Frequency and Association Of GSTM1 and GSTT1 Gene Polymorphisms with Survival in Breast Cancer Patients.

OBJECTIVE: Glutathione S-transferase M1 and T1 (GSTM1 and GSTT1) are the key detoxification enzymes of xenobiotics, including chemotherapeutic drugs. The deletion polymorphisms of GSTM1 and GSTT1 genes are associated with reduced enzyme activity that influenced clinical outcomes of chemotherapeutic agents in breast cancer. However, there is limited information among Thai patients. This research aims to explore the frequency and role of GSTM1 and GSTT1 polymorphisms on survival among Thai patients with breast cancer. METHODS: The retrospective cohort study was performed. Demographic data and clinicopathology characteristics were collected from hospital base registry data and medical records. A multiplex qualitative real-time PCR method was used to detect the presence or absence of the GSTM1 and GSTT1 gene in the genomic DNA samples of the participants. RESULTS: The frequencies of the GSTM1 and GSTT1 null genotypes in 198 breast cancer patients were 65.70% and 33.30%, respectively. The overall survival at 1, 3 and 5 years were 95.00%, 83.00%, 71.00% respectively. The log rank test and Cox proportional hazards revealed a significant different in the 5-years overall survival according to lymph node metastasis and tumor stage (P = 0.014 and P < 0.001). No associations between overall survival and GSTM1 or GSTT1 genotype were found in single or combined genotypes analyses (P = 0.76 and P= 0.15). CONCLUSION: The results of our study provided the epidemiological information for prognostic of survival in breast cancer patients treated with chemotherapy.
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Doxorubicin-conjugated dexamethasone induced MCF-7 apoptosis without entering the nucleus and able to overcome MDR-1-induced resistance.

BACKGROUND: Doxorubicin (DOX) is the most widely used chemotherapeutic agent that has multimodal cytotoxicity. The main cytotoxic actions of DOX occur in the nucleus. The emergence of drug-resistant cancer cells that have the ability to actively efflux DOX out of the nucleus, and the cytoplasm has led to the search for a more effective derivative of this drug. MATERIALS AND METHODS: We created a new derivative of DOX that was derived via simple conjugation of the 3' amino group of DOX to the dexamethasone molecule. RESULTS: Despite having a lower cytotoxic activity in MCF-7 cells, the conjugated product, DexDOX, exerted its actions in a manner that was different to that of DOX. DexDOX rapidly induced MCF-7 cell apoptosis without entering the nucleus. Further analysis showed that Dex-DOX increased cytosolic oxidative stress and did not interfere with the cell cycle. In addition, the conjugated product retained its cytotoxicity in multidrug resistance-1-overexpressing MCF-7 cells that had an approximately 16-fold higher resistance to DOX. CONCLUSION: We have synthesized a new derivative of DOX, which has the ability to overcome multidrug resistance-1-induced resistance. This molecule may have potential as a future chemotherapeutic agent.

Association between ERCC1 Polymorphism and the Risk and Clinicopathological Features of Breast Cancer in Thai Women in the Lower Northeastern Region

Background: Breast cancer is a major public health problem around the world, including Thailand and it has the highest ranking among female cancer. Currently, the diversity or polymorphism of ERCC1 gene (excision repair cross-complementary group 1 gene or ERCC1) was reported to associate with an increased risk of breast cancer. This study aims to investigate the relationship between ERCC1 polymorphism and the breast cancer risk in the lower northeastern region women of Thailand. Materials and Methods: One hundred fifty one samples from breast cancer patients and 120 samples from healthy control group were analysed. Genomic DNA was extracted from white blood cell of all samples. The real-time polymerase chain reaction (qPCR) was used to demonstrate genetic polymorphism of ERCC1. Results: The results showed that the ERCC1 rs11615 polymorphism variant AG was associated with an increased risk of breast cancer. This study demonstrated that the frequency of ERCC1 rs11615 in patients with breast cancer was higher than healthy control group. The ERCC1 polymorphism variant AG carrier presented 3.53-folds high risk of breast cancer [odds ratio (OR) = 3.53, 95% CI = 1.61-7.74, P = 0.001]. In addition, when age, menopause period, number of child, smoking and alcohol drinking were adjusted, the ERCC1 rs11615 variant AG carrier was associated with increased breast cancer risk to 3.97 folds, with OR = 3.79, 95% CI = 1.62-8.84, P = 0.002. Conclusions: This study showed that ERCC1 rs11615 genotype AG was associated with breast cancer risk in the lower northeastern region women of Thailand.

