DNA repair and genetic susceptibility genes in malignant melanoma patients

Author(s)

Fernanda de Toledo Gonçalves

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD)
• Defense date: 2010-01-19

Examining board members

Gilka Jorge Figaro Gattas; Filomena Marino Carvalho; Roger Chammas; Joao Pedreira Duprat Neto; Victor Wunsch Filho

• Advisor: Gilka Jorge Figaro Gattas
• Field of knowledge: Biological Sciences - Genetics
• Indexed in: Banco de Dados Bibliográficos da USP-DEDALUS; Biblioteca Digital de Teses e Dissertações - USP
• Location: Universidade de São Paulo. Biblioteca Central da Faculdade de Medicina; W4.DB8 SP.USP FM-2; G626ge

Abstract

Melanoma is a malignant skin lesion, with high mortalitty rate and its incidence has been rising in the last years. The main risk factors are melanoma family history, presence of multiple benign or atypical nevi and previous melanoma. Immunosuppression, sun sensitivy and intermittent and intense exposure to UV sunlight radiation, without protection, are additional risk factors. The aim of this hospital based case-control study was to evaluate the contribution of genetic polymorphisms of xenobiotic metabolizing enzymes (CYP1A1/MspI, CYP2E1/PstI, GSTM1, GSTT1 and GSTP1/Bsma), DNA repair genes (XRCC1/MspI, XRCC3/NcoI and XPD/PstI) and vitamin D receptor genes (VDR/FokI and VDR/TaqI) to the risk of melanoma. All participants, including 193 melanoma patients (49.7% men and 50.3% women, mean age 52 ± 14.28 years old) and 208 controls (51.4% men and 48.6% women, mean age 48 ± 15.24 years old) gave written informed consent to participate in the study and agreed to donate a sample of bloody to analysis of DNA by PCR-RFLP and answer a questionarie regarding phenotypic characteristics, personal habits and questions regarding sun exposure that could be associated to the disease. The main risk factors to melanoma were European ancestries (p<0.001), light colored eyes (p<0.001), presence of nevi (p<0.001), history of sunburns during the adolescence (p<0.001), no use of sunblock (p<0.034) and exposure of fluorescent lamps (p<0.001). Regarding the genes polymorphisms, only GSTT1 null genotype showed as an inversely positivefactor (OR adjusted = 0.60; 95%CI = 0.37-0.97) to malignant melanoma. However, this association disappeared with multiple regression analysis. The VDR/FokI and VDR/TaqI polymorphisms did not alter the susceptibility to malignant melanoma in the comparison between groups. A joint analysis of phenotype-genotype, individuals with green eyes and polymorphic genotype VDR/FokI, presented almost six times more risk to melanoma (OR adjusted = 5.93, 95% CI = 1.49-23.59). The association between polymorphisms, in at least one polymorphic allele of DNA repair genes XRCC3/NcoI and XPD/PstI increased almost twice the risk of melanoma in the multivariate statistic analysis (OR adjusted = 1.84, 95%CI = 1.08-3.14) and in multiple logistic regression (OR adjusted = 2.32, 95%CI = 1.01-5.36). In the interaction gene-environment the lack of sunscreen doubled the risk of melanoma in individuals with polymorphisms of XPD/PstI (OR adjusted = 2.17, 95%CI = 1.12-4.17). The identification of genetic polymorphisms associated with diseases such as multi factorial case of malignant melanoma should be encouraged in our country, mainly because we live in a tropical country with high solar irradiation in almost all its territory. The identification of genetic markers of susceptibility may provide early and effective prevention of cancer. (AU)