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Francès MP, Vila-Vecilla L, Russo V, Caetano Polonini H, de Souza GT. Utilising SNP Association Analysis as a Prospective Approach for Personalising Androgenetic Alopecia Treatment. Dermatol Ther (Heidelb) 2024; 14:971-981. [PMID: 38555553 PMCID: PMC11052732 DOI: 10.1007/s13555-024-01142-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/14/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION Androgenetic alopecia (AGA) is a prevalent, multifactorial form of hair loss involving complex aetiological factors, such as altered androgen regulation and energy metabolism. Existing treatments offer limited success, thus highlighting the need for advanced, personalised therapeutic strategies. This study focuses on correlating the genetic mechanisms of AGA with molecular targets involved in the response to current treatment modalities. METHODS An anonymised database including 26,607 patients was subjected to analysis. The dataset included information on patients' genotypes in 26 single nucleotide polymorphisms (SNPs), specifically, and diagnosed AGA grades, representing a broad range of ethnic backgrounds. RESULTS In our sample, 64.6% of males and 35.4% of females were diagnosed with female pattern hair loss. This distribution aligns well with prior studies, thus validating the representativeness of our dataset. AGA grading was classified using the Hamilton-Norwood and Ludwig scales, although no association was found to the grade of the disease. SNP association analysis revealed eight SNPs, namely rs13283456 (PTGES2), rs523349 (SRD5A2), rs1800012 (COL1A1), rs4343 (ACE), rs10782665 (PTGFR), rs533116 (PTGDR2), rs12724719 (CRABP2) and rs545659 (PTGDR2), to be statistically significant with a p-value below 0.05. CONCLUSIONS The study establishes a preliminary association between eight specific SNPs and AGA. These genetic markers offer insights into the variability of therapeutic responses, thus underlining the importance of personalised treatment approaches. Our findings show the potential for more targeted research to understand these SNPs' and further roles in AGA pathophysiology and in modulating treatment response.
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Fang C, Huang H, Zhang Q, Wang N, Jing X, Guo J, Ferianc M, Xu Z. Relation between sex hormones and leucocyte telomere length in men with idiopathic pulmonary fibrosis. Respirology 2020; 25:1265-1273. [PMID: 32583532 PMCID: PMC7754418 DOI: 10.1111/resp.13871] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/01/2020] [Accepted: 04/16/2020] [Indexed: 12/30/2022]
Abstract
Background and objective IPF is an ageing‐related lung disorder featuring progressive lung scarring. IPF patients are frequently identified with short telomeres but coding mutations in telomerase can only explain a minority of cases. Sex hormones regulate telomerase activity in vitro and levels of sex hormones are related to LTL. The objective of this study was to explore whether sex hormones were associated with LTL, whether they interacted with genetic variants in telomerase and whether polymorphisms in the exon of androgen metabolism genes were associated with plasma testosterone concentrations in male IPF patients. Methods A case–control study was performed on 101 male IPF subjects and 51 age‐matched healthy controls. Early morning plasma sex hormones were quantified, and whole‐exome sequencing was used to identify rare protein‐altering variants of telomerase and SNP in the exon of androgen metabolism genes. LTL was analysed by PCR and expressed as a T/S ratio. Results LTL, testosterone and DHT were decreased significantly in the IPF group. After adjustments for age and variant status in telomerase‐related genes, only testosterone was positively associated with LTL (P = 0.001). No significant interaction (P = 0.661) was observed between rare protein‐altering variants of telomerase and testosterone. No coding SNP in androgen metabolism genes were significantly associated with testosterone concentrations. Conclusion Plasma testosterone is associated with LTL independent of age or rare protein‐altering variants of telomerase. No genetic variations of androgen‐related pathway genes are associated with androgen concentrations. Further studies are warranted to examine whether hormonal interventions might retard telomere loss in male IPF patients.
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Affiliation(s)
- Chuling Fang
- Department of Respiratory and Critical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Huang
- Department of Respiratory and Critical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qian Zhang
- Department of Respiratory and Critical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Na Wang
- Department of Respiratory and Critical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoyan Jing
- Department of Respiratory and Critical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Guo
- Department of Respiratory and Critical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Martin Ferianc
- Electronic and Electrical Engineering Department, University College London, London, UK
| | - Zuojun Xu
- Department of Respiratory and Critical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Rhie A, Son HY, Kwak SJ, Lee S, Kim DY, Lew BL, Sim WY, Seo JS, Kwon O, Kim JI, Jo SJ. Genetic variations associated with response to dutasteride in the treatment of male subjects with androgenetic alopecia. PLoS One 2019; 14:e0222533. [PMID: 31525235 PMCID: PMC6746394 DOI: 10.1371/journal.pone.0222533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 08/31/2019] [Indexed: 12/30/2022] Open
Abstract
Dutasteride, a dual inhibitor of both type I and II 5α-reductases, is used to treat male pattern hair loss (MPHL). However, patient response to dutasteride varies in each individual, the cause of which is yet to be identified. To identify genetic variants associated with response to dutasteride treatment for MPHL, a total of 42 men with moderate MPHL who had been treated with dutasteride for 6 months were genotyped and analysed by quantitative linear regression, case-control association tests, and Fisher’s exact test. The synonymous single nucleotide polymorphism (SNP) rs72623193 in DHRS9 was most significantly associated with response to dutasteride, followed by the non-synonymous SNP rs2241057 in CYP26B1. Additionally, variants in ESR1, SRD5A1, CYP19A1, and RXRG are suggested to be associated with response to dutasteride. Cumulative effect and interaction among these SNPs were presented in both additive and non-additive models.
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Affiliation(s)
- Arang Rhie
- Genomic Medicine Institute (GMI), Medical Research Center, Seoul National University, Seoul, Korea
- Genome Informatics Section, Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Ho-Young Son
- Genomic Medicine Institute (GMI), Medical Research Center, Seoul National University, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Korea
| | - Soo Jung Kwak
- Genomic Medicine Institute (GMI), Medical Research Center, Seoul National University, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Korea
| | - Seungbok Lee
- Genomic Medicine Institute (GMI), Medical Research Center, Seoul National University, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Young Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Cutaneous Aging and Hair Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
- Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Bark-Lynn Lew
- Department of Dermatology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Woo-Young Sim
- Department of Dermatology, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jeong-Sun Seo
- Genomic Medicine Institute (GMI), Medical Research Center, Seoul National University, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Korea
| | - Ohsang Kwon
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Cutaneous Aging and Hair Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
- Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jong-Il Kim
- Genomic Medicine Institute (GMI), Medical Research Center, Seoul National University, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Korea
| | - Seong Jin Jo
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Cutaneous Aging and Hair Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
- Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
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Katharopoulos E, Sauter K, Pandey AV, Flück CE. In silico and functional studies reveal novel loss-of-function variants of SRD5A2, but no variants explaining excess 5α-reductase activity. J Steroid Biochem Mol Biol 2019; 190:263-272. [PMID: 30703436 DOI: 10.1016/j.jsbmb.2019.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/17/2019] [Accepted: 01/26/2019] [Indexed: 12/16/2022]
Abstract
Androgens are steroid hormones essential for human male and female development. Steroid reductases 5α (SRD5As) are key enzymes in androgen biosynthesis. Mutations in the human SRD5A2 are known to cause loss-of-function and severe 46,XY undervirilization. Gain-of-function variants have been suggested in androgen excess syndromes, but have not been found so far. Therefore we searched for gain-of-function mutations in the human SRD5A2 gene which might explain hyperandrogenic disorders such as the polycystic ovary syndrome, premature adrenarche and prostate cancer. We screened databases for candidate variants and characterised them in silico with the help of a novel SRD5A2 model. We selected 9 coding SNPs (A49T, R50A, P106L, P106A, N122A, L167S, R168C, P173S, R227Q) that have not been described in manifesting individuals, and assessed their enzyme kinetic properties in HEK293 cells. SRD5A2 activity was assessed by conversion of testosterone (T), progesterone (Prog) and androstenedione (Δ4A) to their 5α-reduced metabolites. Variants R50A and P173S showed partial activity with substrates T (34% and 28%) and Δ4A (37% and 22%). With substrate Prog variants P106L, P106A, L167S and R168C in addition showed partial activity (15% to 64%). Functional testing of all other variants showed loss-of-function. As predicted in our in silico analysis, all coding SNPs affected enzyme activity, however none of them showed gain-of-function. Thus excess 5α-reductase activity might be rather regulated at the (post)-transcriptional and/or post-translational level. However through this work seven new coding SNPs were characterised which might be of clinical relevance. It is possible that individuals carrying these SNPs show a minor phenotype that is not yet identified.
