Effect of the anticoagulant ethylenediamine tetra-acetic acid (EDTA) on the estimation of pharmacokinetic parameters: A case study with tigecycline and ciprofloxacin

Tigecycline and ciprofloxacin were employed as the model compounds to study the effect of the anticoagulant ethylenediamine tetra-acetic acid (EDTA), which is used during plasma sample preparations, on the determination of pharmacokinetic parameters. The pharmacokinetic parameters were determined in rats following intravenous infusion with blood samples collected in serum separators, with either EDTA- or heparin-coated tubes. The blood-to-plasma (B:P) partition ratio and plasma protein binding were determined in vitro in rat or human blood collected in either EDTA- or heparin-coated tubes. Drug concentrations were quantified by liquid chromatography coupled with tandem mass spectrometry detection (LC-MS/MS) analysis. In tigecycline-treated rats drug concentrations were twofold lower in EDTA plasma, leading to a twofold lower area under plasma concentration-time curve (AUC) and twofold higher plasma clearance values as compared with those obtained from heparin plasma. No differences were noted in the pharmacokinetic parameters obtained from heparin-treated plasma versus serum. The B:P partition ratio and unbound fraction for tigecycline were significantly higher in EDTA-treated blood. When normalized to the B:P partition ratios, the tigecycline blood clearance values were identical between samples collected in EDTA- or heparin-coated tubes. Similar but smaller differences were observed for ciprofloxacin. It was concluded that EDTA might compete with tigecycline and ciprofloxacin for chelating metal ions and thus affect drug partition between blood and plasma compartments, leading to inaccurate measurement of pharmacokinetic parameters in plasma.

Recent advances in P-glycoprotein-mediated multidrug resistance reversal mechanisms

Expression of the multidrug resistance (MDR) phenotype is responsible for chemotherapy failure in numerous cancers. Overexpression of mdr1 gene-encoded permeability glycoprotein (P-gp) is known to play a pivotal role in the development of this phenotype. The role of P-gp has been proposed as an important goal in the design of chemotherapy strategies. However, modulation of P-gp activity by chemotherapy has limited possibilities because of toxicity and poor specificity. In this article, we review the latest advancements in different potential P-gp-mediated MDR reversal mechanisms as well as the methods of evaluating MDR reversal activity, which would be helpful in finding novel MDR reversal agents (or chemosensitizers).

Recent advances in P-glycoprotein-mediated multidrug resistance reversal mechanisms

Expression of the multidrug resistance (MDR) phenotype is responsible for chemotherapy failure in numerous cancers. Overexpression of mdr1 gene-encoded permeability glycoprotein (P-gp) is known to play a pivotal role in the development of this phenotype. The role of P-gp has been proposed as an important goal in the design of chemotherapy strategies. However, modulation of P-gp activity by chemotherapy has limited possibilities because of toxicity and poor specificity. In this article, we review the latest advancements in different potential P-gp-mediated MDR reversal mechanisms as well as the methods of evaluating MDR reversal activity, which would be helpful in finding novel MDR reversal agents (or chemosensitizers).

DH1, a LOB domain-like protein required for glume formation in rice

T-DNA tagging is a high throughput strategy for identifying and cloning functional genes in plants. In this study, we screened 4416 lab-created T(1) rice T-DNA tagged lines and identified a mutant, designated dh1 (degenerated hull1), with phenotype of degenerated hull and naked pistils and stamens. Approximately 60% florets on the dh1 panicle defected in forming normal palea and lemma. Instead, they formed degenerative velum-like or filamentous organs accompanying with the lack of lodicules, stamens and pistils at different degree. A 361 bp of genomic sequence flanking the T-DNA isolated using TAIL-PCR (Thermal asymmetric interlaced PCR) co-segregated with the mutation phenotype. Results of blastn and gene prediction revealed the T-DNA inserted into the promoter region of a function-predicted gene at 283 bp upstream of its transcription start site (TSS). The predicted gene encoded a LOB (Lateral Organ Boundaries) domain-like protein. RT-PCR analyses indicated the transcription level of target candidate gene, DH1, decreased significantly in dh1 mutant. RNAi aimed at DH1 in wild type plants could partially result in the mutation phenotype of dh1. DH1 could also rescue the mutation phenotype in the complement experiment. The result of transformation by a fused expression vector, pDH1::GFP, revealed that DH1 had the keen spatial and temporal characteristics of expressing at axillary bud, young panicle and floral organs but not at root, leaf, node and culm, and strongly expressing at young tissues but weakly at mature organs. The dh1 presented severer mutation phenotype under relatively longer daylight than under shorter daylight implied that shorter daylight induced the expression of gene(s) redundant to DH1 in function and partially compensated for the loss-of-function. It is the first time to report the LOB-domain gene participating in the development of floral organs in rice.

