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Gholamalizadeh M, Jonoush M, Mobarakeh KA, Amjadi A, Alami F, Valisoltani N, Askarpour SA, Azizi-Tabesh G, Mohammadian MK, Akbari ME, Rajabibazl M, Alemrajabi M, Poodineh J, Sadeghi H, Hosseinzadeh P, Dahka SM, Badeli M, Jarrahi SAM, Doaei S. The effects of FTO gene rs9939609 polymorphism on the association between colorectal cancer and dietary intake. Front Nutr 2023; 10:1215559. [PMID: 37545585 PMCID: PMC10399810 DOI: 10.3389/fnut.2023.1215559] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/21/2023] [Indexed: 08/08/2023] Open
Abstract
Background FTO gene is associated with obesity, dietary intake, and the risk of colorectal cancer (CRC). In this study, patients with colorectal cancer were assessed for the interactions between FTO gene polymorphisms and dietary intake. Methods This case-control study was carried out on 450 participants aged 35-70 years including 150 patients with colorectal cancer and 300 healthy controls. Blood samples were collected in order to extract DNA and genotyping of FTO gene for rs9939609 polymorphism. A validated 168-item food frequency questionnaire (FFQ) and the Nutritionist-IV software were used to assess dietary intake. Results In the participants with the TT genotype of FTO rs9939609 polymorphism, CRC risk was significantly associated with higher intake of dietary fat (OR:1.87 CI95%:1.76-1.99, p = 0.04), vitamin B3 (OR:1.20 CI95%:1.08-1.65, p = 0.04), and vitamin C (OR:1.06 CI95%:1.03-1.15, p = 0.04) and lower intake of β-carotene (OR:0.98 CI95%:0.97-0.99, p = 0.03), vitamin E (OR:0.77 CI95%:0.62-0.95, p = 0.02), vitamin B1 (OR:0.15 CI95%:0.04-0.50, p < 0.01), and biotin (OR:0.72 CI95%:0.0.57-0.92, p = 0.01). No significant association was found between CRC and dietary intake in carriers of AA/AT genotypes after adjustments for the confounders. Conclusion CRC risk may be decreased by β-carotene, vitamins E, B1, and biotin only in those without the risk allele of the FTO gene. The association of CRC and diet may be influenced by FTO genotype. Further studies are warranted.
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Affiliation(s)
- Maryam Gholamalizadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mona Jonoush
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khadijeh Abbasi Mobarakeh
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arezoo Amjadi
- Department of Nutrition, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farkhondeh Alami
- Student Research Committee, Department of Nutrition, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Neda Valisoltani
- Department of Clinical Nutrition. School of Nutrition Science and Dietetics. Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Askarpour
- Division of Food Safety and Hygiene, Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghasem Azizi-Tabesh
- Genomic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Masoumeh Rajabibazl
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Alemrajabi
- Clinical Research Development Center (CRDC), Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Zabol, Iran
| | - Jafar Poodineh
- Department of Clinical Biochemistry, School of Medicine, Zabol University of Medical Sciences, Tehran, Iran
| | - Hossein Sadeghi
- Genomic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Payam Hosseinzadeh
- Gastrointestinal and Liver Diseases Research Center (GLDRC), Iran University of Medical Sciences, Tehran, Iran
| | | | - Mostafa Badeli
- Department of Nutrition, Urmia University of Medical Science, Urmia, Iran
| | | | - Saeid Doaei
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Abdollahi S, Hasanpour Ardekanizadeh N, Poorhosseini SM, Gholamalizadeh M, Roumi Z, Goodarzi MO, Doaei S. Unraveling the Complex Interactions between the Fat Mass and Obesity-Associated (FTO) Gene, Lifestyle, and Cancer. Adv Nutr 2022; 13:2406-2419. [PMID: 36104156 PMCID: PMC9776650 DOI: 10.1093/advances/nmac101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/28/2022] [Accepted: 09/12/2022] [Indexed: 01/29/2023] Open
Abstract
Carcinogenesis is a complicated process and originates from genetic, epigenetic, and environmental factors. Recent studies have reported a potential critical role for the fat mass and obesity-associated (FTO) gene in carcinogenesis through different signaling pathways such as mRNA N6-methyladenosine (m6A) demethylation. The most common internal modification in mammalian mRNA is the m6A RNA methylation that has significant biological functioning through regulation of cancer-related cellular processes. Some environmental factors, like physical activity and dietary intake, may influence signaling pathways engaged in carcinogenesis, through regulating FTO gene expression. In addition, people with FTO gene polymorphisms may be differently influenced by cancer risk factors, for example, FTO risk allele carriers may need a higher intake of nutrients to prevent cancer than others. In order to obtain a deeper viewpoint of the FTO, lifestyle, and cancer-related pathway interactions, this review aims to discuss upstream and downstream pathways associated with the FTO gene and cancer. The present study discusses the possible mechanisms of interaction of the FTO gene with various cancers and provides a comprehensive picture of the lifestyle factors affecting the FTO gene as well as the possible downstream pathways that lead to the effect of the FTO gene on cancer.