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Affiliation(s)
- Efstathios Katharopoulos
- Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; Department of BioMedical Research, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; Graduate School of Bern, University of Bern, 3000 Bern, Switzerland
| | - Kay Sauter
- Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; Department of BioMedical Research, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland
| | - Amit V Pandey
- Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; Department of BioMedical Research, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland
| | - Christa E Flück
- Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; Department of BioMedical Research, University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland.
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Fang C, Guo ZQ, Chen XY, Liu TZ, Zeng XT, Wang XH. Relationship between SRD5A2 rs9282858 polymorphism and the susceptibility of prostate cancer: A meta-analysis based on 20 publications. Medicine (Baltimore) 2017; 96:e6791. [PMID: 28489754 PMCID: PMC5428588 DOI: 10.1097/md.0000000000006791] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The pathogenetic mechanism of prostate cancer (PCa) has not been understood completely, and gene polymorphisms have been demonstrated to play a critical role in the course. It has been reported that rs9282858 polymorphism of steroid 5-α-reductase type 2 (SRD5A2) may affect the susceptibility of PCa, but some researches showed different results. We therefore carried out a meta-analysis to clarify this relationship.Relevant studies were identified through PubMed and Chinese National Knowledge Infrastructure databases concerning the association between SRD5A2 rs9282858 polymorphism and PCa. Odds ratios (ORs) with their 95% confidence intervals (95% CIs) were calculated to assess the strength of the association. Additionally, stratified analyses were performed based on ethnicity and source of control. Besides, heterogeneity test, sensitivity analysis, and publication bias evaluation were conducted in current meta-analysis as well.Ultimately, 20 publications incorporating 30 case-control studies were included in this meta-analysis, involving a total of 7300 cases and 7952 controls. The overall results demonstrated that SRD5A2 rs9282858 polymorphism was remarkably associated with increased susceptibility of PCa (TT vs. AA: OR = 4.08, 95% CI = 1.94-8.58; TT + AT vs. AA: OR = 1.28, 95% CI = 1.11-1.47; TT vs. AA + AT: OR = 4.44, 95% CI = 2.12-9.27; allele T vs. allele A: OR = 1.34, 95% CI = 1.17-1.54). After subgroup analyses by ethnicity and source of control, we also observed a similar trend in Latinos, other-ethnicity, population-based, and hospital-based groups under corresponding genetic models.Our findings indicate that SRD5A2 rs9282858 polymorphism may be a susceptible factor to PCa.
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Affiliation(s)
- Cheng Fang
- Center for Evidence-Based and Translational Medicine
| | - Zhong-Qiang Guo
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiao-Yan Chen
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Tong-Zu Liu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine
| | - Xing-Huan Wang
- Center for Evidence-Based and Translational Medicine
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Price DK, Chau CH, Till C, Goodman PJ, Leach RJ, Johnson-Pais TL, Hsing AW, Hoque A, Parnes HL, Schenk JM, Tangen CM, Thompson IM, Reichardt JK, Figg WD. Association of androgen metabolism gene polymorphisms with prostate cancer risk and androgen concentrations: Results from the Prostate Cancer Prevention Trial. Cancer 2016; 122:2332-40. [PMID: 27164191 PMCID: PMC4956504 DOI: 10.1002/cncr.30071] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 03/10/2016] [Accepted: 03/14/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND Prostate cancer is highly influenced by androgens and genes. The authors investigated whether genetic polymorphisms along the androgen biosynthesis and metabolism pathways are associated with androgen concentrations or with the risk of prostate cancer or high-grade disease from finasteride treatment. METHODS A nested case-control study from the Prostate Cancer Prevention Trial using data from men who had biopsy-proven prostate cancer (cases) and a group of biopsy-negative, frequency-matched controls was conducted to investigate the association of 51 single nucleotide polymorphisms (SNPs) in 12 genes of the androgen pathway with overall (total), low-grade, and high-grade prostate cancer incidence and serum hormone concentrations. RESULTS There were significant associations of genetic polymorphisms in steroid 5α-reductase 1 (SRD5A1) (reference SNPs: rs3736316, rs3822430, rs1560149, rs248797, and rs472402) and SRD5A2 (rs2300700) with the risk of high-grade prostate cancer in the placebo arm of the Prostate Cancer Prevention Trial; 2 SNPs were significantly associated with an increased risk (SRD5A1 rs472402 [odds ratio, 1.70; 95% confidence interval, 1.05-2.75; Ptrend = .03] and SRD5A2 rs2300700 [odds ratio, 1.94; 95% confidence interval, 1.19-3.18; Ptrend = .01]). Eleven SNPs in SRD5A1, SRD5A2, cytochrome P450 family 1, subfamily B, polypeptide 1 (CYP1B1), and CYP3A4 were associated with modifying the mean concentrations of serum androgen and sex hormone-binding globulin; and 2 SNPs (SRD5A1 rs824811 and CYP1B1 rs10012; Ptrend < .05) consistently and significantly altered all androgen concentrations. Several SNPs (SRD5A1 rs3822430, SRD5A2 rs2300700, CYP3A43 rs800672, and CYP19 rs700519; Ptrend < .05) were significantly associated with both circulating hormone levels and prostate cancer risk. CONCLUSIONS Germline genetic variations of androgen-related pathway genes are associated with serum androgen concentrations and the risk of prostate cancer. Further studies to examine the functional consequence of novel causal variants are warranted. Cancer 2016;122:2332-2340. © 2016 American Cancer Society.
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Affiliation(s)
- Douglas K. Price
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Cindy H. Chau
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - Cathee Till
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Phyllis J. Goodman
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Robin J. Leach
- Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Teresa L. Johnson-Pais
- Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Ann W. Hsing
- Cancer Prevention Institute of California, Fremont, CA and Stanford Cancer Institute, Palo Alto, CA
| | - Ashraful Hoque
- Department of Clinical Cancer Prevention, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Howard L. Parnes
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD
| | - Jeannette M. Schenk
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Catherine M. Tangen
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Ian M. Thompson
- Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Juergen K.V. Reichardt
- Division of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
| | - William D. Figg
- Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD
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Shiota M, Fujimoto N, Yokomizo A, Takeuchi A, Itsumi M, Inokuchi J, Tatsugami K, Uchiumi T, Naito S. SRD5A gene polymorphism in Japanese men predicts prognosis of metastatic prostate cancer with androgen-deprivation therapy. Eur J Cancer 2015; 51:1962-9. [DOI: 10.1016/j.ejca.2015.06.122] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 05/24/2015] [Accepted: 06/17/2015] [Indexed: 11/26/2022]
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Sissung TM, Price DK, Del Re M, Ley AM, Giovannetti E, Figg WD, Danesi R. Genetic variation: effect on prostate cancer. BIOCHIMICA ET BIOPHYSICA ACTA 2014; 1846:446-56. [PMID: 25199985 PMCID: PMC4260983 DOI: 10.1016/j.bbcan.2014.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 08/27/2014] [Accepted: 08/28/2014] [Indexed: 02/09/2023]
Abstract
The crucial role of androgens in the development of prostate cancer is well established. The aim of this review is to examine the role of constitutional (germline) and tumor-specific (somatic) polymorphisms within important regulatory genes of prostate cancer. These include genes encoding enzymes of the androgen biosynthetic pathway, the androgen receptor gene, genes that encode proteins of the signal transduction pathways that may have a role in disease progression and survival, and genes involved in prostate cancer angiogenesis. Characterization of deregulated pathways critical to cancer cell growth have lead to the development of new treatments, including the CYP17 inhibitor abiraterone and clinical trials using novel drugs that are ongoing or recently completed [1]. The pharmacogenetics of the drugs used to treat prostate cancer will also be addressed. This review will define how germline polymorphisms are known affect a multitude of pathways, and therefore phenotypes, in prostate cancer etiology, progression, and treatment.