Photoprotection of bacterial-derived melanin against ultraviolet A-induced cell death and its potential application as an active sunscreen

BACKGROUND

The increase in the incidence of non-melanoma skin tumours, photoaging, and immunosuppression demand for more effective sunscreen on ultraviolet A (UVA) irradiation.

OBJECTIVES

The aim of the study is to evaluate the photoprotective effects of a bacterial-derived melanin against UVA-induced damages in vitro and in vivo. Methods Human fibroblasts were used to assess the role of the bacterial-derived melanin on cell viability against UVA. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and nuclear morphology were employed to evaluate the photoprotection at the cellular level. Fluorometric assays were performed to detect the formation of reactive oxygen species (ROS) in the cells. Evaluations of the bacterial-derived melanin as a sunscreen were measured by transmission test and persistent pigment darkening on human skin.

RESULTS

Bacterial-derived melanin efficiently scavenged ROS in the fibroblasts after UVA irradiation. The cell viability of xeroderma pigmentosum (XP) fibroblast treated with varied doses of melanin increased dramatically in comparison with untreated control and the treated XP fibroblasts became more resistant to UVA-induced apoptosis than normal fibroblasts. Although the relative transmission didn't change too much with different concentration of bacterial-derived melanin, this melanin could keep UVA-irradiated skin from pigment darkening and act as an active sunscreen on skin.

CONCLUSIONS

The bacterial-derived melanin provided significant protection to fibroblast cell and human skin against the UVA radiation. It has the potential to be developed as an active sunscreen for the patients with photosensitivity skin to sun exposure.

The new water-soluble artemisinin derivative SM905 ameliorates collagen-induced arthritis by suppression of inflammatory and Th17 responses

BACKGROUND AND PURPOSE

Our previous study showed that SM905, a novel artemisinin derivative, exhibited potent immunosuppressive activity. In this study, we evaluate preventive and therapeutic effect of SM905 on collagen-induced arthritis (CIA) in DBA/1 mice, and investigate its mechanisms both in inflammatory and autoimmune aspects of the disease.

EXPERIMENTAL APPROACH

CIA was induced by type II bovine collagen (CII) in DBA/1 mice. SM905 was given orally either before (continuously 1 day before booster immunization) or after disease onset (continuously 14 days after booster immunization). Disease incidence and severity were monitored, mRNA expression of proinflammatory mediators was determined by real-time PCR, purified T cell proliferation was assessed using [(3)H]-thymidine incorporated assay, and T helper (Th) 17/Th1/Th2 type cytokine production was examined by ELISA.

KEY RESULTS

Oral treatment with SM905 delayed disease onset, reduced arthritis incidence and severity, and suppressed the enhanced expression of pro-inflammatory cytokines, chemokines and chemokine receptors in draining lymph nodes. The CII-induced T cell proliferation and production of interleukin (IL)-17A by T cells were strikingly inhibited. Correspondingly, the mRNA expression of IL-17A and RORgamma t (a specific transcription factor for Th17) was also reduced. This effect was coupled with a striking reduction of IL-6 production, which has a critical role in Th17 development. In established arthritis, SM905 profoundly inhibited disease progression, reduced IL-17A and RORgamma t mRNA expression, and suppressed pro-inflammatory mediator expression in arthritic joints.

CONCLUSIONS AND IMPLICATIONS

SM905 had beneficial effects on CIA by suppressing inflammatory and pathogenic Th17 responses.

Dynamic of modernizing traditional Chinese medicine and the standards system for its development

This article reviewed the process of Traditional Chinese Medicine's modernization on a global scale. This process is motivated by the potential need for traditional medicine as a result of health transitions and increasing drug R&D based on know-how from TCM. The established standards system for modern medicine serves as a basic model yet has limitations in terms of comprehensively evaluating TCM. Spurred by policy committments, research to provide supplements suited to TCM's features and principles is underway. Advanced and interdisciplinary technology and methodology is expected to play an essential role in TCM development.

