1 401 153 ANALYSIS OF ABERRANT METHYLATION ON PROMOTER SEQUENCES OF TUMOR SUPPRESSOR GENES AND TOTAL DNA IN SPUTUM SAMPLES: A PROMISING TOOL FOR EARLY DETECTION OF COPD AND LUNG CANCER IN SMOKERS. BACKGROUND: CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS A DISORDER ASSOCIATED TO CIGARETTE SMOKE AND LUNG CANCER (LC). SINCE EPIGENETIC CHANGES IN ONCOGENES AND TUMOR SUPPRESSOR GENES (TSGS) ARE CLEARLY IMPORTANT IN THE DEVELOPMENT OF LC. IN THIS STUDY, WE HYPOTHESIZE THAT TOBACCO SMOKERS ARE SUSCEPTIBLE FOR METHYLATION IN THE PROMOTER REGION OF TSGS IN AIRWAY EPITHELIAL CELLS WHEN COMPARED WITH NON-SMOKER SUBJECTS. THE PURPOSE OF THIS STUDY WAS TO INVESTIGATE THE USEFULNESS OF DETECTION OF GENES PROMOTER METHYLATION IN SPUTUM SPECIMENS, AS A COMPLEMENTARY TOOL TO IDENTIFY LC BIOMARKERS AMONG SMOKERS WITH EARLY COPD. METHODS: WE DETERMINED THE AMOUNT OF DNA IN INDUCED SPUTUM FROM PATIENTS WITH COPD (N = 23), LC (N = 26), AS WELL AS IN HEALTHY SUBJECTS (CTR) (N = 33), USING A COMMERCIAL KIT FOR DNA PURIFICATION, FOLLOWED BY ABSORBANCE MEASUREMENT AT 260 NM. THE FREQUENCY OF CDKN2A, CDH1 AND MGMT PROMOTER METHYLATION IN THE SAME GROUPS WAS DETERMINED BY METHYLATION-SPECIFIC POLYMERASE CHAIN REACTION (MSP). THE FISHER'S EXACT TEST WAS EMPLOYED TO COMPARE FREQUENCY OF RESULTS BETWEEN DIFFERENT GROUPS. RESULTS: DNA CONCENTRATION WAS 7.4 AND 5.8 TIMES HIGHER IN LC AND COPD COMPARED TO THE (CTR) (P < 0.0001), RESPECTIVELY. METHYLATION STATUS OF CDKN2A AND MGMT WAS SIGNIFICANTLY HIGHER IN COPD AND LC PATIENTS COMPARED WITH CTR GROUP (P < 0.0001). FREQUENCY OF CDH1 METHYLATION ONLY SHOWED A STATISTICALLY SIGNIFICANT DIFFERENCE BETWEEN LC PATIENTS AND CTR GROUP (P < 0.05). CONCLUSIONS: WE PROVIDE EVIDENCE THAT ABERRANT METHYLATION OF TSGS IN SAMPLES OF INDUCED SPUTUM IS A USEFUL TOOL FOR EARLY DIAGNOSTIC OF LUNG DISEASES (LC AND COPD) IN SMOKER SUBJECTS. VIRTUAL SLIDES: THE ABSTRACT MUST FINISH WITH THE FOLLOWING TEXT: VIRTUAL SLIDES THE VIRTUAL SLIDE(S) FOR THIS ARTICLE CAN BE FOUND HERE: HTTP://WWW.DIAGNOSTICPATHOLOGY.DIAGNOMX.EU/VS/1127865005664160. 2012 2 1431 44 DIFFERENTIAL FREQUENCIES OF P16(INK4A) PROMOTER HYPERMETHYLATION, P53 MUTATION, AND K-RAS MUTATION IN EXFOLIATIVE MATERIAL MARK THE DEVELOPMENT OF LUNG CANCER IN SYMPTOMATIC CHRONIC SMOKERS. PURPOSE: THE AIM OF THIS STUDY WAS TO INVESTIGATE THE FREQUENCY OF THREE (EPI)GENETIC ALTERATIONS (P53 AND K-RAS MUTATIONS AND P16(INK4A) PROMOTER HYPERMETHYLATION) IN SYMPTOMATIC CHRONIC SMOKERS COMPARED WITH PATIENTS WITH LUNG