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Redalyc.Genetic Polymorphisms of PPAR Gamma, Arsenic Methylation Salud Pública de México ISSN: 0036-3634 [email protected] Instituto Nacional de Salud Pública México Pineda-Belmontes, Cristina P; Hernández-Ramírez, Raúl U; Hernández-Alcaraz, César; Cebrián, Mariano E; López-Carrillo, Lizbeth Genetic polymorphisms of PPAR gamma, arsenic methylation capacity and breast cancer risk in Mexican women Salud Pública de México, vol. 58, núm. 2, marzo-abril, 2016, pp. 220-227 Instituto Nacional de Salud Pública Cuernavaca, México Available in: http://www.redalyc.org/articulo.oa?id=10645277015 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative ARTÍCULO ORIGINAL Pineda-Belmontes CP y col. Genetic polymorphisms of PPAR gamma, arsenic methylation capacity and breast cancer risk in Mexican women Cristina P Pineda-Belmontes, MHS,(1) Raúl U Hernández-Ramírez, MHS,(1) César Hernández-Alcaraz, MHS,(1) Mariano E Cebrián, PhD,(2) Lizbeth López-Carrillo, DPH.(1) Pineda-Belmontes CP, Hernández-Ramírez RU, Pineda-Belmontes CP, Hernández-Ramírez RU, Hernández-Alcaraz C, Cebrián ME, López-Carrillo L. Hernández-Alcaraz C, Cebrián ME, López-Carrillo L. Genetic polymorphisms of PPAR gamma, Polimorfismos genéticos de PPAR gamma, capacidad arsenic methylation capacity and breast de metilación del arsénico y riesgo de cáncer de mama cancer risk in Mexican women. en mujeres mexicanas. Salud Publica Mex 2016;58:220-227. Salud Publica Mex 2016;58:220-227. Abstract Resumen Objective. To evaluate whether the presence of polymor- Objetivo. Evaluar si la presencia de polimorfismos dePPAR γ phisms of peroxisome proliferator-activated receptor gamma (Pro12Ala) y PPARGC1B (Ala203Pro) modifica la asociación PPARγ (Pro12Ala) and PPARGC1B (Ala203Pro) modifies the entre la capacidad de metilación del arsénico inorgánico association between the inorganic arsenic (iAs) methylation (Asi) y el cáncer de mama (CM). Material y métodos. capacity and breast cancer (BC). Materials and meth- Se entrevistaron mujeres mexicanas y recolectaron muestras ods. Mexican women were interviewed, and blood and urine de sangre y orina de (casos/controles=197/220). La concen- samples were collected from them (cases/controls= 197/220). tración de especies de arsénico urinario y los polimorfismos The concentration of urinary arsenic species and the poly- de interés se determinaron mediante cromatografía líquida morphisms of interest were determined by high-performance de alta resolución acoplada a espectrometría de masas liquid chromatography with inductively coupled plasma mass (HPLC-ICP-MS) y reacción en cadena de la polimerasa (PCR), spectrometry (HPLC-ICP-MS) and polymerase chain reaction respectivamente. Resultados. En mujeres con %MMA (PCR), respectively. Results. In women with a high %MMA (monometilarsénico urinario) y razón de primera metila- (urinary monomethyl arsenic) and high primary methylation ción altas (PM=MMA/Asi) se incrementó el riesgo de CM ratio (PM = MMA/iAs), the risk of BC was increased (odds (RM%MMAT3vsT1=3.60: intervalo de confianza [IC]95%2.02- ratio [OR]%MMA T3vs.T1= 3.60: 95% confidence interval [CI] 6.41, RMPMT3vs.T1=3.47:IC95%1.95-6.17), que se mantuvo, 2.02-6.41, ORPMI T3vs.T1= 3.47: 95%CI 1.95-6.17), which was respectivamente, al ajustar por polimorfismos. No se obser- maintained after adjusting for polymorphisms. No significant varon interacciones significativas entre los polimorfismos y interactions were observed between the polymorphisms las variables arsenicales sobre el riesgo de CM. Conclusión. and the arsenic variables on the risk of BC. Conclusion. Los polimorfismos Pro12Ala y Ala203Pro no modificaron la Pro12Ala and Ala203Pro polymorphisms did not modify the asociación entre la capacidad de metilación del Asi y el CM. association between the iAs methylation capacity and BC. Keywords: breast cancer; arsenic; genetic polymorphisms; Palabras clave: cáncer de mama; arsénico; polimorfismos PPARγ; Mexico genéticos; PPARγ; México (1) Instituto Nacional de Salud Pública. Cuernavaca, México. (2) Centro de Investigación y de Estudios Avanzados, Instituto Politécnico Nacional. Ciudad de México, México. Received on: January 16, 2013 • Accepted on: July 6, 2014 Corresponding author: Dra. Lizbeth López Carrillo. Instituto Nacional de Salud Pública. Av. Universidad 655, col. Santa María Ahuacatitlán. 