Correlation analysis for longitudinal data: applications to HIV and psychosocial research

Correlation analysis is widely used in biomedical and psychosocial research for assessing rater reliability, precision of diagnosis and accuracy of proxy outcomes. The popularity of longitudinal study designs has propelled the proliferation in recent years of new methods for longitudinal and other multi-level clustered data designs, such as the mixed-effect models and generalized estimating equations. Despite these advances, research and methodological development on addressing missing data for correlation analysis is woefully lacking. In this paper, we consider non-parametric inference for the product-moment correlation within a longitudinal data setting and address missing data under both the missing completely at random and missing at random assumptions. We illustrate the approach with real study data in mental health and HIV prevention research.

HLA-DPB1 polymorphism in Blang and Puyi ethnic groups of southwest China inferred from sequence-based typing

In the present study, DNA typing for HLA-DPB1 was performed using polymerase chain reaction (PCR)-sequence-based typing method in two isolated Chinese populations: the Blangs (n = 94) in Shuangjiang County and the Puyis (n = 76) in Luoping County from Yunnan province of Southwest China. These two populations exhibited certain similarity in their allelic distributions of the HLA-DPB1 gene. A total of 11 and 12 alleles at the DPB1 locus were found in the Blang and Puyi groups, respectively. In the Blang group, the most frequent alleles were DPB1*0501 (51.0%) and DPB1*1301 (17.0%). DPB1*030101 was also common with a frequency of 6.4%. In the Puyi group, the most frequent allele was also DPB1*0501 with a frequency of 47.5%, followed by DPB1*1301 (21.1%). Two alleles DPB1*2101 and DPB1*0202 followed, with frequencies ranging between 5% and 8%. The alleles DPB1*4101, DPB1*3301, DPB1*6801 and DPB1*8401 were found for the first time in Chinese populations. A dendrogram constructed by neighbor-joining method showed that the Blang and Puyi ethnic minorities, which had the closest relationship belonged to the southern Chinese.

Power analyses for longitudinal study designs with missing data

Existing methods for power analysis for longitudinal study designs are limited in that they do not adequately address random missing data patterns. Although the pattern of missing data can be assessed during data analysis, it is unknown during the design phase of a study. The random nature of the missing data pattern adds another layer of complexity in addressing missing data for power analysis. In this paper, we model the occurrence of missing data with a two-state, first-order Markov process and integrate the modelling information into the power function to account for random missing data patterns. The Markov model is easily specified to accommodate different anticipated missing data processes. We develop this approach for the two most popular longitudinal models: the generalized estimating equations (GEE) and the linear mixed-effects model under the missing completely at random (MCAR) assumption. For GEE, we also limit our consideration to the working independence correlation model. The proposed methodology is illustrated with numerous examples that are motivated by real study designs.

China-Japan enhance joint research cooperation for drug discoveries and development: News from CJMWDDT 2007 in Jinan, China

Viral hepatitis is currently a major global cause of morbidity and mortality. In some Asian countries like China and Japan, Hepatitis B and C in particular are the most common extremely infectious diseases and are likely to develop into liver cirrhosis. Furthermore, statistics indicate that patients with liver cirrhosis resulting from hepatitis B and C have an increased risk of developing hepatocellular carcinoma (HCC). Scientists have worked tirelessly to find curative therapeutic strategies to control chronic hepatitis and liver cirrhosis, accompanied by improvements in public health and living conditions. China's Shandong University and the University of Tokyo in Japan previously established a longterm cooperative relationship. Cooperative programs include co-training of postgraduates, exchanges of visiting scholars, academic symposia, and a bilateral international joint research program. Some substantive progress has been made as a result of bilateral endeavors. For instance, the Shandong University China-Japan Cooperation Center for Drug Discovery & Screening (SDU-DDSC) has enhanced to serve as an important platform for further close cooperation. At the same time, the International Advancement Center for Medicine & Health Research (IACMHR) - "Drug Discoveries and Therapeutics" and International Research and Cooperation Association for Bio & Socio-Sciences Advancement (IRCA-BSSA) - "BioScience Trends" were established (Visit http://www.ddtjournal.com and http://www.biosciencetrends.com ). The first China-Japan conference on new drug discoveries and therapeutics (CJMWDDT 2007) was recently held in Jinan, China May 27-29, 2007, which provided opportunities for further communication and cooperation and increased knowledge of new drug research and clinical cures for hepatitis. Financially supported by the National Natural Science Foundation of China (NSFC) and the Japan Society for the Promotion of Science (JSPS), the conference covered a wide range of topics in different areas of chemical biology, phytochemistry, medicinal chemistry, and pharmacology and it resulted in informed and genial discussions of hepatitis cures that yielded fruitful results. The active involvement and participation by attendees gave the conference a congenial atmosphere. In the end, an agreement was reached to work together on new drug discovery and effective hepatitis therapeutic strategies, and some agreements have resulted in the creation of handover protocols. The CJMWDDT 2007 was a highly successful scientific event that strengthened and promoted extensive cooperation between China and Japan for the development of new pharmaceutical products and hepatitis cures.