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Affiliation(s)
- Sepideh Abdollahi
- Department of Medical Genetics, School of Medicine, Tehran University of
Medical Sciences, Tehran, Iran
| | - Naeemeh Hasanpour Ardekanizadeh
- Department of Clinical Nutrition, School of Nutrition and Food Sciences,
Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Maryam Gholamalizadeh
- Cancer Research Center, Shahid Beheshti University of Medical
Sciences, Tehran, Iran
| | - Zahra Roumi
- Department of Nutrition, Science and Research Branch, Islamic Azad
University, Tehran, Iran
| | - Mark O Goodarzi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine,
Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Saeid Doaei
- Department of Community Nutrition, School of Nutrition and Food Sciences,
Shahid Beheshti University of Medical Sciences, Tehran, Iran
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3
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Hajiesmaeil M, Mirzaei Dahka S, Khorrami R, Rastgoo S, Bourbour F, Davoodi SH, Shafiee F, Gholamalizadeh M, Torki SA, Akbari ME, Doaei S. Intake of food groups and cervical cancer in women at risk for cervical cancer: A nested case-control study. CASPIAN JOURNAL OF INTERNAL MEDICINE 2022; 13:599-606. [PMID: 35974932 PMCID: PMC9348217 DOI: 10.22088/cjim.13.3.599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/22/2021] [Accepted: 11/28/2021] [Indexed: 11/05/2022]
Abstract
Background The risk of cervical cancer was reported to be influenced by dietary components. This study aimed to illustrate the association between cervical cancer with the intake of food groups in women with a history of cervical neoplasia. Methods This nested case-control study was conducted in 558 people with a history of cervical intraepithelial neoplasia (CIN), including 279 women with cervical cancers and 279 controls with low-grade squamous intraepithelial lesions (LSIL). A validated food frequency questionnaire (FFQ) was used to assess the intake of food groups. Results The intake of fruits and vegetables in the case group was significantly lower than the control group (P=0.001). Low intake of dairy products, vegetables, and fruits was associated with cervical cancer risk (OR=4.67; 95% CI 1.2-9.49, P=0.001; OR=9.75, 95% CI 1.36-19. 51, P=0.001; and OR=4.82, 95% CI 1.09-7.25, P=0.001, respectively). After adjusting for age, family history, age at first menstruation, number of children, history of vaginal infection, and age at first sexual intercourse, the results were still significant. Additional adjustments to BMI did not change the results. Conclusion The results indicate that the risk of cervical cancer can be affected by the intake of certain food groups. Further longitudinal studies are needed to confirm these findings and determine the underlying mechanism of the influence of dietary components on cervical cancer risk.
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Affiliation(s)
- Mogge Hajiesmaeil
- Department of Biology and Biotechnology "Charles Darwin", Sapienza University of Rome, Rome, Italy
| | | | | | - Samira Rastgoo
- Departments of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bourbour
- Departments of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sayed Hossein Davoodi
- Faculty of Nutrition and Food Technology, Departments of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shafiee
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Gholamalizadeh
- Student Research Committee, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saheb Abbas Torki
- Department of Nutrition, Faculty of Nutrition Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Saeid Doaei
- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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4
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do Amaral LA, da Silva Fleming de Almeida T, Oliveira de Souza GH, Baranoski A, Souza Maris R, Bittencourt Junior FF, Murino Rafacho BP, Duenhas Monreal AC, Leite Kassuya CA, Milan Brochado Antoniolli-Silva AC, Freitas dos Santos E, Oliveira RJ. The Use of Natural Fiber-Rich Food Product Is Safe and Reduces Aberrant Crypt Foci in a Pre-Clinical Model. Nutrients 2021; 13:2708. [PMID: 34444868 PMCID: PMC8401268 DOI: 10.3390/nu13082708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/05/2021] [Accepted: 07/10/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Colorectal cancer is a highly prevalent disease, requiring effective strategies for prevention and treatment. The present research aimed to formulate a natural fiber-rich food product (NFRFP) and to evaluate its safety, toxicogenetics, and effects on aberrant crypt foci induced by 1,2-dimethyl-hydrazine in a preclinical model. METHODS A total of 78 male Wistar rats were distributed in six experimental groups: negative control, positive control (1,2-Dimethylhydrazine-40 mg/Kg), and four groups fed with 10% NFRFP: NFRFP, pre-treatment protocol, simultaneous treatment, and post-treatment protocol. RESULTS The NFRFP was shown to be a good source of fibers and did not change biometric, biochemical, hematological, and inflammatory parameters, and did not induce signs of toxicity and genotoxicity/carcinogenicity. NFRFP exhibited a chemopreventive effect, in all protocols, with damage reduction (% DR) of 75% in the comet test. NFRFP reduced the incidence of aberrant crypt outbreaks by 49.36% in the post-treatment protocol. CONCLUSIONS The results suggest the applicability of NFRFP in the human diet due to potential production at an industrial scale and easy technological application in different products, since it could be incorporated in food without altering or causing small changes in final product sensory characteristics.