Alu methylation in serum from patients with nasopharyngeal carcinoma.

BACKGROUND: Nasopharyngeal carcinoma (NPC) is a common cancer in Southern China and Southeast Asia. Alu elements are among the most prevalent repetitive sequences and constitute 11% of the human genome. Although Alu methylation has been evaluated in many types of cancer, few studies have examined the levels of this modification in serum from NPC patients. OBJECTIVE: To compare the Alu methylation levels and patterns between serum from NPC patients and normal controls. MATERIALS AND METHODS: Sera from 50 NPC patients and 140 controls were examined. Quantitative combined bisulfite restriction analysis-Alu (qCOBRA-Alu) was applied to measure Alu methylation levels and characterize Alu methylation patterns. Amplified products were classified into four patterns according to the methylation status of 2 CpG sites: hypermethylated (methylation at both loci), partially methylated (methylation of either of the two loci), and hypomethylated (unmethylated at both loci). RESULTS: A comparison of normal control sera with NPC sera revealed that the latter presented a significantly lower methylation level (p=0.0002) and a significantly higher percentage of hypomethylated loci (p=0.0002). The sensitivity of the higher percentage of Alu hypomethyted loci for distinguishing NPC patients from normal controls was 96%. CONCLUSIONS: Alu elements in the circulating DNA of NPC patients are hypomethylated. Moreover, Alu hypomethylated loci may represent a potential biomarker for NPC screening.

Clinicopathological significance of BRCA1 promoter hypermethylation in Thai breast cancer patients.

Breast cancer susceptibility gene 1 (BRCA1), mapped on chromosome 17q21, is implicated in the mechanisms of cellular DNA repair. Inactivation of this gene is involved in the development of many human cancers, including breast cancer. This study aimed to investigate the prognostic value of BRCA1 promoter hypermethylation and expression in breast cancer cases. Sixty-one breast cancers were examined for BRCA1 hypermethylation by methylation-specific polymerase chain reaction (PCR), and 45 paired normal breast tissues were analyzed for altered BRCA1 mRNA levels by quantitative real-time reverse transcription-polymerase chain reaction (qRT- PCR). Aberrant methylation status in BRCA1 was detected in 15 of 61 cases (24.6%), while reduced expression was found in 7 of 45 (15.6%). BRCA1 hypermethylation was statistically associated with tumor grade III (p=0.04), a high frequency of stage IIB (p=0.02), and triple-negative phenotype (OR= 3.64, 95%CI =1.1-12.3, p=0.03). Our findings indicated that BRCA1 promoter hypermethylation is a useful prognostic marker for breast cancer.

Hypermethylation of suppressor of cytokine signaling 1 in hepatocellular carcinoma patients.

Hepatocellular carcinoma (HCC), the most common primary hepatic tumor, is highly prevalent in the Asia-Pacific region, including Thailand. Many genetic and epigenetic alterations in HCC have been elucidated. The aim of this study was to determine whether aberrant methylation of the suppressor of cytokine signaling 1 gene (SOCS1) occurs in HCCs. Methylation specific-PCR assays were performed to identify the methylation status of SOCS1 in 29 tumors and their corresponding normal liver tissues. An abnormal methylation status was detected in 17 (59%), with a higher prevalence of aberrant SOCS1 methylation significantly correlating with HCC treated without chemotherapy (OR=0.04, 95%CI=0.01-0.31; P=0.001). This study suggests that epigenetic aberrant SOCS1 methylation may be a predictive marker for HCC patients.

LINE-1 methylation in the peripheral blood mononuclear cells of cancer patients.