CANCER AND TO EVALUATE THE USE OF EXFOLIATIVE MATERIAL FOR SUCH ANALYSES. PATIENTS AND METHODS: FIFTY-ONE PATIENTS WITH HISTOLOGICALLY CONFIRMED LUNG CANCER AND 25 CHRONIC SMOKERS (> 20 PACK-YEARS) WERE INVESTIGATED FOR MUTATIONS IN THE K-RAS (CODON 12) AND P53 (CODONS 248, 249, AND 273) GENES AND FOR ALLELIC HYPERMETHYLATION OF THE P16(INK4A) GENE. DNA WAS ISOLATED FROM SPUTUM AND BILATERAL BRONCHIAL LAVAGE, AND BRUSHINGS WERE TAKEN AT BRONCHOSCOPY. RESULTS: FORTY-ONE GENETIC LESIONS WERE DETECTED WITHIN EXFOLIATIVE MATERIAL FROM THE GROUP OF 51 PATIENTS WITH LUNG CANCER AND 10 LESIONS IN THE CHRONIC SMOKER GROUP. K-RAS MUTATIONS OCCURRED EXCLUSIVELY IN THE LUNG CANCER GROUP, WHEREAS P53 MUTATIONS AND P16(INK4A) PROMOTER HYPERMETHYLATION WERE ALSO FOUND IN CHRONIC SMOKERS. THREE OF EIGHT CHRONIC SMOKERS WHO HARBORED AN (EPI)GENETIC ALTERATION WERE SUBSEQUENTLY DIAGNOSED WITH LUNG CANCER. ANALYSIS OF SPUTUM YIELDED INFORMATION EQUIVALENT TO THAT OF SAMPLES OBTAINED DURING BRONCHOSCOPY. CONCLUSION: P16(INK4A) PROMOTER HYPERMETHYLATION AND P53 MUTATIONS CAN OCCUR IN CHRONIC SMOKERS BEFORE ANY CLINICAL EVIDENCE OF NEOPLASIA AND MAY BE INDICATIVE OF AN INCREASED RISK OF DEVELOPING LUNG CANCER OR OF EARLY DISEASE. K-RAS MUTATIONS OCCUR EXCLUSIVELY IN THE PRESENCE OF CLINICALLY DETECTABLE NEOPLASTIC TRANSFORMATION. MOLECULAR ANALYSIS OF SPUTUM FOR SUCH MARKERS MAY PROVIDE AN EFFECTIVE MEANS OF SCREENING CHRONIC SMOKERS TO ENABLE EARLIER DETECTION AND THERAPEUTIC INTERVENTION OF LUNG CANCER. 2000 3 6314 39 THE RELATIONSHIP BETWEEN THE EPIGENETIC AGING BIOMARKER "GRIMAGE" AND LUNG FUNCTION IN BOTH THE AIRWAY AND BLOOD OF PEOPLE LIVING WITH HIV: AN OBSERVATIONAL COHORT STUDY. BACKGROUND: AGE-RELATED COMORBIDITIES SUCH AS CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARE COMMON IN PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (PLWH). WE INVESTIGATED THE RELATIONSHIP BETWEEN COPD AND THE EPIGENETIC AGE OF THE AIRWAY EPITHELIUM AND PERIPHERAL BLOOD OF PLWH. METHODS: AIRWAY EPITHELIAL BRUSHINGS FROM 34 PLWH ENROLLED IN THE ST. PAUL'S HOSPITAL HIV BRONCHOSCOPY COHORT AND PERIPHERAL BLOOD FROM 378 PLWH ENROLLED IN THE STRATEGIC TIMING OF ANTIRETROVIRAL TREATMENT (START) STUDY WERE PROFILED FOR DNA METHYLATION. THE DNA METHYLATION BIOMARKER OF AGE AND HEALTHSPAN, GRIMAGE, WAS CALCULATED IN BOTH TISSUE COMPARTMENTS. WE TESTED THE ASSOCIATION OF GRIMAGE WITH COPD IN THE AIRWAY EPITHELIUM AND AIRFLOW OBSTRUCTION AS DEFINED BY AN FEV(1)/FVC<0.70, AND FEV(1) DECLINE OVER 6 YEARS IN