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Affiliation(s)
- Tristan M Sissung
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Douglas K Price
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marzia Del Re
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Ariel M Ley
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Elisa Giovannetti
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - William D Figg
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Romano Danesi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
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Aschim EL, Oldenburg J, Kristiansen W, Giwercman A, Witczak O, Fosså SD, Haugen TB. Genetic variations associated with the effect of testicular cancer treatment on gonadal hormones. Hum Reprod 2014; 29:2844-51. [PMID: 25336703 DOI: 10.1093/humrep/deu274] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Do genetic variations in the testosterone pathway genes modify the effect of treatment on the levels of testosterone and LH in long-term testicular cancer (TC) survivors (TCSs)? SUMMARY ANSWER Variations in LH receptor (LHR) and in 5α-reductase II (SRD5A2) genes may modify the effect of TC treatment on testosterone levels, whereas genetic variations in the androgen receptor (AR) may modify the effect on LH levels. WHAT IS KNOWN ALREADY TCSs experience variable degrees of long-term reduction in gonadal function after treatment. This variability can in part be explained by treatment intensity, but may also be due to individual variations in genes involved in the function and metabolism of reproductive hormones. STUDY DESIGN, SIZE, DURATION Cross-sectional study on testosterone and LH levels in 637 Norwegian TCSs in relation to genetic variants and TC treatment. PARTICIPANTS/MATERIALS, SETTING, METHODS The single nucleotide polymorphisms LHR Asn291Ser (rs12470652) and Ser312Asn (rs2293275), as well as SRD5A2 Ala49Thr (rs9282858) and Val89Leu (rs523349) were analyzed by allele-specific PCR. The insertion polymorphism LHR InsLQ (rs4539842) was analyzed by sequencing. The numbers of AR CAG and GGN repeats were determined by capillary electrophoresis. Blood samples were collected 5-21 years after diagnosis (median 11 years) and serum total testosterone and LH were analyzed by commercial immunoassays. The TCSs were divided into four groups according to their treatment; surgery only, radiotherapy and chemotherapy with ≤850 or >850 mg of cisplatin. Polymorphisms presenting P < 0.1 for the interaction term with treatment in an initial two-way analysis of covariance (ANCOVA) were investigated further in two consecutive one-way ANCOVA analyses to elucidate the interaction between treatment and genotype. MAIN RESULTS AND THE ROLE OF CHANCE For the whole group of TCSs, there were no significant differences between the hormone levels in homozygotes for the wild type and carriers of at least one polymorphic allele for the investigated polymorphisms. Three of the polymorphisms showed signs of interaction with treatment, i.e. LHR InsLQ, SRD5A2 A49T and the AR CAG repeat. Follow-up analyses revealed three situations where only one of the genotypes of the polymorphism where associated with significantly different hormone levels after surgery compared with after additional cytotoxic treatment: For LHR InsLQ, only the wild-type allele was associated with lower testosterone levels after cisplatin > 850 mg compared with after surgery (24% lower, P < 0.001). For SRD5A2 A49T, testosterone levels were lower after radiotherapy compared with after surgery, but only for the heterozygotes for the polymorphism (39% lower, P = 0.001). In comparison, the testosterone levels were just slightly lower after radiotherapy (6% lower, P = 0.039) or cisplatin ≤ 850 mg (7% lower, P = 0.041), compared with surgery, independent of genotypes. For AR CAG, only the reference length of CAG = 21-22 had significantly higher LH levels after cisplatin ≤ 850 mg compared with after surgery (70% higher, P < 0.001). Independent of genotypes, however, LH levels after cisplatin ≤ 850 mg were only 26% higher than after surgery (P = 0.005). LIMITATIONS, REASONS FOR CAUTION Unadjusted P-values are presented. For analysis involving genotypes, the level of statistical significance was adjusted for the total number of polymorphisms tested, n = 7, i.e. to P < 0.007 (0.5/7). The rather weak associations indicate that additional polymorphisms are involved in the modulation. WIDER IMPLICATIONS OF THE FINDINGS To our knowledge, this is the first study supporting the notion that polymorphisms may explain at least some of the inter-individual differences in endocrine response to TC treatment. Our findings suggest that individuals with certain genotypes may be more vulnerable to certain treatments. Knowledge on genetic predisposition concerning treatment-related endocrine gonadotoxicity to different treatment regimens may help tailoring TC therapy when possible. STUDY FUNDING/COMPETING INTERESTS This study was supported by the Research Council of Norway (Grant No. 160619). There were no competing interests.
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Affiliation(s)
- E L Aschim
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, P.O. Box 4, St. Olavs plass, Oslo NO-0130, Norway
| | - J Oldenburg
- Department of Clinical Cancer Research, Oslo University Hospital, Oslo NO-0424, Norway
| | - W Kristiansen
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, P.O. Box 4, St. Olavs plass, Oslo NO-0130, Norway
| | - A Giwercman
- Molecular Reproduction Research, Department of Clinical Sciences Malmö, Lund University, Malmö SE-205 02, Sweden
| | - O Witczak
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, P.O. Box 4, St. Olavs plass, Oslo NO-0130, Norway
| | - S D Fosså
- Department of Clinical Cancer Research, Oslo University Hospital, Oslo NO-0424, Norway
| | - T B Haugen
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, P.O. Box 4, St. Olavs plass, Oslo NO-0130, Norway
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Dušenka R, Tomaškin R, Kliment J, Dobrota D, Dušenková S, Vilčková M, Sivoňová MK. Polymorphism of the SRD5A2 gene and the risk of prostate cancer. Mol Med Rep 2014; 10:3151-6. [PMID: 25310105 DOI: 10.3892/mmr.2014.2621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 05/02/2014] [Indexed: 11/06/2022] Open
Abstract
Androgens are actively involved in the development of the prostate gland and appear to be essential for prostate carcinogenesis. The product of the SRD5A2 gene, membrane‑bound steroid 5‑α‑reductase, type II enzyme, is key in testosterone metabolism. The present study explored the association between the SRD5A2 V89L gene polymorphism and the risk of developing prostate cancer. The study cohort consisted of 456 male Slovak patients, including 260 cases with histologically confirmed prostate cancer and 196 age‑matched controls without any clinically suspected infections of the prostate. Polymerase chain reaction-restriction fragment length polymorphism analysis was used to detect the SRD5A2 polymorphism on codon 89. Odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs) for different allele variants were calculated in order to determine the association between the SRD5A2 V89L gene polymorphism and prostate cancer. The distribution of V89L variants in the control group was consistent with the Hardy‑Weinberg equilibrium (χ2 test, P=0.266) with a significant deviation in the case group (χ2 test, P=0.04). However, no association between the SRD5A2 polymorphism and an increased risk of developing prostate cancer was identified. When the wild type VV variant was used as a reference, the ORs for different allele variants ranged from 1.11 (95% CI 0.66‑1.87, P=0.70) for the LL genotype to 0.99 (95% CI 0.68‑1.46, P=0.99) for the LL + VL genotypes. No particular allele variant was identified to exhibit an increased capacity to promote the development of highly aggressive prostate cancer (Gleason ≥7) or induce carcinogenesis at an earlier onset (<65 years of age). It was confirmed that in the population studied, the SRD5A2 V89L polymorphism was not associated with the risk of prostate cancer and SRD5A2 was not shown to be a key gene involved in prostate cancer development. Published data indicate that a combination of multiple genetic changes are required for prostate cancer development, rather than a single gene change. Therefore, it was hypothesized that high-throughput genotyping may be more effective than single nucleotide polymorphism detection.
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Affiliation(s)
- Róbert Dušenka
- Department of Medical Biochemistry, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin 03601, Slovakia
| | - Roman Tomaškin
- Department of Urology, Jessenius Faculty of Medicine and UHM, Comenius University in Bratislava, Martin 03601, Slovakia
| | - Ján Kliment
- Department of Urology, Jessenius Faculty of Medicine and UHM, Comenius University in Bratislava, Martin 03601, Slovakia
| | - Dušan Dobrota
- Department of Medical Biochemistry, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin 03601, Slovakia
| | - Svetlana Dušenková
- Department of Urology, Jessenius Faculty of Medicine and UHM, Comenius University in Bratislava, Martin 03601, Slovakia
| | - Marta Vilčková
- Department of Medical Biochemistry, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin 03601, Slovakia
| | - Monika Kmeť'ová Sivoňová
- Department of Medical Biochemistry, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin 03601, Slovakia
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11
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Affiliation(s)
- Menelaos L Batrinos
- Professor Emeritus of Endocrinology, Athens University Medical School, Athens, Greece
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12
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Li Q, Zhu Y, He J, Wang M, Zhu M, Shi T, Qiu L, Ye D, Wei Q. Steroid 5-alpha-reductase type 2 (SRD5A2) V89L and A49T polymorphisms and sporadic prostate cancer risk: a meta-analysis. Mol Biol Rep 2013; 40:3597-608. [PMID: 23277398 DOI: 10.1007/s11033-012-2434-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Accepted: 12/18/2012] [Indexed: 02/07/2023]
Abstract
Steroid 5-α-reductase type 2 (SRD5A2) V89L and A49T polymorphisms are thought to play a crucial role in the androgen synthesis and metabolic pathway, but their associations with prostate cancer risk remain controversial. To provide a more precise estimation of the associations between V89L and A49T polymorphisms and prostate cancer risk, we performed a meta-analysis using all published case-control studies of prostate cancer since January 1995. We used odds ratio (OR) and its 95% confidence interval (CI) to assess the strength of the association under various genetic models in both overall and stratified analyses. We also calculated the false-positive report probability, the power of the current study, and the observed P value for significant findings. This analysis included 45 eligible studies of a total of 15,562 cases and 15,385 controls, in which no significant associations were found for the V89L polymorphisms under all genetic models. However, small excess prostate cancer risk was associated with the 49T allele in mixed populations compared with the 49A allele (OR = 1.24, 95% CI = 1.02-1.50), and similar results were observed in Caucasians (OR = 1.24, 95% CI = 1.01-1.53). The sensitivity analysis further strengthened the validity of these findings without publication bias. Although there was no overall association between V89L and prostate cancer risk, A49T might play a role in the etiology of prostate cancer among Caucasians. Additional large and well-designed studies are warranted to validate these findings.