GMP implementation in China: A double-edged sword for the pharmaceutical industry

China's Good Manufacturing Practice (GMP) standards that mainly parallel WHO standards were made compulsory in 2004. However, GMP implementation had both positive as well as negative impacts on the pharmaceutical industry, with negatives including pharmaceutical companies suffering economic hardships, poor execution of GMP standards, and sequent health scares. This report briefly describes the problems with GMP implementation in China.

Deletion of Tip30 leads to rapid immortalization of murine mammary epithelial cells and ductal hyperplasia in the mammary gland

Transformation of mammary epithelial cells (MECs) from the normal to the neoplastic stage requires the dysregulation of tumor suppressor genes and proto-oncogenes. Tip30 is a tumor suppressor that can inhibit estrogen receptor-mediated transcription in MECs, but its role in MEC proliferation remains unknown. Here, we show that deleting the Tip30 gene leads to ductal hyperplasia in mouse mammary glands early in life and extensive mammary hyperplasia with age. Tip30(-/-) mammary glands transplanted into wild-type mammary fat pads also display mammary trees with extensive ductal hyperplasia. Strikingly, Tip30 deletion promotes proliferation of primary MECs and results in rapid immortalization of MECs in vitro relative to wild-type cells. Gene array analysis identified significant increases in the expression of mammary epithelial growth factors Wisp2 and Igf-1 in Tip30(-/-) cells. Knockdown of either Wisp2 or Igf-1 using short interfering RNA dramatically inhibited proliferation of Tip30(-/-) cells. Together, these results suggest that Tip30 is an intrinsic and negative regulator of MEC proliferation partly through the inhibition of Wisp2 and Igf-1 expression, and its absence in the mammary gland may predispose MECs to neoplastic transformation.

A review of 227 cases of small papillary thyroid carcinoma

AIMS

To review differences in biological aggressiveness, clinical behaviors or selected surgical treatments between the PMC and the slightly larger PTC of 1.0<T<or=2.0 cm.

METHODS

Two hundred and twenty-seven cases of papillary thyroid carcinoma not larger than 2.0 cm, diagnosed and treated at the Kuma Hospital, Kobe, Japan, with a 10-year follow-up from 1992 to 2003, were reviewed.

RESULTS

The small PTCs demonstrated excellent outcomes, and persistent/recurrent disease was identified in only nine patients (4%). None of the patients died of the disease. A multivariate analysis revealed that massive extrathyroidal extension at presentation was the only independent prognostic factor for locoregional recurrence. Subdivision into PMCs and slightly larger tumors (1<T<or=2 cm) did not affect the excellent outcomes, but the patients in the latter subgroup received more lymph node surgery and displayed more aggressive clinico-histological features such as higher rates of extrathyroidal extension, lymph node metastasis, loss of polarity, invasive growth pattern and loss of cohesiveness.

CONCLUSIONS

Small PTC not larger than 2.0 cm could be considered as favorable a prognosis as PMC.

Does loss of residual renal function lead to malnutrition in peritoneal dialysis patients?

OBJECTIVES

It is usually believed that loss of residual renal function is associated with anorexia and the development of malnutrition. We conducted a retrospective study in our center to evaluate the effect of declining residual renal function on patients' nutritional status.

METHODS

All incident uremic patients (n = 46) who began peritoneal dialysis from January 1, 2003 June 1, 2003 in our center were closely followed for 1 year with focus on maintaining strict volume control with time on dialysis. Patient's residual renal function (RRF) was assessed by the average renal urea and creatinine clearances. Those patients who had more than 50% decrease in GFR were selected for the present analysis. Serum albumin (ALB), dietary protein intake (DPI) and subjective global assessment (SGA) were closely followed.