BACKGROUND: Recently, we classified LINE-1 loci according to their methylation statuses and found that the percentage of hypomethylated LINE-1 loci ((u)C(u)C) can differentiate between the peripheral blood mononuclear cells (PBMCs) of oral cancer patients and normal controls with a higher specificity and sensitivity than overall methylation levels. Here, we evaluated the LINE-1 methylation levels and patterns in PBMCs from patients with cancers of the nasopharynx, lung, liver, bile duct, breast and colon. METHODS: Combined Bisulfite Restriction Analysis (COBRA) of LINE-1 loci was performed to examine the LINE-1 methylation statuses of PBMCs from 216 cancer patients with 6 different types of cancer compared with 144 normal controls. RESULTS: Only colorectal and nasopharyngeal cancer samples were found to have lower levels of overall LINE-1 methylation compared with normal controls (p<0.0001 and p=0.0022). However, %(u)C(u)C in cancers of the colon, liver, lung and nasopharynx was significantly higher compared with normal controls (p<0.0001, p<0.0001, p=0.01 and p=0.001, respectively). Furthermore, ROC curve analyses of these four cancer types also demonstrated the potential of %(u)C(u)C as a biomarker for cancer diagnosis. CONCLUSION: Changes in the levels and patterns of genome-wide methylation of PBMCs are associated with cancer risk. For LINE-1, %(u)C(u)C is a more effective tumour marker for determining cancer risk than overall methylation levels.

Epstein-Barr virus strains defined by the latent membrane protein 1 sequence characterize Thai ethnic groups.

Epstein-Barr virus (EBV) is ubiquitous in the human population and seroepidemiological studies have revealed that more than 90% of adults are infected with the virus in Thailand. It has been suggested that latent membrane protein 1 (LMP1) variants may differ in their tumorigenicity and geographical localization. The distribution of LMP1 variants of EBV in the Thai population was studied. A total of 259 LMP1 sequences from ten Thai ethnic groups (Lahu, Lisu, Shan, Red Karen, White Karen, Hmong, Akha, Mlabri, Moken and Urak Lawoi) were studied using direct PCR sequencing. Nucleotide sequences corresponding to the C terminus of the LMP1, including previously published sequences from central and southern Thais, were used in the phylogenetic analysis. Five strains--the B95-8 prototype, China 1, China 2, Mediterranean (Med) and SEA 2--were identified in ethnic groups in Thailand. The major strain and the distribution pattern differed by group and location. When the ethnic groups were classified by linguistic group, the prevalence of the SEA 2 strain was significantly different between Austro-Thais and other linguistic groups (P=0.0001), whereas, among Tibeto-Burman linguistic groups, the prevalence of the Med strain was different between matrilocal and patrilocal groups (P=0.0245). The distribution of LMP1 strains in ethnic minorities in Thailand is associated with ethnogeographical factors and the social/marriage system. This study thus provides evidence for the importance of interactions between populations in virus diversity.

Real-time PCR assay for rapid detection of GSTM1 polymorphism in nasopharyngeal carcinoma patients.

Nasopharyngeal carcinoma (NPC) is a common public health problem in Thailand. Glutathione S-transferase M1 gene deletion (GSTM1 null genotype) carriers have been reported to be at increased risk and therefore this parameter is a potential marker for screening of NPC high-risk individuals. However, the conventional polymerase chain reaction (C-PCR) assay commonly used for GSTM1 null genotype detection is not suitable for mass screening since it is inconvenient, time consuming and unsafe due to the use of a toxic chemical. Currently, real-time PCR (R-PCR) assay is recommended for quicker and safer detection of various genetic polymorphisms. The aim of this study was to develop a SYBR green I R-PCR assay combined with melting curve analysis for GSTM1 polymorphism detection in Thai NPC patients. The results were compared to those from the C-PCR assay using DNA samples from peripheral blood leukocytes of 120 Thai NPC patients. The frequencies of GSTM1 polymorphism detected by the R-PCR and the C-PCR were the same. Forty-eight individuals that were GSTM1+ in the R-PCR assay showed 2 peaks with melting points of 82.5 and 87.5 that correlated with the appearance of 2 DNA bands in the C-PCR assay (i.e., one for GSTM1 at 215 base pairs (bp) and one for ?-globin at 268 bp). By contrast, 72 individuals that were GSTM1?- in the R-PCR assay showed 1 peak with a melting point of 87.5C that correlated with the appearance of 1 DNA band for -globin at 268 bp in the C-PCR assay. The R-PCR assay using SYBR Green I and melting curve analysis for GSTM1 polymorphism detection was as reliable as C-PCR assay but was quicker and safer and more amenable to large scale screening in Thai NPC cases.