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Affiliation(s)
- Qiaoxin Li
- Cancer Research Laboratory, Fudan University Shanghai Cancer Institute, Shanghai, China
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13
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Muller DC, Giles GG, Sinclair R, Hopper JL, English DR, Severi G. Age-Dependent Associations between Androgenetic Alopecia and Prostate Cancer Risk. Cancer Epidemiol Biomarkers Prev 2012; 22:209-15. [DOI: 10.1158/1055-9965.epi-12-0860] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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14
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Androgen Metabolism Gene Polymorphisms, Associations with Prostate Cancer Risk and Pathological Characteristics: A Comparative Analysis between South African and Senegalese Men. Prostate Cancer 2012; 2012:798634. [PMID: 23091730 PMCID: PMC3468128 DOI: 10.1155/2012/798634] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 08/03/2012] [Accepted: 08/20/2012] [Indexed: 12/31/2022] Open
Abstract
Prostate cancer is the most common cancer in men in developed countries and the leading cause of mortality in males in less developed countries. African ethnicity is one of the major risk factors for developing prostate cancer. Pathways involved in androgen metabolism have been implicated in the etiology of the disease. Analyses of clinical data and CYP3A4, CYP3A5, and SRD5A2 genotypes were performed in South African White (120 cases; 134 controls), Mixed Ancestry (207 cases; 167 controls), and Black (25 cases; 20 controls) men, as well as in Senegalese men (86 cases; 300 controls). Senegalese men were diagnosed earlier with prostate cancer and had higher median PSA levels compared to South African men. Metastasis occurred more frequently in Senegalese men. Gene polymorphism frequencies differed significantly between South African and Senegalese men. The CYP3A4 rs2740574 polymorphism was associated with prostate cancer risk and tumor aggressiveness in South African men, after correction for population stratification, and the SRD5A2 rs523349 CG genotype was inversely associated with high-stage disease in Senegalese men. These data suggest that variants previously associated with prostate cancer in other populations may also affect prostate cancer risk in African men.
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15
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Schleutker J. Polymorphisms in androgen signaling pathway predisposing to prostate cancer. Mol Cell Endocrinol 2012; 360:25-37. [PMID: 21782882 DOI: 10.1016/j.mce.2011.07.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 06/30/2011] [Accepted: 07/01/2011] [Indexed: 11/30/2022]
Abstract
Prostate cancer is the most frequent male malignancy diagnosed in western countries and androgens are known to mediate key physiological processes in prostate tissue. Since endogenous androgens have long been considered to be risk factors for prostate cancer, genes involved in androgen biosynthesis and metabolism have been extensively studied. In this review, association of androgen pathway genes, their polymorphic sites and risk of prostate cancer in different ethnic backgrounds is addressed together with their use to predict susceptibility and clinical outcomes of prostate cancer patients. The effect of the polymorphisms seems vary in different patients, populations and ethnic backgrounds. To date it is evident that the association between androgen pathway gene polymorphisms and prostate cancer risk is complex and many of the results are characterized by irreproducibility, which can be attributed to a variety of biological, statistical and technical reasons. In the future, with increasing knowledge, developing technologies and new genomic biomarkers it likely becomes possible to better estimate the risk of prostate cancer, and distinguish indolent disease from aggressive based on molecular profiling, and the analysis of gene-gene and gene-environment interactions.
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Affiliation(s)
- Johanna Schleutker
- Institute of Biomedical Technology, University of Tampere, and Centre for Laboratory Medicine, Tampere University Hospital, Biokatu 8, 33520 Tampere, Finland.
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16
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Zhao D, Wu W, Xu B, Niu X, Cui H, Zhang Y, Wang Z, Wang X. Variants in the SRD5A2 gene are associated with quality of semen. Mol Med Rep 2012; 6:639-44. [PMID: 22735779 DOI: 10.3892/mmr.2012.965] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 06/19/2012] [Indexed: 11/05/2022] Open
Abstract
Spermatogenesis and sperm maturation are androgen-dependent processes. Steroid 5α-reductase (SRD5A) is a key enzyme converting testosterone into the more active metabolite, dihydrotestosterone (DHT). We aimed to investigate the association between the genetic variants of SRD5A2 (rs4952197, rs2268797, rs13395648, rs523349 and rs632148) and semen quality. Variant genotyping and semen analysis was performed in 708 males with definite idiopathic infertility by TaqMan SNP genotyping assays and computer-assisted semen analysis, respectively. It was found that the rs13395648 TC genotype was associated with a significantly lower semen volume compared with the TT genotype (P=0.016). The same trend was found between the combination of the TC and CC genotypes and the TT genotype (P=0.020). With regard to variant rs632148, subjects with the GC genotype had significantly lower sperm motility in comparison to those with the GG genotype (P=0.029). The sperm motility between the combination of the GC and CC genotypes and the GC genotype was also significantly different (P=0.033). These findings indicate that genetic variants in the SRD5A2 gene may be associated with semen quality.
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Affiliation(s)
- Dan Zhao
- State Key Laboratory of Reproductive Medicine, Department of Urology, First Affiliated Hospital of Nanjing Medical University, and School of Public Health, Nanjing Medical University, Nanjing 210029, PR China
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17
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Six novel susceptibility Loci for early-onset androgenetic alopecia and their unexpected association with common diseases. PLoS Genet 2012; 8:e1002746. [PMID: 22693459 PMCID: PMC3364959 DOI: 10.1371/journal.pgen.1002746] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 04/16/2012] [Indexed: 12/21/2022] Open
Abstract
Androgenetic alopecia (AGA) is a highly heritable condition and the most common form of hair loss in humans. Susceptibility loci have been described on the X chromosome and chromosome 20, but these loci explain a minority of its heritable variance. We conducted a large-scale meta-analysis of seven genome-wide association studies for early-onset AGA in 12,806 individuals of European ancestry. While replicating the two AGA loci on the X chromosome and chromosome 20, six novel susceptibility loci reached genome-wide significance (p = 2.62×10−9–1.01×10−12). Unexpectedly, we identified a risk allele at 17q21.31 that was recently associated with Parkinson's disease (PD) at a genome-wide significant level. We then tested the association between early-onset AGA and the risk of PD in a cross-sectional analysis of 568 PD cases and 7,664 controls. Early-onset AGA cases had significantly increased odds of subsequent PD (OR = 1.28, 95% confidence interval: 1.06–1.55, p = 8.9×10−3). Further, the AGA susceptibility alleles at the 17q21.31 locus are on the H1 haplotype, which is under negative selection in Europeans and has been linked to decreased fertility. Combining the risk alleles of six novel and two established susceptibility loci, we created a genotype risk score and tested its association with AGA in an additional sample. Individuals in the highest risk quartile of a genotype score had an approximately six-fold increased risk of early-onset AGA [odds ratio (OR) = 5.78, p = 1.4×10−88]. Our results highlight unexpected associations between early-onset AGA, Parkinson's disease, and decreased fertility, providing important insights into the pathophysiology of these conditions. While most genome-wide association studies (GWAS) focus on the identification of susceptibility loci for a specific disease, this hypothesis-free approach also enables the identification of unexpected associations between different diseases by taking advantage of the previously published GWAS associations. Androgenetic Alopecia (AGA, also known as male pattern baldness) is the most common type of hair loss in humans. Parkinson's disease is reported to occur more commonly in men than in women; however, there are no studies investigating the link between AGA and Parkinson's disease. Here, we show that a specific genetic locus, chromosome 17q21.31, which is associated with Parkinson's disease, is also a susceptibility locus for early-onset AGA. We further investigate the association between early-onset AGA and Parkinson's disease, irrespective of genotype, directly in a large-scale web-based study. We find that men with early-onset AGA have 28% higher risk of developing Parkinson's disease. The early-onset AGA locus on chromosome 17q21.31 has also been linked to decreased fertility previously. Future studies of this locus may implicate novel biological pathways affecting these three conditions.