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Affiliation(s)
- Luane Aparecida do Amaral
- Center for Studies in Stem Cells, Cell Therapy and Toxicological Genetics–CeTroGen, University Hospital Maria Aparecida Pedrossian, Federal University of Mato Grosso do Sul, Campo Grande 79080-190, Brazil; (L.A.d.A.); (A.B.); (A.C.M.B.A.-S.)
- Postgraduate Program in Health and Development in the Midwest Region, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
| | - Taina da Silva Fleming de Almeida
- Postgraduate Program in Biotechnology, Faculty of Pharmaceutical Sciences, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (T.d.S.F.d.A.); (B.P.M.R.)
| | | | - Adrivanio Baranoski
- Center for Studies in Stem Cells, Cell Therapy and Toxicological Genetics–CeTroGen, University Hospital Maria Aparecida Pedrossian, Federal University of Mato Grosso do Sul, Campo Grande 79080-190, Brazil; (L.A.d.A.); (A.B.); (A.C.M.B.A.-S.)
- Postgraduate Program in Health and Development in the Midwest Region, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
| | - Rafael Souza Maris
- Clinical Analysis Laboratory, University Center of Grande Dourados, Dourados 79824-900, Brazil; (R.S.M.); (F.F.B.J.)
| | | | - Bruna Paola Murino Rafacho
- Postgraduate Program in Biotechnology, Faculty of Pharmaceutical Sciences, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (T.d.S.F.d.A.); (B.P.M.R.)
- Faculty of Pharmaceutical Sciences, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
- Postgraduate Program in Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | | | | | - Andréia Conceição Milan Brochado Antoniolli-Silva
- Center for Studies in Stem Cells, Cell Therapy and Toxicological Genetics–CeTroGen, University Hospital Maria Aparecida Pedrossian, Federal University of Mato Grosso do Sul, Campo Grande 79080-190, Brazil; (L.A.d.A.); (A.B.); (A.C.M.B.A.-S.)
- Postgraduate Program in Health and Development in the Midwest Region, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
| | - Elisvânia Freitas dos Santos
- Postgraduate Program in Health and Development in the Midwest Region, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
- Postgraduate Program in Biotechnology, Faculty of Pharmaceutical Sciences, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil; (T.d.S.F.d.A.); (B.P.M.R.)
- Faculty of Pharmaceutical Sciences, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
| | - Rodrigo Juliano Oliveira
- Center for Studies in Stem Cells, Cell Therapy and Toxicological Genetics–CeTroGen, University Hospital Maria Aparecida Pedrossian, Federal University of Mato Grosso do Sul, Campo Grande 79080-190, Brazil; (L.A.d.A.); (A.B.); (A.C.M.B.A.-S.)
- Postgraduate Program in Health and Development in the Midwest Region, Medical School, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
- Postgraduate Program in Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences, Food and Nutrition, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
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5
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Gholamalizadeh M, Tabrizi R, Bourbour F, Rezaei S, Pourtaheri A, Badeli M, Jarrahi SAM, Akbari ME, Kalantari N, Doaei S. Are the FTO Gene Polymorphisms Associated with Colorectal Cancer? A Meta-analysis. J Gastrointest Cancer 2021; 52:846-853. [PMID: 34212310 DOI: 10.1007/s12029-021-00651-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 08/30/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) is reported to be associated with some gene polymorphisms. However, the effect of the fat mass and obesity associated (FTO) gene on colorectal cancer is not yet clear. This meta-analysis aimed to investigate the association of the FTO gene polymorphism and colorectal cancer. METHODS PubMed, Web of science, Scopus, and Embase were explored to identify the studies investigating the relationship between rs9939609 and rs17817449 polymorphisms of FTO gene and colorectal cancer, and the published papers from 2000 to 2019 were collected. This meta-analysis was conducted by using a random-effects model for the best estimation of the desired outcomes. RESULTS In this study, 1528 studies were initially included and five eligible case-control studies including 13,460 cases and 22,578 controls were eligible for further analyses. No significant association was found between risk allele of FTO rs9939609 (OR = 0.98, 0.87-1.1) and rs17817449 (OR = 0.9, 0.79-1.03) polymorphisms and colorectal cancer risk. The subgroup analyses considering the source of the control group and race found no significant association between FTO polymorphisms and the risk of colon cancer. CONCLUSIONS This study indicated that rs9939609 and rs17817449 FTO gene polymorphisms are not associated with colorectal cancer risk. Individual studies involving different FTO polymorphisms are needed to further evaluation of the associations between the FTO gene and colon cancer.