Association between EBNA2 and LMP1 subtypes of Epstein-Barr virus and nasopharyngeal carcinoma in Thais.

BACKGROUND: Nasopharyngeal carcinoma (NPC) is an Epstein-Barr virus (EBV)-associated malignancy that is common in Thailand. The association of the EBV nuclear antigen 2 gene (EBNA2) and the latent membrane protein 1 gene (LMP1) with NPC is unclear. OBJECTIVE: To determine the association between EBNA2 and LMP1 subtypes of EBV and NPC in Thais. STUDY DESIGN: EBV DNA from blood samples of 75 Thai patients with NPC and 44 age-matched controls was examined by PCR for EBNA2 subtypes (EBV type 1 and type 2) and LMP1 subtypes (wild-type LMP1 (wt-LMP1) and LMP1 containing a 30-bp deletion (del-LMP1)). RESULTS: The frequencies of EBV type 1 in cases (96.0%) and controls (97.7%) were similar. The frequency of del-LMP1 in cases (58.7%) was higher than in controls (36.4%) (p=0.023). Among NPC patients, the frequency of del-LMP1 in stages III and IV (65.6%) was higher than in stages I and II (18.2%) (p=0.006). By analyzing nucleotide sequence of the LMP1 region, a new subtype, Thai1, was identified. CONCLUSION: LMP1 subtypes of EBV may be involved in NPC susceptibility. The del-LMP1 variant may be a useful molecular marker for early detection, diagnosis and prognosis of Thai patients with NPC.

Cytochrome P450 2A6 polymorphism in nasopharyngeal carcinoma.

Nitrosamine has been identified as a carcinogen for nasopharyngeal carcinoma (NPC). Here, we investigated if a nitrosamine metabolizing gene, cytochrome P450 2A6 (CYP2A6) played an important role in NPC development. Relationships between the disease and the CYP2A6 were studied in 74 NPC patients and 137 age-matched healthy controls by using PCR-RFLP assay to distinguish between a wide type allele, *1A, and two mutant alleles, *1B and *4C. Overall, a significant association between CYP2A6 polymorphism and NPC development was observed (P<0.05). Individual with mutant alleles had an increased risk for NPC when compared to those with *1A/*1A (OR=2.37, 95% CI=1.27-4.46). In addition, males who carried mutant alleles of CYP2A6 had a fivefold increased risk for NPC when compared with those who carried *1A/*1A genotype (OR=5.02, 95% CI=1.82-14.14). It is thus suggested that CYP2A6 polymorphism may play a crucial role in NPC susceptibility and it may be used as a risk marker for NPC.

Glutathione S-transferase M1 gene polymorphism in Thai nasopharyngeal carcinoma.

Nasopharyngeal carcinoma (NPC) is a serious health problem in Thailand. It is caused by the combined effects of Epstein-Barr virus (EBV), carcinogens and genetic susceptibility. The glutathione S-transferase M1 gene (GSTM1) encodes a phase II enzyme responsible for detoxifying carcinogenic electrophiles. Polymorphic null forms of the gene GSTM1 lack enzyme activity and have been associated with susceptibility to several cancers including NPC. To examine the association between GSTM1 polymorphism and NPC susceptibility in Thais, GSTM1 genotypes (normal and null genotypes) in 78 NPC patients and 145 age-matched healthy controls were determined using PCR assays. Overall, no statistically significant differences were observed in the frequency of GSTM1 genotypes between cases and controls, nor among NPC patients compared on the basis of sex and clinical stage of disease. Carriers with the GSTM1 null genotype had a 2.9-fold increased risk for NPC of WHO type III when compared to those with GSTM1 normal genotype (P < 0.05 with OR =2.9, 95% CI = 1.2-6.8). When cases and controls were categorized into 3 age groups (>40, (>45 and (>50 years), the frequencies of GSTM1 null genotype in cases the (>45 and (>50 age groups were significantly different from controls (P< 0.05). In addition, carriers of the GSTM1 null genotype in age groups (>45 and (>50 years had a 2-fold and 3-fold increased risk for NPC when compared to those with GSTM1 normal genotype (OR = 2.2, 95% CI = 1.1-4.7 and OR = 3.0, 95% CI = 1.2-7.5). We suggest that GSTM1 polymorphism may be associated with NPC susceptibility in Thais, especially for GSTM1 null genotype carriers of age higher than 45 years. The GSTM1 null genotype may be a useful genetic marker for predicting Thai NPC and for screening of early stages of Thai NPC.

