No description available.

The metabolism of vitamin D commences with exposure of the skin to sunlight. The growing recognition of its role in insulin resistance, autoimmune disorders, infections, cancer, as well as the health of cells that influence physical and mental function have profound implications on how we define vitamin D requirements and why we should care whether they are met or not. Most of the actions of vitamin D are mediated by the vitamin D receptor (VDR), a protein whose gene sequence can vary, giving rise to polymorphic forms which are potent enough to affect the binding capacity of this protein to vitamin D. Some of these polymorphic forms of VDR gene may be associated with reduced effectiveness of vitamin D and hence predispose individuals to diseases such as type 2 diabetes and insulin resistance. An earlier study, the Surya Study, looked at the responsiveness of the South-Asian women living in Auckland to vitamin D. The research described here is an extension of this study and its focus was to identify the associations/linkages between certain polymorphic forms of the VDR gene and the disease conditions and intervention responsiveness in the same women. The first objective was to compare two well known techniques for genotyping single nucleotide polymorphisms (SNPs) of the VDR gene at the 3’ end, namely BsmI, ApaI and TaqI: the newer real-time polymerase chain reaction (qPCR) and the traditional restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR) techniques. This comparison was performed to evaluate alternative methods for genotyping which consumed less time than RFLP-PCR. When the presence of each polymorphism by both the techniques was compared in this cohort of South-Asian women, it was found that RFLP-PCR proved to be a more reliable technique than qPCR for genotyping the VDR gene. Another objective of this project was to investigate the prevalence of the above three polymorphisms along with Cdx-2 and FokI SNPs which are present at the 5’ end of the VDR gene, in the population under study and their possible association with phenotypes such as vitamin D responsiveness and insulin resistance. These women were screened and biochemical data was collected during the earlier Surya Study. Of these, eighty-one women were then selected for intervention based on them having high insulin resistance (HOMA-IR>1.93) and serum 25(OH)D<50 nmol/L. Out of these eighty-one women, forty-two were given vitamin D supplement and thirty-nine were given a placebo for six months. Baseline and endpoint measurements included insulin resistance (HOMA-IR), insulin sensitivity (HOMA2%S) etc. How each individual responded to treatment in the intervention group was analysed in the context of the polymorphisms that they had. An association of insulin resistance with BsmI, ApaI and TaqI SNPs was observed in this cohort of 239 women. The response to insulin resistance in the vitamin D supplemented group significantly differed for FokI genotype compared to other genotypes. This explained why certain women responded to treatment better than the others. When the frequencies of the genotypes of these five SNPs of the VDR gene were compared to other studies of different ethnicities, the results of this study were consistent with few studies but contradictory to others. The possible reasons for these differences could be because of small sample size and different ethnicities under study due to which the frequency of alleles and hence the genotypes differed.

The metabolism of vitamin D commences with exposure of the skin to sunlight. The growing recognition of its role in insulin resistance, autoimmune disorders, infections, cancer, as well as the health of cells that influence physical and mental function have profound implications on how we define vitamin D requirements and why we should care whether they are met or not. Most of the actions of vitamin D are mediated by the vitamin D receptor (VDR), a protein whose gene sequence can vary, giving rise to polymorphic forms which are potent enough to affect the binding capacity of this protein to vitamin D. Some of these polymorphic forms of VDR gene may be associated with reduced effectiveness of vitamin D and hence predispose individuals to diseases such as type 2 diabetes and insulin resistance. An earlier study, the Surya Study, looked at the responsiveness of the South-Asian women living in Auckland to vitamin D. The research described here is an extension of this study and its focus was to identify the associations/linkages between certain polymorphic forms of the VDR gene and the disease conditions and intervention responsiveness in the same women. The first objective was to compare two well known techniques for genotyping single nucleotide polymorphisms (SNPs) of the VDR gene at the 3’ end, namely BsmI, ApaI and TaqI: the newer real-time polymerase chain reaction (qPCR) and the traditional restriction fragment length polymorphism polymerase chain reaction (RFLP-PCR) techniques. This comparison was performed to evaluate alternative methods for genotyping which consumed less time than RFLP-PCR. When the presence of each polymorphism by both the techniques was compared in this cohort of South-Asian women, it was found that RFLP-PCR proved to be a more reliable technique than qPCR for genotyping the VDR gene. Another objective of this project was to investigate the prevalence of the above three polymorphisms along with Cdx-2 and FokI SNPs which are present at the 5’ end of the VDR gene, in the population under study and their possible association with phenotypes such as vitamin D responsiveness and insulin resistance. These women were screened and biochemical data was collected during the earlier Surya Study. Of these, eighty-one women were then selected for intervention based on them having high insulin resistance (HOMA-IR>1.93) and serum 25(OH)D<50 nmol/L. Out of these eighty-one women, forty-two were given vitamin D supplement and thirty-nine were given a placebo for six months. Baseline and endpoint measurements included insulin resistance (HOMA-IR), insulin sensitivity (HOMA2%S) etc. How each individual responded to treatment in the intervention group was analysed in the context of the polymorphisms that they had. An association of insulin resistance with BsmI, ApaI and TaqI SNPs was observed in this cohort of 239 women. The response to insulin resistance in the vitamin D supplemented group significantly differed for FokI genotype compared to other genotypes. This explained why certain women responded to treatment better than the others. When the frequencies of the genotypes of these five SNPs of the VDR gene were compared to other studies of different ethnicities, the results of this study were consistent with few studies but contradictory to others. The possible reasons for these differences could be because of small sample size and different ethnicities under study due to which the frequency of alleles and hence the genotypes differed.