BLOOD. FINDINGS: THE AIRWAY EPITHELIUM OF PLWH WITH COPD WAS ASSOCIATED WITH GREATER GRIMAGE RESIDUALS COMPARED TO PLWH WITHOUT COPD (BETA=3.18, 95%CI=1.06-5.31, P=0.005). IN BLOOD, FEV(1)/FVC50 PACK-YEARS, P<0.001) AND DIFFERED AMONG MALE AND FEMALE DISEASE-FREE SMOKERS. IN SUMMARY, P16 METHYLATION IS VERY FREQUENT AMONG NON-SMALL CELL LUNG CARCINOMA PATIENTS, AND CORRELATES WITH HEAVY CIGARETTE CONSUMPTION ONLY IN DISEASE-FREE SMOKERS. 2007 8 2018 50 EPIGENETIC CHANGE (GATA-4 GENE METHYLATION) IS ASSOCIATED WITH HEALTH STATUS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE. GENE METHYLATION IS AN EPIGENETIC CHANGE THAT INVOLVES A HERITABLE MODIFICATION OF CHROMATIN STRUCTURE THAT ALTERS GENE EXPRESSION WITHOUT A CHANGE IN DNA SEQUENCE. IT HAS PREVIOUSLY BEEN SHOWN THAT METHYLATION OF THE GATA-4 GENE PROMOTER REGION IN SPUTUM DNA IS ASSOCIATED WITH LOW LUNG FUNCTION AND INCREASED ODDS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AMONG SMOKERS. GIVEN THESE FINDINGS, WE HYPOTHESIZED THAT GATA-4 GENE METHYLATION IN SPUTUM DNA WOULD BE ASSOCIATED WITH LOW HEALTH STATUS, AS MEASURED BY THE ST. GEORGE'S RESPIRATORY QUESTIONNAIRE (SGRQ), IN SUBJECTS WITH COPD. SELF-REPORTED SGRQ, SPIROMETRY, AND INDUCED SPUTUM SAMPLES WERE OBTAINED FROM 168 COPD SUBJECTS FROM THE LOVELACE SMOKERS COHORT. GATA-4 GENE METHYLATION WAS EVALUATED IN SPUTUM DNA USING NESTED METHYLATION-SPECIFIC POLYMERASE CHAIN REACTION (PCR) ASSAYS. USING GENERAL LINEAR MODEL WITH POISSON REGRESSION, WE FOUND THAT GATA-4 GENE METHYLATION WAS SIGNIFICANTLY ASSOCIATED WITH OVERALL LOWER SGRQ HEALTH STATUS (PARAMETER ESTIMATE = .296, P < .001). THIS FINDING REMAINED SIGNIFICANT EVEN AFTER CONTROLLING FOR AGE, LUNG FUNCTION, AND OTHER COVARIATES. IN AN ADDITIONAL ANALYSIS USING LOGISTIC REGRESSION AND COMPARING EXTREME TERTILES OF OVERALL SGRQ SCORE, WE CONFIRMED THAT GATA-4 GENE METHYLATION WAS ASSOCIATED WITH A 3-FOLD INCREASE IN RISK OF POOR HEALTH STATUS (OR 2.95 AND P = .028). THE UNEXPLORED LINKS BETWEEN EPIGENETIC CHANGES AND PSYCHOSOCIAL FACTORS SUCH AS HEALTH STATUS ARE CRITICAL GAPS IN THE LITERATURE. THIS STUDY IS THE FIRST TO SUGGEST THAT AIRWAY GATA-4 GENE METHYLATION STATUS MAY INDEPENDENTLY PREDICT HEALTH STATUS IN INDIVIDUALS WITH COPD. 2015 9 672 39 BRAF, KRAS AND HELICOBACTER PYLORI EPIGENETIC CHANGES-ASSOCIATED CHRONIC GASTRITIS IN EGYPTIAN PATIENTS WITH AND WITHOUT GASTRIC CANCER. WE AIMED TO STUDY MLH1 AND MGMT METHYLATION STATUS IN HELICOBACTER PYLORI-ASSOCIATED CHRONIC GASTRITIS IN EGYPTIAN PATIENTS WITH AND WITHOUT GASTRIC CANCER. 