Recent origin and cultural reversion of a hunter-gatherer group.

Contemporary hunter-gatherer groups are often thought to serve as models of an ancient lifestyle that was typical of human populations prior to the development of agriculture. Patterns of genetic variation in hunter-gatherer groups such as the Kung and African Pygmies are consistent with this view, as they exhibit low genetic diversity coupled with high frequencies of divergent mtDNA types not found in surrounding agricultural groups, suggesting long-term isolation and small population sizes. We report here genetic evidence concerning the origins of the Mlabri, an enigmatic hunter-gatherer group from northern Thailand. The Mlabri have no mtDNA diversity, and the genetic diversity at Y-chromosome and autosomal loci are also extraordinarily reduced in the Mlabri. Genetic, linguistic, and cultural data all suggest that the Mlabri were recently founded, 500-800 y ago, from a very small number of individuals. Moreover, the Mlabri appear to have originated from an agricultural group and then adopted a hunting-gathering subsistence mode. This example of cultural reversion from agriculture to a hunting-gathering lifestyle indicates that contemporary hunter-gatherer groups do not necessarily reflect a pre-agricultural lifestyle.

The p53 codon 72 polymorphism in Thai nasopharyngeal carcinoma.

Nasopharyngeal carcinoma (NPC) is a serious cancer in Thailand. To address on the genetic risk factor for NPC, we investigated association between the p53 codon 72 polymorphism (Pro/Arg) and NPC susceptibility in the Thai. The genotype frequency of this polymorphism in 102 NPC patients and 148 age-matched healthy controls was determined by using a PCR-RFLP assay. No statistically significant difference in the overall genotype frequencies or allele frequencies between cases and controls was observed. Among NPC patients, no statistical significant difference in p53 genotype frequencies between sex, histological types and clinical stages was observed. When cases and controls were categorized into 3 groups of age, >40, >45 and >50 years, the frequencies of p53 genotype in the cases were significantly different from those of the controls (P<0.05). The p53 Pro homozygotes with age of >40 years had twofold to threefold higher risk to develop NPC and the risk was increased with age (Odds Ratio (OR) increased from 2.01 to 2.63 by age >40 to >50 years). Individuals of age >40, >45 and >50 years with an Arg/Arg genotype and of age >45 and >50 years with combined Arg/Arg or Arg/Pro genotype had lower risk to develop NPC than those with Pro/Pro genotype (P<0.05). Collectively, we suggest that the p53 gene polymorphism may associate with NPC susceptibility in Thai population, particularly the Pro/Pro genotype carriers with age of >40 years. The detection of this p53 polymorphism may be a useful tool for screening of early stage and diagnosis of NPC.

Significance of plasma IgA and IgG antibodies to Epstein-Barr virus early and viral capsid antigens in Thai nasopharyngeal carcinoma.