RESULTS

There were 16 patients (9 males and 7 females) included in the present analysis, among whom 31.3% were diabetics. Patients' GFR declined significantly (RRF were 4.32 +/- 2.69, 2.99 +/- 2.21 and 1.24 +/- 0.99 ml/min for Months 1, 6 and 12, respectively, p < 0.05), along with a significant decline in urine volume (985.62 +/- 543.29, 698.13 +/- 463.59 and 425.63 +/- 320.52 ml/d for Months 1, 6 and 12, respectively, p < 0.01). Although weekly peritoneal Kt/V did not increase significantly, peritoneal ultrafiltration increased significantly during this period (428.75 +/- 408.96, 534.38 +/- 296.39, 844.38 +/- 440.35 ml for Months 1, 6 and 12, respectively, p < 0.05). Serum ALB increased significantly (32.34 +/- 5.07, 34.74 +/- 4.89 and 36.21 +/- 3.98 g/l for Months 1, 6 and 12, respectively, p < 0.01). DPI also increased significantly. The prevalence of malnutrition (by SGA) decreased from 62.5% at the start of dialysis to 18.8% at the end of this study (p < 0.05).

CONCLUSIONS

Our study suggests that rapid decline of residual renal function in PD patients does not necessarily lead to decreased dietary protein intake and deteriorated nutritional status. Focus on incremental peritoneal fluid removal along with the decline in residual renal function and, thus, maintaining volume control may be one of the critical reasons for the success.

Investigation of the immunosuppressive activity of artemether on T-cell activation and proliferation

BACKGROUND AND PURPOSE

Artemisinin and its derivatives exhibit potent immunosuppressive activity. The purpose of the current study was to examine the immunosuppressive activity of artemether directly on T lymphocytes and to explore its potential mode of action.

EXPERIMENTAL APPROACH

In vitro, T-cell proliferation was measured using [(3)H]-thymidine incorporation assay in cells stimulated with ConA, alloantigen and anti-CD3 antibody. CFSE-labeled cell division and cell cycle distribution were monitored by flow cytometry. In vivo, the effects of artemether were evaluated in delayed-type hypersensitivity (DTH) and purified T-cell responses to ovalbumin in ovalbumin-immunized mice. The activation of extracellular signal-regulated kinase1/2 (ERK1/2) and Raf1 were assessed by Western blot analysis and the activation of Ras was tested in pull-down assays.

KEY RESULTS

We show that, in vitro, artemether suppressed ConA- or alloantigen-induced splenocyte proliferation, influenced production of the cytokines IL-2 and IFN-gamma and inhibited cell cycle progression through the G0/G1 transition. In vivo, administration of artemether attenuated CD4 T-cell-mediated DTH reaction, and suppressed antigen-specific T-cell response in immunized mice. Further experiments showed that, treatment with artemether impaired both antigen- and anti-CD3-induced phosphorylation of ERK. In primary T cells, artemether profoundly inhibited anti-CD3-induced phosphorylation of Raf1 and activation of Ras.

CONCLUSIONS AND IMPLICATIONS

This study provided experimental evidence of the immunosuppressive effects of artemether directly on T cells both in vitro and in vivo. Its immunosuppressive mechanism involved inhibition of the activation of the Ras-Raf1-ERK1/2 protein kinase cascade in T cells.

Sequencing-based analysis of the HLA-DPB1 polymorphism in Nu ethnic group of south-west China

In the present study, DNA typing for HLA-DPB1 was performed using polymerase chain reaction-sequencing-based typing method in 72 randomly selected Nu ethnic individuals inhabiting the Yunnan province of south-west China. Among the 12 detected DPB1 alleles, the most frequent was DPB1*1301, with the percentage of 20.83%, followed by DPB1*0501 (19.44%), DPB1*040101 (16.67%) and DPB1*2801 (9.72%). The allele DPB1*1501 was found for the first time in the Chinese population. Neighbour-joining showed that the Nu ethnic minority belonged to East Asian cluster and was most closely related to Lisu, being consistent with the historical records. In addition, the results obtained in this study will also provide useful information on organ transplantation, forensic investigations and disease association studies.