Vitamin D is central in calcium turnover, and adequate levels are important for skeletal health. It is not clear how large contributions from food and sunlight are in Swedish primary care patients, considering the low radiation of UVB in Sweden and fortification of some foods, and whether differences exist between patients of immigrant and Swedish origin. Increasing incidence of osteoporosis-related fractures is a major global health problem. Genetic variations in metabolising enzymes and in the Vitamin D receptor (VDR) have also been shown to be of importance to the overall effect of vitamin D. Polymorphic variation in the gene CYP2R1 encoding the 25-hydroxylase has previously been reported to correlate with circulating levels of 25(OH)D3. Results of association studies between genetic variants of the VDR and muscle strength, as well as falls have been contradictory. The purposes of this thesis were to examine possible differences in plasma-25(OH)D3 levels and intake of vitamin D between Swedish and immigrant female primary care patients, to estimate what foods contribute the most, and to identify contributors to vitamin D status (Paper I-II). Furthermore, the relationship between polymorphisms in the CYP2R1 gene and levels of 25(OH)D3 as well as other biochemical parameters (parathyroid hormone, calcium, phosphate and fibroblast growth factor 23) of skeletal homeostasis, bone mineral density and incidence of fractures was investigated (Paper III). Also, the association between genetic variations in the gene for the vitamin D receptor and measures of muscle strength, physical performance and falls (Paper IV), was investigated by using data from a Swedish multicenter study of elderly men (MrOS). Most important results: Vitamin D deficiency was common, with significant difference between Swedish born and immigrant patients (Paper I). Food intake of vitamin D is associated with circulating vitamin D, but the factors most strongly affecting vitamin D levels were reported sun holiday and origin (Paper II). CYP2R1 polymorphisms are associated with circulating levels of 25(OH)D3 and bone mineral density (Paper III). VDR genetic variants do not appear to have a direct effect on muscle strength or physical performance and incidence of falls in elderly Swedish men (Paper IV).