Epstein-Barr virus (EBV) is an important causal factor of human nasopharyngeal carcinoma (NPC). High levels of serum IgA and IgG antibodies to EBV early and viral capsid antigens (IgA/EA, IgA/VCA, IgG/EA and IgG/VCA) have been reported in NPC patients. Since specific serum IgA/EA, IgA/VCA and IgG/EA are claimed to be useful serological markers for NPC. In order to evaluate whether plasma IgA/EA, IgA/VCA, IgG/EA and IgG/VCA antibody levels are useful markers for diagnosis and prognosis of Thai NPC, we examined the prevalence of these antibodies in 79 NPC patients, and 127 age-matched controls (47 healthy subjects (HS), 32 cases of other disease (OD) and 48 cases of other cancer (OC)) by using an indirect immunofluorescence assay. The prevalence of plasma IgA/EA, IgA/VCA, and IgG/EA in NPC patients (55.7, 68.4 and 68.4%) was significantly higher than in the HS (0.0, 0.0 and 20.5%,), OD (0.0, 0.0 and 3.1%) and OC (0.0, 0.0 and 20.8%) groups (p<0.05). The prevalence of plasma IgG/VCA in NPC patients (93.7%) was significantly different from those for the OD and OC groups (71.9 and 43.8%) but not for the HS group (89.4%). In NPC patients, the geometric mean titers (GMT) of plasma IgA/EA, IgA/VCA and IgG/EA were increased with an advanced clinical stage of disease but not IgG/VCA. In contrast, GMT of IgG/VCA was increased with aggressive type of disease (histological type) but not IgA/EA, IgA/VCA, and IgG/VCA. The results of our study suggest that plasma IgA/EA, IgA/VCA and IgG/EA antibodies may be useful markers for diagnosis and assessing prognosis of Thai NPC.

Anthropological implication of the SDF1-3'A allele distribution in Southeast Asia and Melanesia.

The distribution of the SDF1-3'A allele among 1848 individuals in Southeast Asia and Melanesia was studied with the polymerase chain reaction-restriction fragment length polymorphism assay. The SDF1-3'A allele frequency in the populations of mainland Southeast Asia ranged from 0.0 to 0.355, whereas in the populations of insular Southeast Asia and Melanesia, it ranged from 0.233 to 0.733, with an increasing cline from west to east. Correlation between SDF1-3'A frequency and longitude values was highly significant for the populations in the Pacific region (r = 0.867, P < 0.001). The geographic distribution of the SDF1-3'A frequencies in the Pacific region was interpreted by an admixture of Austronesians with the aboriginal people in situ. In addition, this study found high proportions of SDF1-3'A/3'A homozygous individuals in several populations, which will enable us to evaluate roles of the SDF1 genotypes in SDF-1 expression.

Prevalence of hepatitis B and C virus infection in rural ethnic populations of Northern Thailand.

BACKGROUND: In Thailand, the population is composed of multiethnic stocks. However, many epidemiological studies on HBV and HCV have focused on blood donors with Thai and/or Chinese ethnic background. Available information on HBV and HCV infections among ethnic minorities in Thailand is limited. OBJECTIVE: So as to contribute to the local public health planning, we have conducted an ethno-epidemiological survey for the HBV and HCV infections among several minorities in a multiethnic center, Northern Thailand. STUDY DESIGN: A total of 658 individuals from seven ethnic groups, Lahu, Lisu, Shan, Red Karen, White Karen, Hmong and Akha, living in northern Thailand were studied for the prevalence of HBV and HCV infections by the use of particle agglutination tests. RESULTS: An overall prevalence of HBs-Ag, anti-HBs and anti-HCV in the seven groups was 10.3, 33.0 and 3.8%, respectively. The positivity rate of HBV and HCV infection in each tribe ranged 4.7% (Akha)-22.6% (Lahu) and 2.0% (Hmong and Akha)-8.1% (Shan), respectively. Sexual difference in the prevalence of HBV was not observed, whereas the prevalence of HCV was significantly higher in the males (P<0.05). The prevalence of HBV was significantly different (P<0.005) by the groups but that of HCV was not. CONCLUSIONS: The prevalence of HBV and HCV infection in Thai ethnic minorities was investigated. We demonstrated that HBV was a more common infectious agent found in this populations than HCV. The prevalence of HBV infection was different by tribe but not by sex. In contrast, the prevalence of HCV infection was not different by tribe but by sex (males were infected more than females). The present study showed that HBV and HCV infection are widely spread in rural ethnic populations of northern Thailand. Thus, a nation wide but community-base epidemiological survey is required for the public health planning to control their related serious diseases.