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18
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Yassa M, Hijal T, Giraud P. Prostate cancer and androgenic alopecia. Expert Rev Endocrinol Metab 2012; 7:169-173. [PMID: 30764008 DOI: 10.1586/eem.11.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Prostate cancer is a burden on society. Its prevalence can reach up to 80% in males aged 70 years and older. Current screening programs based on prostate-specific antigen testing lead to overdiagnosis and overtreatment with uncertain benefits on survival. Androgenic alopecia is also highly prevalent in elderly males. Observational studies have found that androgenic alopecia is linked to prostate cancer, but studies have been conflictual. Further research should focus on finding the exact mechanism linking these two pathologies. This should help clinicians improve screening programs and guide research into novel molecules to help in the prevention and treatment of both androgenic alopecia and prostate cancer.
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Affiliation(s)
- Michael Yassa
- a Department of Radiation Oncology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Canada.
| | - Tarek Hijal
- b Department of Radiation Oncology, McGill University Hospital Center, Montreal, Canada
| | - Philippe Giraud
- c Department of Radiation Oncology, European Georges Pompidou Hospital, Paris Descartes University, Paris, France
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19
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Fernández-Cancio M, Audí L, Andaluz P, Torán N, Piró C, Albisu M, Gussinyé M, Yeste D, Clemente M, Martínez-Mora J, Blanco A, Granada ML, Marco M, Ferragut J, López-Siguero JP, Beneyto M, Carles C, Carrascosa A. SRD5A2 gene mutations and polymorphisms in Spanish 46,XY patients with a disorder of sex differentiation. ACTA ACUST UNITED AC 2011; 34:e526-35. [PMID: 21631525 DOI: 10.1111/j.1365-2605.2010.01136.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
One hundred and forty-six index patients with 46,XY DSD in whom gonads were confirmed as testes were consecutively studied for a molecular diagnosis during the period 2002-2010. AR gene was analysed in all patients as the first candidate gene, yielding a mutation in 42.5% of cases and SRD5A2 gene was analysed as the second candidate gene, resulting in the characterization of 10 different mutations (p.Y91D, p.G115D, p.Q126R, p.R171S, p.Y188CfsX9, p.N193S, p.A207D, p.F219SfsX60, p.R227Q and p.R246W) in nine index patients (6.2% of the total number of 46,XY DSD patients). One of the mutations (p.Y188CfsX9) has never been reported. In addition, we genotyped SRD5A2 gene p.V89L and c.281+15T>C polymorphisms in 46,XY DSD and in 156 normal adult males and found that patients with SRD5A2 mutations or without a known molecular diagnosis presented a higher frequency of homozygous p.L89, homozygous TT and combined CCTT genotypes compared with controls. This result suggests that 46,XY DSD patient phenotypes may be influenced by SRD5A2 polymorphism genotypes. SRD5A2 gene mutations may not be as infrequent as previously considered in 46,XY DSD patients with variable degrees of external genitalia virilization at birth and normal T production and appears to be the second aetiology in our series.
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Affiliation(s)
- M Fernández-Cancio
- Unidad Investigación Endocrinología y Nutrición Pediátricas, Institut de Recerca, Hospital Vall d'Hebron, CIBERER (Centro de Investigación Biomédica en Red), Instituto de Salud Carlos III, Universitat Autònoma de Barcelona, Barcelona, Spain.
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20
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Yip L, Rufaut N, Sinclair R. Role of genetics and sex steroid hormones in male androgenetic alopecia and female pattern hair loss: an update of what we now know. Australas J Dermatol 2011; 52:81-8. [PMID: 21605090 DOI: 10.1111/j.1440-0960.2011.00745.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The role of genetic predisposition and the influence of sex steroid hormones are indisputable to the pathogenesis of male androgenetic alopecia (MAGA). The role of sex steroid hormones in female pattern hair loss (FPHL) is less known. A good knowledge of the pathophysiology underlying MAGA and FPHL empowers the clinician to confidently counsel patients and make informed therapeutic decisions. Vigorous research in recent years has provided greater insight into the role of genetics and sex steroids in physiological hair growth and cycling, as well as in hair follicle miniaturization, the histological hallmark of MAGA and FPHL. In the present review article directed towards clinicians, we discuss the current understanding of the role of androgens and oestrogens, as well as genetic associations with MAGA and FPHL. We also briefly discuss the interpretation of direct-to-consumer genetic testing for baldness to help clinicians understand the limitations of such tests.
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Affiliation(s)
- Leona Yip
- Department of Dermatology, St Vincent's Hospital, Melbourne, Victoria, Australia.
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21
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Yazdabadi A, Sinclair R. Treatment of female pattern hair loss with the androgen receptor antagonist flutamide. Australas J Dermatol 2011; 52:132-4. [PMID: 21605098 DOI: 10.1111/j.1440-0960.2010.00735.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Female pattern hair loss is a common but difficult to manage condition. Commonly used treatments include oral antiandrogens such as spironolactone and topical minoxidil. The response to treatment is variable. We report a woman whose hair loss progressed while using spironolactone and topical minoxidil in combination, but reversed with flutamide, a potent androgen receptor antagonist.
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Affiliation(s)
- Anosha Yazdabadi
- Department of Dermatology, St. Vincent's Hospital Melbourne and Department of Medicine, St. Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
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22
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Li X, Huang Y, Fu X, Chen C, Zhang D, Yan L, Xie Y, Mao Y, Li Y. Meta-analysis of three polymorphisms in the steroid-5-alpha-reductase, alpha polypeptide 2 gene (SRD5A2) and risk of prostate cancer. Mutagenesis 2010; 26:371-83. [PMID: 21177315 DOI: 10.1093/mutage/geq103] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The steroid-5-alpha-reductase, alpha polypeptide 2 (SRD5A2) gene plays a crucial role in androgen metabolism pathway in human prostate. It encodes SRD5A2 enzyme, which catalyses testosterone to dihydrotestosterone (DHT). DHT is the main active structure binding with androgen receptor (AR). After the activation of AR, it further regulates a series of target genes in androgen metabolism pathway. However, no clear consensus has been reached on the association between the SRD5A2 V89L, A49T and TA repeat polymorphisms and prostate cancer (PCa) risk. Thus, we performed a meta-analysis of 31 association studies with 14,726 PCa cases and 15,802 controls. We found no association between PCa and 89L compared with 89V allele [odds ratio (OR) = 1.02, 95% confidence interval (CI) 0.98-1.06, P(heterogeneity) = 0.44]. The 49T allele showed a significantly elevated effect on the high stage (Stages III-IV) of PCa risk both under the dominant genetic model (OR = 2.13, 95% CI 1.44-3.15, P(heterogeneity) = 0.65) and in the contrast T versus A allele (OR = 2.06, 95% CI 1.41-3.02, P(heterogeneity) = 0.69). There was a significantly decreased association between PCa and long TA repeat as compared versus short TA repeat (OR = 0.86, 95% CI 0.74-1.00, P(heterogeneity) = 0.79). No significant between-study heterogeneity was found in all subjects under four genetic models (dominant model, recessive model, allele comparison and homozygosity comparison) for these three polymorphisms, respectively, so the fixed effects model was used to pool the result. Our result indicated that carriers of 49T might improve the risk of PCa in higher stages (Stages III-IV), carriers of long TA repeat might decrease the risk of PCa and 89L may not be an important risk factor for PCa. However, due to the limited sample sizes, this meta-analysis did not achieve sufficiently conclusive results. Still more well-designed studies should be performed to clarify the role of these three polymorphisms in the development of PCa.
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Affiliation(s)
- Xia Li
- State Key Laboratory of Genetic Engineering, Institute of Genetics, School of Life Science, Fudan University, Shanghai 200433, People's Republic of China
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23
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Jiang J, Tang NLS, Ohlsson C, Eriksson AL, Vandenput L, Liao C, Wang X, Chan FWK, Kwok A, Orwoll E, Kwok TCY, Woo J, Leung PC. Association of SRD5A2 Variants and Serum Androstane-3α,17β-Diol Glucuronide Concentration in Chinese Elderly Men. Clin Chem 2010; 56:1742-9. [DOI: 10.1373/clinchem.2010.150607] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND
Results of recent studies have demonstrated that genetic variants of the enzyme steroid 5α reductase type II (SRD5A2) are associated with serum concentrations of major androgen metabolites such as conjugates of androstane-3α,17β-diol-glucuronide (3α-diol-G). However, this association was not consistently found among different ethnic groups. Thus, we aimed to determine whether the association with SRD5A2 genetic variations exists in a cohort of healthy Chinese elderly men, by examining 2 metabolite conjugates: androstane-3α,l7β-diol-3-glucuronide (3α-diol-3G) and androstane-3α,17β-diol-17-glucuronide (3α-diol-17G).