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Affiliation(s)
- Maryam Gholamalizadeh
- Students Research Committee, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Tabrizi
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Fatemeh Bourbour
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahla Rezaei
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.,Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azam Pourtaheri
- School of Medicine, Mashhad University of Medical Sciences, Tehran, Iran
| | - Mostafa Badeli
- Department of Nutrition, Urmia University of Medical Science, Urmia, Iran
| | | | | | - Naser Kalantari
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Doaei
- Research Center of Health and Environment, Guilan University of Medical Sciences, Rasht, Iran.
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Mansour SR, Moustafa MAA, Saad BM, Hamed R, Moustafa ARA. Impact of diet on human gut microbiome and disease risk. New Microbes New Infect 2021; 41:100845. [PMID: 34035924 PMCID: PMC8138677 DOI: 10.1016/j.nmni.2021.100845] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/24/2020] [Accepted: 12/30/2020] [Indexed: 12/19/2022] Open
Abstract
The gut microbiome of humans comprises a diverse group of trillions of microorganisms including symbiotic organisms, opportunistic pathogens and commensal organisms. This microbiota plays a major role in digesting food; it also helps with absorbing and synthesizing some nutrients and releases their metabolites, which may deliver a variety of growth-promoting and growth-inhibiting factors that influence human health either directly or indirectly. The balance between microbial species, especially those responsible for the fermentation of different substrates within the microbial community, which are in the majority, depends on daily diet. Therefore, an unbalanced diet may lead to the progression and development of human diseases. These include metabolic and inflammatory disorders, cancer and depression, as well as infant health and longevity. We provide an overview of the effect of diet on the human microbiome and assess the related risk of disease development.
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Affiliation(s)
- S R Mansour
- Botany Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
| | - M A A Moustafa
- Faculty of Medicine, 6 October University, 6 October, Egypt
| | - B M Saad
- Botany Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
| | - R Hamed
- Botany Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
| | - A-R A Moustafa
- Botany Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
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7
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Wang JY, Chen LJ, Qiang P. The Potential Role of N6-Methyladenosine (m6A) Demethylase Fat Mass and Obesity-Associated Gene (FTO) in Human Cancers. Onco Targets Ther 2020; 13:12845-12856. [PMID: 33364780 PMCID: PMC7751723 DOI: 10.2147/ott.s283417] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/27/2020] [Indexed: 12/12/2022] Open
Abstract
N6-methyladenosine (m6A) demethylase fat mass and obesity-associated gene(FTO), previously recognized to be related with obesity and diabetes, was gradually discovered to be dysregulated in multiple cancers and plays an oncogenic or tumor-suppressive role. However, the specific expression and pro- or anti-cancer role of FTO in various cancers remained controversial. In this review, through summarizing the available literature, we found that FTO single nucleotide polymorphisms (SNPs) were closely related with cancer risk. Additionally, the dysregulation of FTO was implicated in multiple biological processes, such as cancer cell apoptosis, proliferation, migration, invasion, metastasis, cell-cycle, differentiation, stem cell self-renewal and so on. These modulations mostly relied on the communications between FTO and specific signaling pathways, including PI3K/AKT, MAPK and mTOR signaling pathways. Furthermore, FTO had great potential for clinical application by serving as a prognostic biomarker.
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Affiliation(s)
- Jin-Yan Wang
- Department of Obstetrics and Gynecology, Zhangjiagang First People's Hospital, Zhangjiagang Jiangsu 215600, People's Republic of China.,Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People's Republic of China
| | - Li-Juan Chen
- Department of Obstetrics and Gynecology, Zhangjiagang First People's Hospital, Zhangjiagang Jiangsu 215600, People's Republic of China
| | - Ping Qiang
- Department of Gynecology, Zhangjiagang First People's Hospital, Zhangjiagang Affiliated Hospital of Soochow University, Zhangjiagang, Jiangsu 215600, People's Republic of China
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