1,25-dihydroxyvitamin D3 (1,25VD), the active form of vitamin D (VD), suppresses the growth of numerous human cancer cell lines by inhibiting cell cycle progression and inducing cell death. Genes that mediate each of these activities remain largely unidentified and there are no preclinical data for 1,25VD analogues in ovarian cancer (OCa). We hypothesize that 1,25VD and its analogues inhibit the development of OCa. In this study, we demonstrated, (a) 1,25VD causes cell cycle arrest at the G1/S and G2/M transition and induces apoptosis in OCa cells. (b) We also found that gadd45 is one of primary target genes for 1,25VD-mediated G2/M arrest. A direct repeat 3 (DR3) vitamin D response element (VDRE) is identified in the fourth exon of gadd45. This exonic VDRE forms a complex with the vitamin D receptor (VDR)/retinoid X receptor (RXR) heterodimer in vitro and mediates the induction of reporter activity by 1,25VD in vivo. VDR is recruited in a ligand-dependent manner to the exonic enhancer but not to the gadd45 promoter regions. In OCa cells expressing GADD45 anti-sense cDNA or GADD45-null mouse embryo fibroblasts, 1,25VD fails to induce G2/M arrest, suggesting that G2/M arrest induced by 1,25VD is mediated through GADD45. Further study showed that GADD45 mediates the effect of 1,25VD by decreasing cdc2 kinase activity. (c) hTERT, the catalytic subunit of telomerase, is identified as a primary target for 1,25VD. 1,25VD decreases telomerase activity and hTERT mRNA expression. The down-regulation of hTERT mRNA is due to decreased mRNA stability by 1,25VD, rather than decreased transcription of hTERT through VDRE. Clones stably transfected with hTERT showed higher telomerase activity and longer telomere length than parental cells. Moreover, hTERT clones resist 1,25VD-induced apoptosis and growth inhibition. In contrast to parental cells which do not recover from prolonged treatment with 1,25VD, hTERT clones re-grew rapidly after 1,25VD withdrawal. (d) We demonstrated that the 1,25VD analogue EB1089 inhibits OCa cells in vitro and OCa xenograft in vivo without inducing hypercalcemia. We also demonstrated precursors for epithelial OCa express VDR and human primary ovarian surface epithelial cells respond to 1,25VD. Taken together, these results strongly suggest that 1,25VD analogues may be effective in the chemoprevention and chemotherapy of OCa.

<p>Correa, P. 2002. Vitamin D and its receptor in parathyroid tumors. Acta Universitatis Upsaliensis. Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1186. 49 pp. Uppsala. ISBN 91-554-541-0 </p><p>Hyperparathyroidism (HPT) is characterized by tumor development in the parathyroid glands and excessive production of parathyroid hormone. Parathyroidectomy is the only considered therapy for the majority of patients. </p><p>LOH (loss of heterozygosity) analysis revealed putative tumor suppressor genes on chromosome regions 1p and 11q in tumors from patients with truly mild hypercalcemia.</p><p>Active vitamin D [1,25(OH)2D3] and its receptors, the vitamin D receptor (VDR), are essential regulators of the calcium homeostasis and are involved in HPT development. The VDR-FokI polymorphism, coupled to bone mineral density, was found not to be associated to development of primary HPT (pHPT). The total VDR mRNA levels is reduced in adenomas of pHPT as well as in hyperplastic glands of secondary HPT (sHPT). The VDR exon 1f transcripts were exclusively downregulated in the adenomas of pHPT, suggesting default regulation of the tissue-specially expressed VDR 1f promoter. The cytochrome P450 enzymes responsible for synthesis and degradation of 1,25(OH)2D3, namely vitamin D3 25-hydroxylase (25-hydroxylase), 25-hydroxyvitamin D3 1a-hydroxylase (1a-hydroxylase) and 25-hydroxyvitamin D3 24-hydroxylase (24-hydroxylase) were found to be expressed in normal and pathological parathyroid glands. Tumors of pHPT and sHPT demonstrated increased 1a-hydroxylase and reduced 24- and 25-hydroxylase expression, suggesting an augmented local production of active vitamin D. In contrast, parathyroid carcinomas displayed reduced expression of all three hydroxylases. The gained knowledge of vitamin D metabolism and catabolism in parathyroid tumors may indicate possibilities for novel treatment of sHPT and perhaps pHPT.</p>

