Increased PTEN gene expression in patients with endometrial carcinoma from areas of high risk depleted uranium exposure

Assess human blood uranium levels of some Iraqi companies

The goal of this study is to measure the uranium concentration levels in the blood of Iraqi workers employed in certain government companies. Assessing the initial level of uranium toxicity in their blood and the possibility of health problems occurring. 184 blood samples from Iraqi government companies and the control group were collected in this study. A solid-state nuclear track detector (CR-39) was used to measure the amount of uranium present. Two drops of blood (100 μl) were placed on CR-39. The CR-39 was irradiated with a thermal neutron using the fission-track technique (241Am-9Be) to determine the uranium concentration in blood samples. The statistical analysis is carried out using the Origin Lab 2024 version. The results show the average of uranium concentration at all locations has a higher level compared to the control group. The blood samples from workers at the phosphate company had the highest amount (1.021 ± 0.050 μg/l), compared to samples from other factories. This result confirms that there is a connection between the concentration of uranium and phosphate substances. The results suggest that there is a slight increase in uranium levels that is related to both age and years of employment.

Long-term environmental metal exposure is associated with hypomethylation of CpG sites in NFKB1 and other genes related to oncogenesis

BACKGROUND

Long-term environmental exposure to metals leads to epigenetic changes and may increase risks to human health. The relationship between the type and level of metal exposure and epigenetic changes in subjects exposed to high concentrations of metals in the environment is not yet clear. The aim of our study is to find the possible association of environmental long-term exposure to metals with DNA methylation changes of genes related to immune response and carcinogenesis. We investigated the association of plasma levels of 21 essential and non-essential metals detected by ICP-MS and the methylation level of 654 CpG sites located on NFKB1, CDKN2A, ESR1, APOA5, IGF2 and H19 genes assessed by targeted bisulfite sequencing in a cohort of 40 subjects living near metal mining area and 40 unexposed subjects. Linear regression was conducted to find differentially methylated positions with adjustment for gender, age, BMI class, smoking and metal concentration.

RESULTS

In the metal-exposed group, five CpGs in the NFKB1 promoter region were hypomethylated compared to unexposed group. Four differentially methylated positions (DMPs) were associated with multiple metals, two of them are located on NFKB1 gene, and one each on CDKN2A gene and ESR1 gene. Two DMPs located on NFKB1 (chr4:102500951, associated with Be) and IGF2 (chr11:2134198, associated with U) are associated with specific metal levels. The methylation status of the seven CpGs located on NFKB1 (3), ESR1 (2) and CDKN2A (2) positively correlated with plasma levels of seven metals (As, Sb, Zn, Ni, U, I and Mn).

CONCLUSIONS

Our study revealed methylation changes in NFKB1, CDKN2A, IGF2 and ESR1 genes in individuals with long-term human exposure to metals. Further studies are needed to clarify the effect of environmental metal exposure on epigenetic mechanisms and pathways involved.

The clinicopathology and survival characteristics of patients with POLE proofreading mutations in endometrial carcinoma: A systematic review and meta-analysis

Background

Endometrial carcinoma (EC) is classified into four distinct molecular subgroups. Patients with polymerase epsilon exonuclease domain mutated (POLE-EDM) tumors have the best prognosis of all. This meta-analysis consolidated the clinicopathology variations reported in the POLE-mutant subtype and survival parameters in patients with EC.

Methods

The following internet data bases were searched: PubMed, Web of science, Embase and Scimage directory. Data was extracted from eligible studies including sample size, number of positive POLE-mutant cases, EDM sequencing information, clinicopathologic, and survival data. Meta-analysis and a random-effects model produced pooled estimates of POLE prognostic parameters using 95% confidence intervals (CI), hazard ratios (HR), and odds ratios (OR).

Results

The meta-analysis included 11 cohort studies comprising 5508 EC patients (442 POLE EDM tumors). Patients with POLE mutant EC were associated with improved disease specific survival (HR = 0.408, 95% CI: 0.306 to 0.543) and progression-free survival (HR = 0.231, 95% CI: 0.117 to 0.456). POLE-mutated tumors were mostly endometrioid histology (84.480%; 95% CI: 77.237 to 90.548), although not significantly more than wild type tumors (OR = 1.386; p = 0.073). The POLE mutant tumors significantly present (p<0.001) at Federation of International of Gynecologists and Obstetricians (FIGO) lower stages I-II (OR = 2.955, p<0.001) and highest grade III (OR = 1.717, P = 0.003). The tumors are significantly associated with invasion less than half (<50%) of the myometrium (OR = 1.765, p = 0.001), but not deeply invasive EC (MI>50%, OR = 0.83, p = 0.34). POLE mutations significantly protected against lymph node metastases (OR = 0.202, p = 0.001), and have no clear association with lymph-vascular space invasion (OR = 0.967, 95% 0.713–1.310, p = 0.826). The tumors are predominantly of low ESMO risk stratification distribution (40.356%; 95% CI: 27.577 to 53.838).