METHODS
We used GC-MS and LC-MS to measure serum sex steroid concentrations, including testosterone and dihydrotestosterone, and 3α-diol-3G and 3α-diol-17G in 1182 Chinese elderly men age 65 and older. Genotyping of the 3 SRD5A2 tagSNPs [rs3731586, rs12470143, and rs523349 (V89L)] was performed by using melting-temperature–shift allele-specific PCR.
RESULTS
The well-described SRD5A2 missense variant rs523349 (V89L) was modestly associated with the 3α-diol-17G concentration (P = 0.040). On the other hand, SNP rs12470143 was found to be significantly correlated with 3α-diol-3G concentration (P = 0.021). Results of haplotype analysis suggested that the presence of an A-C-G haplotype leads to an increased 3α-diol-3G concentration, a finding consistent with results of single SNP analysis.
CONCLUSIONS
The genetic variation of SRD5A2 is associated with circulating 3α-diol-3G and 3α-diol-17G concentrations in Chinese elderly men. In addition, we showed that SRD5A2 haplotypic association, rather than a single SNP alone, might be a better predictor of the 3α-diol-G concentration. Thus, the effect of either the haplotype itself or of other ungenotyped SNPs in linkage disequilibrium with the haplotype is responsible for the interindividual variation of 3α-diol-G.
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Affiliation(s)
| | - Nelson LS Tang
- Departments of Chemical Pathology
- Laboratory of Genetics of Disease Susceptibility, Li Ka Shing Institute of Health Sciences, Hong Kong SAR, China
| | - Claes Ohlsson
- Center for Bone Research at the Sahlgrenska Academy, Institute of Medicine and
| | - Anna L Eriksson
- Center for Bone Research at the Sahlgrenska Academy, Departments of Internal Medicine and Geriatrics, Gothenburg University, Gothenburg, Sweden
| | - Liesbeth Vandenput
- Center for Bone Research at the Sahlgrenska Academy, Departments of Internal Medicine and Geriatrics, Gothenburg University, Gothenburg, Sweden
| | | | | | | | - Anthony Kwok
- Jockey Club Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eric Orwoll
- Oregon Health and Science University, Portland, OR
| | | | - Jean Woo
- Medicine and Therapeutics, Faculty of Medicine, and
- Community and Family Medicine, Faculty of Medicine, and
| | - Ping Chung Leung
- Jockey Club Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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24
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Hu DG, Gardner-Stephen D, Severi G, Gregory PA, Treloar J, Giles GG, English DR, Hopper JL, Tilley WD, Mackenzie PI. A Novel Polymorphism in a Forkhead Box A1 (FOXA1) Binding Site of the Human UDP Glucuronosyltransferase 2B17 Gene Modulates Promoter Activity and Is Associated with Altered Levels of Circulating Androstane-3α,17β-diol Glucuronide. Mol Pharmacol 2010; 78:714-22. [DOI: 10.1124/mol.110.065953] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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25
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Cremers RG, Aben KK, Vermeulen SH, den Heijer M, van Oort IM, Kiemeney LA. Androgenic alopecia is not useful as an indicator of men at high risk of prostate cancer. Eur J Cancer 2010; 46:3294-9. [PMID: 20561779 DOI: 10.1016/j.ejca.2010.05.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Revised: 05/12/2010] [Accepted: 05/19/2010] [Indexed: 11/20/2022]
Abstract
BACKGROUND Androgens are assumed to play a central role in the pathophysiology of both prostate cancer (PC) and androgenic alopecia (AA). A correlation between the two phenotypes may be relevant for identification of men at high risk of PC. We evaluated the association between AA at different ages and PC in a large case-control study. METHODS The case group comprised 938 PC patients recruited from a population-based cancer registry. The controls (n = 2160) were a random sample of the male general population. All subjects completed a questionnaire on risk factors for cancer, including questions on hair pattern at different ages using an adapted version of the Hamilton-Norwood scale, race and family history of PC. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression. RESULTS Baldness at early age appeared to be associated with a lower risk of PC (baldness at age 20: OR = 0.86; 95% CI 0.69-1.07 and baldness at age 40: OR = 0.81; 95% CI 0.70-0.96). Baldness at completion of the questionnaire was not associated with PC: OR = 1.10; 95% CI 0.89-1.34. An isolated 'frontal baldness' or 'vertex baldness' pattern was not significantly associated with PC at any age. Presence of a combined 'frontal and vertex' baldness pattern at age 40 was associated with a decreased risk of PC (OR = 0.62; 95% CI 0.45-0.86). There were no significant associations between AA and aggressive PC. CONCLUSIONS We did not find consistent positive associations between AA at different ages and PC. Surprisingly, if anything, baldness at early age is inversely related to PC in this study. Androgenic alopecia is not useful as an indicator of men at high risk of PC.
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Affiliation(s)
- Ruben G Cremers
- Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre, The Netherlands
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Might early baldness protect from prostate cancer by increasing skin exposure to ultraviolet radiation? Cancer Epidemiol 2010; 34:507. [PMID: 20451486 DOI: 10.1016/j.canep.2010.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 03/24/2010] [Accepted: 04/14/2010] [Indexed: 11/21/2022]
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Male pattern baldness and prostate cancer risk in a population-based case-control study. Cancer Epidemiol 2010; 34:131-5. [PMID: 20206591 DOI: 10.1016/j.canep.2010.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Revised: 02/04/2010] [Accepted: 02/05/2010] [Indexed: 12/21/2022]
Abstract
PURPOSE Male pattern baldness (MPB) and prostate cancer (PCa) share commonality as prevalent, heritable and androgen-related conditions. Studies exploring the relationship between the two conditions have been inconclusive. Using a population-based, case-control study of PCa, we explore the relationship between early-onset MPB and PCa risk. METHODS Cases were men aged 35-74 diagnosed with PCa between 2002 and 2005 in King County, Washington. Controls were frequency matched by age and identified by random digit dialing. Hair pattern at age 30 and at 1 year prior to diagnosis (cases) or reference date (controls) was determined using showcards. PCa risk associated with balding was assessed with logistic regression. RESULTS Data from 999 cases of PCa and 942 controls were analyzed. Hair loss at age 30 was more common in controls (25.2%) than cases (19.8%, p=0.005), and those with hair loss at age 30 had a 29% relative risk reduction for PCa (OR 0.71, 95% CI 0.56-0.91). No risk reduction was seen for men only reporting hair loss at referent age (OR 0.90, 95% CI 0.73-1.12). In men aged >60 at referent date, the risk reduction was greater for men with hair loss at age 30 from both the top of head and forehead (OR 0.55, 95% CI 0.33-0.93). CONCLUSION Early-onset MPB was associated with a reduced relative risk of PCa in this population-based study. Further research into a possible mechanistic link between these prevalent and androgen-related conditions is warranted.
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Schulze JJ, Rane A, Ekström L. Genetic variation in androgen disposition: implications in clinical medicine including testosterone abuse. Expert Opin Drug Metab Toxicol 2010; 5:731-44. [PMID: 19442030 DOI: 10.1517/17425250902976862] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Testosterone replacement therapy in hypogonadal men has been used for > 60 years. The use of testosterone substitution is continuously growing and is given to aging men to improve the quality of life. Because testosterone use is associated with muscle strength enhancing effects, it has become a popular drug to abuse. Doping with anabolic steroids, such as testosterone, is a severe challenge to the vision, moral and ethics in sports and has also become a significant and increasing problem in society. OBJECTIVE The primary aim of this review is to summarize and discuss the contribution of genetic components to inter-individual variation in androgen disposition. CONCLUSION Genetic variation has a large impact on androgen disposition. This variation is of the utmost importance for the interpretation of doping test results and may modulate the effects of testosterone replacement therapy and testosterone doping.
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Affiliation(s)
- Jenny J Schulze
- Karolinska Institutet, Division of Clinical Pharmacology, Stockholm, Sweden
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Wang C, Tao W, Chen Q, Hu H, Wen XY, Han R. SRD5A2 V89L polymorphism and prostate cancer risk: a meta-analysis. Prostate 2010; 70:170-8. [PMID: 19760631 DOI: 10.1002/pros.21050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Increasing studies investigating the association between steroid 5-alpha reductase type II gene polymorphism at codon 89 (SRD5A2 V89L) and susceptibility to prostate cancer (PCa) confer inconsistent results. To precisely estimate the relationship with more statistical power, a meta-analysis was performed. METHODS A comprehensive search was conducted to identify all case-control studies investigating such an association. Odds ratio (OR) and its 95% confidence interval (CI) were used to evaluate the size effect. RESULTS Twenty-five eligible reports were identified including 8,615 cases/9,089 controls in 33 comparisons. In overall analysis, no significant associations were found in all genetic models. Subgroup analyses by ethnicity revealed that small excess PCa risks were observed in dominant model (OR, 1.11; 95% CI, 1.03-1.19 for (LL + VL) vs. VV; P < 0.01; P(heterogeneity) = 0.49) and L allele frequency comparison (OR, 1.09; 1.03-1.15 for L allele frequency; P < 0.01; P(heterogeneity) = 0.07) in Europeans. Meanwhile, SRD5A2 V89L polymorphism was significantly associated with an increased PCa risk in men aged < or =65 under the co-dominant (OR, 1.70; 95% CI, 1.09-2.66 for LL vs. VV; P = 0.02; P(heterogeneity) = 0.31) and recessive (OR, 1.75; 95% CI, 1.14-2.68 for LL vs. (VV + VL); P = 0.01; P(heterogeneity) = 0.12) models. However, no significant associations were found in Asians and Africans. CONCLUSIONS Our study suggests SRD5A2 V89L polymorphism could play a low-penetrant role in PCa risk among Europeans and individuals younger than 65 years. Additional well-designed studies are warranted to validate these findings.