62100 Cuernavaca, Morelos, México. Email: [email protected] 220 salud pública de méxico / vol. 58, no. 2, marzo-abril de 2016 PPAR gamma, arsenic and breast cancer ARTÍCULO ORIGINAL he activation of peroxisome proliferator-activated this type of cancer.16 Additionally, during in vitro tests, receptor gamma (PPARγ) consistently induces iAs interferes with adipogenesis signaling by reducing Tapoptosis, inhibits cellular proliferation, and promotes the expression of PPARγ17,18 and consequently affects cellular differentiation in both hormone-dependent and the balance of cellular proliferation and differentiation hormone-independent mammary tumors.1-5 PPARγ is a in breast, colon, and prostate tumors.17 Additionally, ligand-dependent transcription factor that belongs to iAs can act as an endocrine disruptor and can thus be the superfamily of nuclear hormone receptors (estrogen, considered related to BC by means of the overexpres- progesterone). Ligands modulate PPARγ functions, sion of aromatase, an enzyme that limits the rate of thereby releasing receptor corepressors and permitting estrogen synthesis.19 The expression of this enzyme can binding of coactivators, which facilitates its transacti- be inhibited by PPARγ activation via the overexpression vation.6 An important gene in said transactivation of of BRCA1 (tumor suppressor gene) and the inhibition of PPARγ is PPARγ coactivator 1 beta (PPARGC1B), which PGE2 (proinflammatory prostaglandin E2).20 can also bind to and activate the α and β estrogen recep- In accordance with the preceding findings, the ob- tors (ERs) in vitro in a ligand-independent manner, with jective of this study is to evaluate whether the previously greater affinity for ERβ.7 observed association between the methylation capacity Genetic variants of these genes, Pro12Ala of the of iAs and BC is modified according to the presence of PPARγ gene and Ala203Pro of the PPARGC1B gene, have the Pro12Ala polymorphism of the PPARγ gene and the been evaluated in relation to the risk of breast cancer Ala203Pro polymorphism of the PPARGC1B gene in (BC) in previous epidemiological studies. Evidence Mexican women, considering that BC is a major problem that the Pro12Ala polymorphism of the PPARγ gene is not only in Mexico but also in Latin America.21 related to BC is contradictory. In two studies conducted, one in Taiwanese women and the other in the cohort of Materials and methods the Nurses’ Health Study, no significant associations between the Pro12Ala variant and BC were found.3,8 In Study population contrast, in a prospective study in the USA, a margin- ally significant increased risk of BC was detected in During the period from 2007 to 2011, a case-control study homozygous carriers of the G allele.9 For its part, the was conducted in five northern Mexico states (Chihua- Ala203Pro polymorphism has scarcely been studied in hua, Coahuila, Sonora, Durango, and Nuevo León) relation to BC. Wirtenberger and colleagues reported an where the incidence of BC is higher than elsewhere in increased risk of familial BC for the carriers of the GC the country.14 For the purposes of this report, the first and CC genotypes of Ala203Pro in a German cohort.7 197 cases and 220 recruited controls were included. Li and colleagues, although not evaluating Ala203Pro, The eligibility criteria of the cases were the following: found an increased risk of ER-positive BC in Swedish women with histologically confirmed BC, a minimum and Finnish women who carried risk alleles of several age of 18 years, no history of any other type of cancer, polymorphisms of PPARGC1B.10 Our research group and a minimum of one year of residence in the study confirmed the absence of a significant association be- area. The patients were identified in hospital units (n = tween the Pro12Ala variant of the PPARγ gene and BC 17) of the Mexican Institute of Social Security (Instituto and detected a marginally significant negative associa- Mexicano del Seguro Social – IMSS), Secretary of Health, tion in women who were heterozygous for the Ala203Pro University Hospitals, and the Institute of Security and polymorphism of the PPARGC1B gene.11 Social Services for State Workers (Instituto de Seguridad Recently, our research group has also identified that y Servicios Sociales de los Trabajadores del Estado – ISSSTE) the adult female residents in northern Mexico, who are located in those states. The response rate was 94.8%. exposed to inorganic arsenic (iAs) principally through The controls were healthy women without a his- drinking water12 and food,13 with less capacity for uri- tory of cancer who were matched with the index case nary elimination, evaluated through the percentage of by age (±5 years) and place of residence. Controls were elimination of monomethyl arsenic (%MMA), presented identified in the five aforementioned states, by means an increased risk of BC (Odd Ratio [OR]%MMAQ5vs.Q1= of the master sampling frame of the System of National 2.63; 95% confidence interval [95%CI] 1.89–3.66; p for Health Surveys of Mexico, composed of basic geostatisti- trend < 0.001).14,15 While the mechanisms by which iAs cal areas (BGAs) with square-shaped (20–80) regions in could be a cofactor of BC have not been clearly eluci- urban areas and tracts of approximately 10 000 hectares dated, it has been observed that sodium arsenite mimics with identifiable natural limits in rural areas. The BGAs the effects of estradiol in the BC cell line MCF-7, inducing were randomly selected and, within them, the squares, cellular proliferation, which, in turn, is a risk factor for in which the domiciles were located systematically to salud pública de méxico / vol. 58, no. 2, marzo-abril de 2016 221 ARTÍCULO ORIGINAL Pineda-Belmontes CP y col.
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