Odontogenic tumours: a retrospective study of 1642 cases in a Chinese population

A total of 1642 odontogenic tumour cases retrieved from the files of the College of Stomatology, Sichuan University, China were retrospectively analyzed for gender, age, tumour site and relative frequency of various types, and the data compared with that of previous reports. The final diagnosis in each case was based on the WHO 2005 histopathological classification of odontogenic tumours. Of these tumours 1592 (97.0%) were benign and 50 (3.0%) were malignant. Ameloblastoma (40.3%) was the most frequent type, followed by keratocystic odontogenic tumour (35.8%), odontoma (4.7%) and odontogenic myxoma (4.6%). The mean age of the patients was 32.1, with a wide range (3-84 years). The male-female ratio and maxilla-mandible ratio were 1.4:1 and 1:4.0, respectively. Ameloblastoma and keratocystic odontogenic tumours, important indications of extensive surgical procedures, are not considered rare in this Chinese population, whereas odontoma is uncommon.

Novel IRF6 mutations in Chinese patients with Van der Woude syndrome

Van der Woude syndrome (VWS) (OMIM 119300) is a dominantly inherited, developmental disorder that is characterized by pits and/or sinuses of the lower lip and a cleft lip and/or cleft palate. Mutations in the interferon regulatory factor 6 gene (IRF6) have been recently identified in patients with VWS, with more than 60 mutations reported. However, the VWS phenotype, IRF6 mutation genotypes, and their interrelationships in Chinese VWS patients have not been studied. Here, we report 11 Chinese families with variable clinical phenotypes of VWS and identified mutations in all patients. Of the 11 mutations, 8 appeared to be novel: CC5.6GT, T342A, 566delA, C748T, C756A, C989A, C1209G, and 1316delT. Seven mutations caused a change or loss of the IRF6 domain. The marked phenotypic variation may be caused by the action of certain modifier genes on IRF6 function.

Cytotoxicity of a newly synthesized nitroxide derivative of 4-ferrocenecarboxyl-2,2,6,6-tetramethylpiperidine-1-oxyl in high metastatic lung tumor cells

Low molecular weight nitroxides are widely used as electron paramagnetic resonance (EPR)-detectable spin labels in the biological and pathological areas. A novel nitroxide derivative, 4-ferrocenecarboxyl-2,2,6,6-tetramethyl piperidine-1-oxyl (FC-TEMPO), was synthesized for evaluating the effects of spin label compounds on tumor cells and firstly its biological effects on tumor and normal cells were evaluated. The cytotoxicity of FC-TEMPO in the high metastatic lung carcinoma cells (95-D) showed that it markedly inhibited the viability of cancer cells in a dose-dependent manner, while it was less toxic to a normal human cell line. Further studies found that FC-TEMPO suppressed the growth of tumor cells by induced apoptosis through activating caspase-3 but not caspase-8 which was proved by caspase inhibitors, and the cell cycle arrest at G1 phase. Moreover, the concomitant increase of superoxide dismutase (SOD) and catalase (CAT) activity was observed. Taken together, these results might provide a base for further anticancer investigations of nitroxides and their potential pharmacological applications.

Mitochondrial polymorphisms as risk factors for endometrial cancer in southwest China

It is just in recent years that mitochondrial DNA (mtDNA) mutations have been found in solid tumors. Although a direct link between the presence of mtDNA mutations and the development of tumors has not been made, mtDNA mutations might prove significant in the detection of tumor recurrence and possibly in the detection of genotoxic damage. To investigate the relationship between mtDNA variation and endometrial cancer, we collected blood samples from subjects with Han native background in Yunnan province in China, 49 of them with pathologically conformed endometrial cancer and 31 as controls with no cancer disease and sequenced two hypervariable segments of control region, part of 16sRNA gene, tRNA(leu) (tRNA is transfer RNA) gene and ND1 gene of mtDNA and identified some diagnostic polymorphisms by restriction fragment length polymorphism of coding region of mtDNA. We could not identify the suspected mutations that are related to diabetes and obesity from our endometrial cancer patients. However, our data showed that patients with endometrial cancers clustered in haplogroup D in a significantly higher frequency when compared with controls, implicating a possible association of haplogroup D to endometrial cancer. We concluded that mitochondrial polymorphisms in haplogroup D might play a genetic role in predisposing to endometrial cancer.