Protective effect of copy number polymorphism of glutathione S-transferase T1 gene on melanoma risk in presence of CDKN2A mutations, MC1R variants and host-related phenotypes

Hereditary melanoma: Update on syndromes and management: Genetics of familial atypical multiple mole melanoma syndrome

Malignant melanoma is considered the most lethal skin cancer if it is not detected and treated during its early stages. About 10% of melanoma patients report a family history of melanoma; however, individuals with features of true hereditary melanoma (ie, unilateral lineage, multigenerational, multiple primary lesions, and early onset of disease) are in fact quite rare. Although many new loci have been implicated in hereditary melanoma, CDKN2A mutations remain the most common. Familial melanoma in the presence of multiple atypical nevi should raise suspicion for a germline CDKN2A mutation. These patients have a high risk of developing multiple primary melanomas and internal organ malignancies, especially pancreatic cancer; therefore, a multidisciplinary approach is necessary in many cases. The value of dermoscopic examination and total body photography performed at regular intervals has been suggested by a number of studies, and should therefore be considered for these patients and their first-degree relatives. In addition, genetic counseling with the possibility of testing can be a valuable adjunct for familial melanoma patients. This must be performed with care, however, and only by qualified individuals trained in cancer risk analysis.

Where genotype is not predictive of phenotype: towards an understanding of the molecular basis of reduced penetrance in human inherited disease

Some individuals with a particular disease-causing mutation or genotype fail to express most if not all features of the disease in question, a phenomenon that is known as 'reduced (or incomplete) penetrance'. Reduced penetrance is not uncommon; indeed, there are many known examples of 'disease-causing mutations' that fail to cause disease in at least a proportion of the individuals who carry them. Reduced penetrance may therefore explain not only why genetic diseases are occasionally transmitted through unaffected parents, but also why healthy individuals can harbour quite large numbers of potentially disadvantageous variants in their genomes without suffering any obvious ill effects. Reduced penetrance can be a function of the specific mutation(s) involved or of allele dosage. It may also result from differential allelic expression, copy number variation or the modulating influence of additional genetic variants in cis or in trans. The penetrance of some pathogenic genotypes is known to be age- and/or sex-dependent. Variable penetrance may also reflect the action of unlinked modifier genes, epigenetic changes or environmental factors. At least in some cases, complete penetrance appears to require the presence of one or more genetic variants at other loci. In this review, we summarize the evidence for reduced penetrance being a widespread phenomenon in human genetics and explore some of the molecular mechanisms that may help to explain this enigmatic characteristic of human inherited disease.

Effect of GSTM1 polymorphism on risks of basal cell carcinoma and squamous cell carcinoma: a meta-analysis

Glutathione S-transferases are important enzymes in the detoxification of a wide range of reactive oxygen species produced during melanin synthesis and oxidative stress processes. Glutathione S-transferase M1 (GSTM1) null genotype may be a candidate genetic polymorphism with a role in susceptibility to skin cancer such as basal and squamous cell carcinomas. We conducted a systematic review and meta-analysis to define the effect of GSTM1 null polymorphism on skin cancer risk. We searched the PubMed, Embase, and Web of Science databases to identify published case-control studies investigating the association between GSTM1 null genotype and skin cancer risk. Between-study heterogeneity was assessed using the I (2) statistic. Odds ratios (OR) with corresponding 95 % confidence intervals (95 % CI) from individual studies were pooled using fixed and random effects models. Nineteen case-control studies (4,275 cases and 4,255 controls) were considered eligible and included in the meta-analysis, and 11 of which were on basal cell carcinoma; ten, on melanoma, and seven, on squamous cell carcinoma. Overall, the GSTT1 null genotype was not associated with the risk of skin cancer (OR, 1.01; 95 % CI 0.93-1.11; P = 0.76). Subgroup analysis by histological types showed that GSTT1 null genotype was not associated with risks of basal cell carcinoma (OR, 1.06; 95 % CI 0.92-1.21; P = 0.42), squamous cell carcinoma (OR, 0.97; 95 % CI 0.76-1.24; P = 0.80), and cutaneous malignant melanoma (OR, 1.00; 95 % CI 0.88-1.14; P = 0.60). Therefore, this meta-analysis suggests that GSTM1 null polymorphism is not associated with risks of basal and squamous cell carcinomas.

Genetics of pigmentation in skin cancer--a review

Skin pigmentation is one of the most overt human physical traits with consequences on susceptibility to skin cancer. The variations in skin pigmentation are dependent on geographic location and population ethnicity. Skin colouration is mainly due to the pigmentation substance melanin, produced in specialized organelles (melanosomes) within dendritic melanocytes, and transferred to neighbouring keratinocytes. The two types of melanin synthesized in well defined chemical reactions are the protective dark coloured eumelanin and the sulphur containing light red-yellow pheomelanin. The events leading to the synthesis of melanin are controlled by signalling cascades that involve a host of genes encoding ligands, receptors, transcription factors, channel transporters and many other crucial molecules. Several variants within the genes involved in pigmentation have been associated with high risk phenotypes like fair skin, brown-red hair and green-blue eyes. Many of those variants have also been implicated in the risk of various skin cancers. The variants within the key pigmentation gene, melanocortin-receptor 1 (MC1R), in particular have been ubiquitously linked with high risk traits and skin cancers involving both pigmentary and non-pigmentary functions and likely interaction with variants in other genes. Many of the variants in other genes, functional in pigmentation pathway, have also been associated with phenotypic variation and risk of skin cancers. Those genes include agouti signalling protein (ASIP), tyrosinase (TYR), tyrosinase-related protein 1 (TYRP1), oculocutaneous albinism II (OCA2), various solute carrier genes and transporters. Most of those associations have been confirmed in genome wide association studies that at the same time have also identified new loci involved in phenotypic variation and skin cancer risk. In conclusion, the genetic variants within the genes involved in skin pigmentation besides influencing phenotypic traits are important determinants of risk of several skin cancers. However, ultimate risk of skin cancer is dependent on interplay between genetic and host factors.