Conclusions

POLE mutations serve as an important biomarker of favorable prognosis in EC. The tumors are characteristically high grade, early stage, and remain localized in the endometrium with reduced likelihood of lymph node metastasis for improved survival prospects and the lowest risk classification. These findings have implications for medical management of EC.

Weaponised uranium and adverse health outcomes in Iraq: a systematic review

Background

The US military first deployed depleted uranium (DU) weapons in Iraq during the Gulf War in 1990 and in the 2003 invasion of Iraq. Research into the health impacts of DU has been mired in debate and controversy. Research funded by the US government has denied the health risks posed by DU to the Iraqi population, while opponents have claimed that DU is responsible for increased rates of birth defects and cancers in Iraq. Others assert that the public health impacts of DU weapons remain uncertain. This systematic review identified, appraised and synthesised all human observational studies assessing adverse health outcomes associated with DU exposure among the Iraqi population. To our knowledge, no systematic review has been conducted on the topic previously.

Methods

We searched 11 electronic databases for human observational studies published between 1990 and 2020 that measured association between exposure to weaponised uranium and health outcomes (including cancer, birth defects, immune system function and mortality) among the Iraqi population. We assessed risk of bias using the Navigation Guide’s risk of bias tool and rated certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations approach (PROSPERO: CRD42018108225).

Results

Our searches identified 2601 records, of which 28 met our inclusion criteria. We identified five additional eligible reports from other sources. Two articles reported the results of multiple relevant studies; our final set included 33 articles reporting on 36 eligible studies. Most studies (n=30, 83%) reported a positive association between uranium exposure and adverse health outcomes. However, we found that the reviewed body of evidence suffers from a high risk of bias.

Conclusion

The available evidence suggests possible associations between exposure to depleted uranium and adverse health outcomes among the Iraqi population. More primary research and the release of missing data are needed to design meaningful health and policy interventions in Iraq.

The frequency of POLE-mutation in endometrial carcinoma and prognostic implications: a systemic review and meta-analysis

Background

Endometrial carcinoma (EC) is classified into four distinct molecular subgroups including ultramutated DNA polymerase epsilon (POLE). POLE-mutated tumors have the best prognosis and are a promising target for immunotherapy. This meta-analysis consolidated the reported variation of POLE-mutant frequency and assessed prognostic value in EC.

Methods

Internet searches explored scientific data bases: EMBASE, PubMed, and the Cochrane Central Register of Controlled Trials databases. Data was extracted from eligible studies including: sample size, number of positive POLE-mutant cases, sequencing information, clinicopathologic data, and survival data. Meta-analysis and a random-effects model produced pooled estimates of POLE frequency and prognostic parameters using 95% confidence intervals (CI), hazard ratios (HR), and odd ratios (OR).

Results

Six thousand three hundred and forty-six EC patient cases were pooled from 25 studies. The pooled proportion of POLE gene mutation in EC was 8.59% (95% CI, 7.01 to 10.32), of which 8.22% (95% CI, 6.27 to 10.42) were type I and 0.93% (95% CI, 0.34 to 1.81) type 2. Clinicopathologic data showed that POLE-mutated tumors are mostly endometrioid. They present at higher levels in earlier stages (I–II) of EC (89.51%; 95% CI, 81.11 to 95.66) at the highest grade III (51.53%; 95% CI, 36.08 to 66.84) with reduced myometrial invasion (OR, 1.48, 95% CI, 0.99 to 2.20). Survival analysis indicated favorable overall survival (HR, 0.90), disease-specific survival (HR, 0.41), and progression-free survival (HR, 0.23) for POLE mutant EC.

Conclusions

Almost one-tenth of EC patients have POLE-mutated tumors. Given their improved prognostic potential, identifying the POLE mutation status is key for the management of EC patients.