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Affiliation(s)
- Chunyang Wang
- Tianjin Institute of Urological Surgery, Tianjin Key Laboratory of Urology, Tianjin Medical University, Tianjin, China
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Li J, Coates RJ, Gwinn M, Khoury MJ. Steroid 5-{alpha}-reductase Type 2 (SRD5a2) gene polymorphisms and risk of prostate cancer: a HuGE review. Am J Epidemiol 2010; 171:1-13. [PMID: 19914946 DOI: 10.1093/aje/kwp318] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Steroid 5-alpha-reductase type 2 (SRD5a2) is a critical enzyme in androgen metabolism. Two polymorphisms in the SRD5a2 gene, V89L (rs523349) and A49T (rs9282858), have been studied for associations with prostate cancer risk, with conflicting results. The authors conducted a systematic review and meta-analysis (1997-2007) to examine these associations and compared the results with findings from genome-wide association studies of prostate cancer. The meta-analysis included 24 case-control studies (10,088 cases and 10,120 controls for V89L and 4,998 cases and 5,451 controls for A49T). The authors found that prostate cancer was not associated with V89L (L allele vs. V allele: odds ratio = 0.99, 95% confidence interval: 0.94, 1.05) and was probably not associated with A49T (T allele vs. A allele: odds ratio = 1.10, 95% confidence interval: 0.86, 1.40). These results could have been distorted by spectrum-of-disease bias, convenience sampling of cases and controls, genotype misclassification, and/or confounding. Neither V89L nor A49T was included in microarray chips used for published genome-wide association studies. Analysis of well-designed population-based studies with pathway-based arrays containing common genetic variants could be useful for identifying genetic factors in prostate cancer.
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Affiliation(s)
- Jun Li
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, MS K55, Atlanta, GA 30341, USA.
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Dhillon VS, Yeoh E, Fenech M. DNA repair gene polymorphisms and prostate cancer risk in South Australia--results of a pilot study. Urol Oncol 2009; 29:641-6. [PMID: 19914098 DOI: 10.1016/j.urolonc.2009.08.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 08/17/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Single nucleotide polymorphisms (SNPs) in DNA repair genes may impact on DNA damage, and cancer risk. To elucidate the role of SNPs in DNA repair genes in prostate cancer (PC) we conducted a case-control study comprising of 118 Caucasian men affected with late onset PC and 132 age-matched healthy controls from South Australia. METHODS AND MATERIALS We examined the association between PC risk with nonsynonymous SNPs (nsSNPs) in 5 genes involved in 3 DNA-repair pathways: (1) base excision repair (BER): hOGG1 C1245G (Ser326Cys) and XRCC1 G28152A (Arg399Gln); (2) nucleotide excision repair (NER): XPD G23591A (Asp312Asn); (3) homologous recombination repair: RAD51 G135C (in 5' untranslated region) and XRCC3 C18067T (Thr241Met). RESULTS Prostate cancer risk was significantly increased only for carriers of the G allele of the C1245G polymorphism in the hOGG1 gene (OR = 2.28; 95% CI = 1.36-3.83; P = 0.002). CONCLUSION Our results suggest that this common nsSNP in a gene involved in repair of oxidative damage to DNA may contribute to PC susceptibility in South Australian men.
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Affiliation(s)
- Varinderpal S Dhillon
- Commonwealth Scientific and Industrial Research Organization (CSIRO)-Food and Nutritional Sciences, Adelaide, Australia
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Ahn J, Schumacher FR, Berndt SI, Pfeiffer R, Albanes D, Andriole GL, Ardanaz E, Boeing H, Bueno-de-Mesquita B, Chanock SJ, Clavel-Chapelon F, Diver WR, Feigelson HS, Gaziano JM, Giovannucci E, Haiman CA, Henderson BE, Hoover RN, Kolonel LN, Kraft P, Ma J, Le Marchand L, Overvad K, Palli D, Stattin P, Stampfer M, Stram DO, Thomas G, Thun MJ, Travis RC, Trichopoulos D, Virtamo J, Weinstein SJ, Yeager M, Kaaks R, Hunter DJ, Hayes RB. Quantitative trait loci predicting circulating sex steroid hormones in men from the NCI-Breast and Prostate Cancer Cohort Consortium (BPC3). Hum Mol Genet 2009; 18:3749-57. [PMID: 19574343 DOI: 10.1093/hmg/ddp302] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Twin studies suggest a heritable component to circulating sex steroid hormones and sex hormone-binding globulin (SHBG). In the NCI-Breast and Prostate Cancer Cohort Consortium, 874 SNPs in 37 candidate genes in the sex steroid hormone pathway were examined in relation to circulating levels of SHBG (N = 4720), testosterone (N = 4678), 3 alpha-androstanediol-glucuronide (N = 4767) and 17beta-estradiol (N = 2014) in Caucasian men. rs1799941 in SHBG is highly significantly associated with circulating levels of SHBG (P = 4.52 x 10(-21)), consistent with previous studies, and testosterone (P = 7.54 x 10(-15)), with mean difference of 26.9 and 14.3%, respectively, comparing wild-type to homozygous variant carriers. Further noteworthy novel findings were observed between SNPs in ESR1 with testosterone levels (rs722208, mean difference = 8.8%, P = 7.37 x 10(-6)) and SRD5A2 with 3 alpha-androstanediol-glucuronide (rs2208532, mean difference = 11.8%, P = 1.82 x 10(-6)). Genetic variation in genes in the sex steroid hormone pathway is associated with differences in circulating SHBG and sex steroid hormones.
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Affiliation(s)
- Jiyoung Ahn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Mononen N, Schleutker J. Polymorphisms in Genes Involved in Androgen Pathways as Risk Factors for Prostate Cancer. J Urol 2009; 181:1541-9. [DOI: 10.1016/j.juro.2008.11.076] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Indexed: 10/21/2022]
Affiliation(s)
- Nina Mononen
- Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Johanna Schleutker
- Laboratory of Cancer Genetics, Institute of Medical Technology, University of Tampere and Tampere University Hospital, Tampere, Finland
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Wang MH, Shugart YY, Cole SR, Platz EA. A simulation study of control sampling methods for nested case-control studies of genetic and molecular biomarkers and prostate cancer progression. Cancer Epidemiol Biomarkers Prev 2009; 18:706-11. [PMID: 19258478 DOI: 10.1158/1055-9965.epi-08-0839] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Incidence density sampling is typically the least biased efficient method for control sampling in nested case-control studies. However, in studies of genetic variants and prostate cancer progression, some argue that controls should be sampled from men who did not progress by end of follow-up. Thus, we examined the validity of relative risk (RR) estimates of prostate cancer progression using three methods for control sampling from cohorts of men with prostate cancer generated by Monte Carlo simulation. METHODS Data were simulated for nine scenarios for combinations of genotype frequency (10%, 30%, and 50%) and association (RR, 1.0, 1.5, and 2.0) using prostate progression rates from Johns Hopkins Hospital. RRs estimated from conditional logistic regression for the genetic association from case-control studies nested in the nine cohort scenarios using three control sampling methods, (a) incidence density sampling, (b) incidence density sampling without replacement of selected controls, and (c) "pure" control sampling (i.e., men who did not progress by end of long-term follow-up), were compared with the true RRs. RESULTS Use of controls selected by incidence density sampling produced unbiased RR estimates of progression. In our setting, only a slight bias was produced by use of incidence density sampling without replacement. In contrast, use of controls selected by pure control sampling produced biased RR estimates, except when there was no association; extent of bias increased with increasing size of the association and duration of follow-up. CONCLUSIONS Nested case-control studies designed to estimate the association of genetic variants with risk of prostate cancer progression should use incidence density sampling to provide a valid RR estimate.