Correa, P. 2002. Vitamin D and its receptor in parathyroid tumors. Acta Universitatis Upsaliensis. Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1186. 49 pp. Uppsala. ISBN 91-554-541-0 Hyperparathyroidism (HPT) is characterized by tumor development in the parathyroid glands and excessive production of parathyroid hormone. Parathyroidectomy is the only considered therapy for the majority of patients. LOH (loss of heterozygosity) analysis revealed putative tumor suppressor genes on chromosome regions 1p and 11q in tumors from patients with truly mild hypercalcemia. Active vitamin D [1,25(OH)2D3] and its receptors, the vitamin D receptor (VDR), are essential regulators of the calcium homeostasis and are involved in HPT development. The VDR-FokI polymorphism, coupled to bone mineral density, was found not to be associated to development of primary HPT (pHPT). The total VDR mRNA levels is reduced in adenomas of pHPT as well as in hyperplastic glands of secondary HPT (sHPT). The VDR exon 1f transcripts were exclusively downregulated in the adenomas of pHPT, suggesting default regulation of the tissue-specially expressed VDR 1f promoter. The cytochrome P450 enzymes responsible for synthesis and degradation of 1,25(OH)2D3, namely vitamin D3 25-hydroxylase (25-hydroxylase), 25-hydroxyvitamin D3 1a-hydroxylase (1a-hydroxylase) and 25-hydroxyvitamin D3 24-hydroxylase (24-hydroxylase) were found to be expressed in normal and pathological parathyroid glands. Tumors of pHPT and sHPT demonstrated increased 1a-hydroxylase and reduced 24- and 25-hydroxylase expression, suggesting an augmented local production of active vitamin D. In contrast, parathyroid carcinomas displayed reduced expression of all three hydroxylases. The gained knowledge of vitamin D metabolism and catabolism in parathyroid tumors may indicate possibilities for novel treatment of sHPT and perhaps pHPT.

No description available.

No description available.

O melanoma é uma lesão maligna da pele, com alta taxa de mortalidade cuja incidência vem aumentando nos últimos anos. Os principais fatores de risco são a história familial da doença, presença de nevos benignos múltiplos ou nevos atípicos e melanoma prévio. Imunossupressão, sensibilidade ao sol e exposição intermitente e intensa à radiação UV da luz solar, sem proteção, são fatores de risco adicionais. O objetivo deste estudo caso-controle de base hospitalar foi avaliar a contribuição de polimorfismos de genes de metabolização de xenobióticos (CYP1A1/MspI, CYP2E1/PstI, GSTM1, GSTT1 e GSTP1/Bsma), de genes de reparo do DNA (XRCC1/MspI, XRCC3/NcoI e XPD/PstI) e do gene do receptor de vitamina D (VDR/FokI e VDR/TaqI) no risco de melanoma. Consentiram em participar 193 pacientes com melanoma (49,7% homens e 50,3% mulheres, média de 52 ± 14,28 anos) e 208 controles (51,4% homens e 48,6% mulheres, média de 48 ± 15,24 anos) que após responderem a um questionário detalhado sobre hábitos e tipos de exposição a fatores de risco cederam amostras biológicas para análsie do DNA por PCR-RFLP. Os principais fatores de risco para o melanoma foram ascendência européia (p<0,001), cor de olhos claros (p<0,001), presença de nevos (p<0,001), histórico de queimadura grave na adolescência (p<0,001), falta de filtro solar (p<0.034) e exposição à lâmpadas fluorescentes (p=0,001). Quanto à análise dos polimorfismos de genes de metabolização de xenobióticos somente o GSTT1 nulo revelou associação inversamente positiva com o risco de melanoma maligno (OR ajustado = 0,60; IC95% = 0,37-0,97). Entretanto, essa associação não se manteve após a análise de regressão múltipla escalonada. Os polimorfismos VDR/FokI e VDR/TaqI não modificaram a susceptibilidade ao melanoma maligno na comparação entre os grupos. Na análise conjunta do fenótipo-genótipo, indivíduos com olhos verdes e genótipo VDR/FokI polimórfico, apresentaram risco praticamente seis vezes maior de melanoma (OR ajustado = 5,93; IC95% = 1,49-23,59). A associação entre os polimorfismos em pelo menos um dos alelos dos genes de reparo do DNA, XRCC3/NcoI e XPD/PstI aumentou praticamente duas vezes o risco de melanoma tanto na análise estatística multivariada (OR ajustado = 1,84; IC95% = 1,08-3,14) quanto na regressão logística múltipla escalonada (OR ajustado = 2,32; IC95% = 1,01-5,36). Na interação genemeio ambiente a falta do uso de filtro solar dobrou o risco de melanoma em indivíduos com polimorfismo XPD/PstI (OR ajustado = 2,17; IC95% = 1,12- 4,17). A identificação de polimorfismos genéticos associados com doenças multifatorias como o caso do melanoma maligno devem ser estimuladas em nosso meio, principalmente por vivermos em um país tropical com alta incidência solar em praticamente todo seu território. A identificação de marcadores genéticos de susceptibilidade pode propiciar medidas precoces e eficazes de prevenção do câncer. / 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.