood as a measure of individual exposure to this carcinogen. Dietary intake of aflatoxin was measured at the individual level in 20 residents of Keneba, West Kiang, The Gambia, over a 7-day period and correlated with the level of aflatoxin bound to peripheral blood albumin at the beginning and end of the study. Complementary enzyme-linked immunosorbent assay and high-performance liquid chromatography-fluorescence techniques were used to assay the aflatoxin adducts. All subjects were exposed to aflatoxin originating from several food types, with an average daily intake of 1.4 micrograms/day. A significant correlation (r = 0.55; P = < 0.05) was observed between the dietary intake and the level of albumin-bound aflatoxin at the end of the study. In addition, a good agreement was obtained with the two analytical techniques. A comparison of matched chronic hepatitis B surface antigen carriers with noncarriers did not reveal any difference in adduct formation for a given dietary intake of aflatoxin. These studies demonstrate the validity of aflatoxin-albumin adducts as a marker of human exposure to this carcinogen.

Evaluation of methods for quantitation of aflatoxin-albumin adducts and their application to human exposure assessment.

Aflatoxin (AF) albumin adducts are found in peripheral blood after exposure to aflatoxin B1 (AFB1) and the measurement of these adducts is potentially a useful tool in the epidemiological study of the role of AFB1 in the etiology of liver cancer. Three complementary approaches to the quantitation of AF-albumin adducts are described: (a) enzyme-linked immunosorbent assay (ELISA) performed directly on intact albumin (direct ELISA); (b) ELISA performed on an albumin hydrolysate (hydrolysis ELISA); (c) high-performance liquid chromatographic fluorescence detection of AF-lysine adduct after albumin hydrolysis and immunoaffinity purification. These techniques have been validated by direct comparison with rat albumin samples modified to a known extent. Detection limits of approximately 100, 5.0, and 5.0 pg AF/mg human albumin were determined for the three methods, respectively. Samples obtained from individuals from Thailand, The Gambia, Kenya, and France have been used to validate the measurement of AF-albumin adducts by these three methods. Levels of 7 to 338 pg AF/mg albumin were observed in the former two countries while no adducts were detected in samples from France. The relative properties of the three assays, with special regard to their application in epidemiological studies, are considered. A combination of the hydrolysis ELISA for large scale screening followed by confirmatory analyses in positive samples by high-performance liquid chromatographic fluorescence is suggested as an optimum methodology.

Application of antibody methods to the detection of aflatoxin in human body fluids.

Four different approaches to the quantification of human exposure to aflatoxins (AF) are presented: (i) analysis of urinary AF metabolites and DNA adducts, (ii) assay of AF bound to blood proteins and to lymphocyte DNA, (iii) immunocytochemical localization of AF in individual cells, and (iv) detection of AF in human breast milk. The potential applications of these approaches for assessing the role of both AF and hepatitis B virus (HBV) in primary hepatocellular carcinoma (HCC) are presented. The advantages and limitations of the methods for use in large-scale epidemiological studies are discussed, with particular attention to sensitivity.

Monitoring of individual human exposure to aflatoxins (AF) and N-nitrosamines (NNO) by immunoassays.

Highly sensitive immunoassays have been used to quantitate aflatoxins (AF) and N-nitrosamines (NNO) in human body fluids and tissues, respectively. This approach was taken in order to quantitate environmental exposure to these agents at an individual level to facilitate the investigation of their role in the etiology of human cancer. In order to analyse AF in human urine, an immunopurification step has been developed by using AF-specific antibody bound to AH-Sepharose 4B gel in a small (4-ml gel volume) affinity column prior to enzyme-linked immunosorbent assay (ELISA). The ELISA can be used to quantitate aflatoxin B1 (AFB1) over the range 0.01 ng/ml to 10 ng/ml and the assay system has been validated by using human urine samples spiked with AFB1 over this concentration range. In addition, 29 urine samples from the Philippines have been analysed and found to contain a range of levels from zero to 4.25 ng/ml AFB1 equivalent with a mean of 0.875 ng/ml. This compared with a mean of 0.066 ng/ml AFB1 equivalent in samples from France. Radioimmunoassay of O6-methyldeoxyguanosine (O6-medG) has been performed on human oesophageal and cardiac stomach mucosal DNA from tissue samples obtained during surgery in Linxian County, People's Republic of China, an area of high risk for both oesophageal and stomach cancer. Using the methodology described and having 1 mg of hydrolyzed DNA allows the detection of approximately 25 fmol O6medG per mg DNA.(ABSTRACT TRUNCATED AT 250 WORDS)