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Affiliation(s)
- Ming-Hsi Wang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and Department of Medicine, Saint Agnes Hospital, Room E6132, 615 North Wolfe Street, Baltimore, MD 21205, USA
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Paz-y-Miño C, Witte T, Robles P, Llumipanta W, Díaz M, Arévalo M. Association among polymorphisms in the steroid 5alpha-reductase type II (SRD5A2) gene, prostate cancer risk, and pathologic characteristics of prostate tumors in an Ecuadorian population. ACTA ACUST UNITED AC 2009; 189:71-6. [PMID: 19215786 DOI: 10.1016/j.cancergencyto.2008.09.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Revised: 09/15/2008] [Accepted: 09/23/2008] [Indexed: 11/19/2022]
Abstract
Androgens are essential to normal prostate growth and development. It is therefore possible that polymorphisms in the androgen synthesis gene 5alpha-reductase type II (SRD5A2) may be involved in the progression of prostate tumors. We evaluated the relationship of two single-nucleotide polymorphisms, A49T and V89L, with prostate cancer risk in a case-control study. A total of 114 prostate cancer patients and 144 healthy control males were genotyped. We found highly significant differences between the two polymorphisms, the risk of developing prostate cancer, and some of the clinical-pathologic characteristics. Individuals who carry at least one V allele may have a higher risk of developing prostate cancer [odds ratio (OR) = 7.5, 95% confidence interval (CI) = 2.57-22.08, P<0.001]. In addition, individuals with LL genotype showed reduction in the progression to a higher tumor stage (OR = 0.10, 95%CI = 0.040-0.27, P<0.001). The A49T substitution was associated with a higher pTNM stage (OR = 2.87, 95%CI 1.14-7.21, P = 0.003) and elevated Gleason grade (OR = 3.14, 95%CI = 1.12-8.78; P = 0.004). Furthermore, the allelic frequencies of the A49T variant (33% controls and 45% cases) are the highest reported worldwide. These findings suggest that among the Ecuadorian population, these polymorphisms influence the risk of developing prostate cancer.
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Affiliation(s)
- César Paz-y-Miño
- Human Molecular Genetics and Cytogenetics Laboratory, Biological Sciences School, Pontifical Catholic University of Ecuador, 12 de Octubre, entre Patria y Veintimilla, Quito, Ecuador 17012184.
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Scariano JK, Treat E, Alba F, Nelson H, Ness SA, Smith AY. The SRD5A2 V89L polymorphism is associated with severity of disease in men with early onset prostate cancer. Prostate 2008; 68:1798-805. [PMID: 18780294 DOI: 10.1002/pros.20842] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Emerging evidence indicates that testosterone (T), and not dihydrotestosterone (DHT), is the most relevant androgen that promotes carcinogenesis in the prostate. Steroid 5-alpha reductase type II (SRD5A2) catalyzes the irreversible conversion of T to DHT in male reproductive organs. Because the SRD5A2 gene is highly polymorphic at codon 89, two SRD5A2 isoforms are expressed that differ in K(m) and V(max) values. The more common and rapid catalytic isoform contains a valine residue at position 89; the slower-catalytic variant contains leucine at this position. METHODS Thirty-three men with early onset prostate cancer (PCa) were genotyped for the SRD5A2 V89L substitution and other polymorphisms in genes encoding receptors or enzymes that play important roles in pathways of steroid metabolism to ascertain if they were associated with standard clinical measures of disease progression at the time of diagnosis. RESULTS The expression of at least one SRD5A2 leucine allele in young men with PCa was associated with more significant disease at the time of presentation, as was defined by pretreatment PSA level, clinical staging and Gleason score when compared with affected subjects harboring the more common SRD5A2 valine variant. A dosage effect of a single leucine allele was evident in heterozygotes, as values of their clinical and pathological variables were consistently situated between the extremes of the homozygous V or L phenotypes. CONCLUSION The SRD5A2 leucine isoform appears to be acting in a dose-dependent manner as a significant disease-modifying factor in young men diagnosed with PCa.
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Affiliation(s)
- John K Scariano
- Department of Pathology and Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico 87131-0001, USA
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Vaarala MH, Mattila H, Ohtonen P, Tammela TL, Paavonen TK, Schleutker J. The interaction of CYP3A5 polymorphisms along the androgen metabolism pathway in prostate cancer. Int J Cancer 2008; 122:2511-6. [DOI: 10.1002/ijc.23425] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Bibliography. Current world literature. Adrenal cortex. Curr Opin Endocrinol Diabetes Obes 2008; 15:284-299. [PMID: 18438178 DOI: 10.1097/med.0b013e3283040e80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pearce CL, Van Den Berg DJ, Makridakis N, Reichardt JKV, Ross RK, Pike MC, Kolonel LN, Henderson BE. No association between the SRD5A2 gene A49T missense variant and prostate cancer risk: lessons learned. Hum Mol Genet 2008; 17:2456-61. [PMID: 18469342 DOI: 10.1093/hmg/ddn145] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The steroid 5-alpha reductase type II gene (SRD5A2) encodes the enzyme which converts testosterone (T) to the more active androgen dihydrotestosterone. A non-synonymous single-nucleotide polymorphism, A49T (rs9282858), in SRD5A2 has been implicated in prostate cancer risk; however, results have been inconsistent. In 1999, we reported a strong association between the A49T variant and prostate cancer risk among African-Americans and Latinos in the Hawaii-Los Angeles Multiethnic Cohort (MEC). We report here an updated analysis of MEC data including the five major ethnic groups of the MEC, an increased sample size, improved genotyping technology and a comprehensive meta-analysis of the published literature. We found a non-statistically significant positive association between prostate cancer risk and carrying either the AT or TT genotype [odds ratio (OR) = 1.16, 95% confidence interval (CI) 0.79-1.69] in the MEC. This finding is in contrast to our previous results of ORs of 3.28 and 2.50 for the association between prostate cancer risk and the variant in African-American and Latino men, respectively; this can be accounted for by genotyping error in our earlier study. Meta-analysis of the published literature, including the current MEC data, shows a summary OR of 1.13 (95% CI 0.95-1.34) for the A49T variant with prostate cancer risk among sporadic, unselected cases. After evaluating more than 6000 cases and 6000 controls, there is little evidence of a role for the SRD5A2 A49T variant in prostate cancer risk. Overall, this report highlights the importance of rigorous genotyping quality control measures and replication efforts in genetic association studies.
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Affiliation(s)
- C Leigh Pearce
- 1Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90033, USA.
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Cussenot O, Azzouzi AR, Nicolaiew N, Mangin P, Cormier L, Fournier G, Valeri A, Cancel-Tassin G. Low-Activity V89L Variant in SRD5A2 Is Associated with Aggressive Prostate Cancer Risk: An Explanation for the Adverse Effects Observed in Chemoprevention Trials Using 5-Alpha-Reductase Inhibitors. Eur Urol 2007; 52:1082-7. [PMID: 17448593 DOI: 10.1016/j.eururo.2007.04.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2006] [Accepted: 04/02/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The 5-alpha-reductase type 2 (5A2) enzyme catalyses the irreversible conversion of testosterone to dihydrotestosterone, the most active androgen in the prostate. This key enzyme in prostate gland physiopathology has recently been targeted by using inhibitors for chemoprevention of prostate cancer. However, some controversies have arisen by the observation of greater than expected high-grade tumours in men diagnosed with prostate cancer in the finasteride chemoprevention trial. To help understand the impact of prolonged exposure to low 5A2 activity on prostate cancer risk, we analysed the rather common genetic V89L polymorphism, which has previously been well characterised functionally for determining low enzymatic activities. METHODS The study was performed on 1605 white Caucasian French men categorised in 803 patients with prostate adenocarcinoma and 802 matched healthy male controls. The different alleles and genotypes were analysed according to case-control status and the aggressiveness pattern of the tumours. RESULTS The V89L amino acid substitution leading to the homozygous genotype LL increased the risk of clinically significant disease (odds ratio [OR]=1.89, 95% confidence interval (%95 CI), 1.07-2.74; p=0.0017) and was also associated with the most aggressive patterns of the disease (OR=2.56, 95%CI, 1.41-4.63; p=0.002). CONCLUSIONS Our data confirm in a large and homogeneous Caucasian French population that the low-activity V89L variant is associated with an increased risk of aggressive prostate cancer. These results corroborate that long-term exposure to 5A2 inhibitors (chemoprevention) must be evaluated in terms of risk of prostate cancer adverse effects.
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Prayer-Galetti T. Editorial comment on: Low-activity V89L variant in SRD5A2 is associated with aggressive prostate cancer risk: an explanation for the adverse effects observed in chemoprevention trials using 5-alpha-reductase inhibitors. Eur Urol 2007; 52:1087-8. [PMID: 17448594 DOI: 10.1016/j.eururo.2007.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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