39 PATIENTS WERE INCLUDED IN OUR STUDY. THEY WERE DIVIDED INTO 2 GROUPS; PATIENTS WITHOUT (GROUP I) AND WITH GASTRIC ADENOCARCINOMA (GROUP II). PATIENTS WERE SUBJECTED TO CLINICAL EXAMINATION, ABDOMINAL ULTRASOUND AND UPPER ENDOSCOPY FOR GASTRIC BIOPSY. BIOPSIES WERE SUBJECTED TO UREASE TEST, HISTOLOGICAL EXAMINATION, AND DNA PURIFICATION. H. PYLORI, BRAF, KRAS, MLH1 AND MGMT METHYLATION WERE ASSESSED BY QUANTITATIVE PCR. DNA SEQUENCING WAS PERFORMED TO ASSESS BRAF AND KRAS GENES MUTATION. QPCR OF H. PYLORI WAS SIGNIFICANTLY HIGHER IN PATIENTS WITH ADENOCARCINOMA (GROUP II) THAN THOSE WITHOUT ADENOCARCINOMA (GROUP I); WITH A P < 0.001 AS WELL AS IN PATIENTS WITH AGE ABOVE 50 YEARS WITH A P VALUE = 0.008. BY APPLYING LOGISTIC REGRESSION ANALYSIS IT WAS REPORTED THAT THE H. PYLORI QPCR IS A SIGNIFICANT PREDICTOR TO THE ADENOCARCINOMA WITH OR = 1.025 (95 % CI: 1. 002-1.048), WITH SENSITIVITY OF 90 % AND SPECIFICITY OF 100 %. ADENOCARCINOMA PATIENTS HAD A SIGNIFICANTLY HIGHER MEAN AGE AND LEVELS OF H. PYLORI, BRAF, K-RAS, METHYLATED MGMT AND METHYLATED MLH1 THAN THOSE OF GASTRITIS PATIENTS. DNA SEQUENCE ANALYSIS OF BRAF (CODON 12) AND KRAS (CODON 600) HAD GENES MUTATION IN GASTRIC ADENOCARCINOMA VERSUS CHRONIC GASTRITIS. CONCLUSION: H. PYLORI MAY CAUSE EPIGENETIC CHANGES PREDISPOSING THE PATIENTS TO CANCER STOMACH. ESTIMATION OF H. PYLORI BY QPCR CAN BE A GOOD PREDICTOR TO ADENOCARCINOMA. BRAF AND KRAS GENES MUTATION WERE REVELED IN GASTRITIS AND ADENOCARCINOMA PATIENTS. 2016 10 3497 59 IDENTIFICATION OF NOVEL EPIGENETIC ABNORMALITIES AS SPUTUM BIOMARKERS FOR LUNG CANCER RISK AMONG SMOKERS AND COPD PATIENTS. OBJECTIVES: SMOKING IS A COMMON RISK FACTOR FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND LUNG CANCER. ALTHOUGH COPD PATIENTS HAVE HIGHER RISK OF LUNG CANCER COMPARED TO NON-COPD SMOKERS, THE MOLECULAR LINKS BETWEEN THESE DISEASES ARE NOT WELL-DEFINED. THIS STUDY AIMS TO IDENTIFY GENES THAT ARE DOWNREGULATED BY CIGARETTE SMOKE AND COMMONLY REPRESSED IN COPD AND LUNG CANCER. MATERIALS AND METHODS: PRIMARY HUMAN AIRWAY EPITHELIAL CELLS (HAEC) WERE EXPOSED TO CIGARETTE-SMOKE-EXTRACT (CSE) FOR 10-WEEKS AND SIGNIFICANTLY SUPPRESSED GENES WERE IDENTIFIED BY TRANSCRIPTOME ARRAY. EPIGENETIC ABNORMALITIES OF THESE GENES IN LUNG ADENOCARCINOMA (LUAD) FROM PATIENTS WITH OR WITHOUT COPD WERE DETERMINED USING GENOME-WIDE AND GENE-SPECIFIC ASSAYS AND BY IN VITRO TREATMENT OF CELL LINES WITH TRICHOSTATIN-A OR 5-AZA-2-DEOXYCYTIDINE. RESULTS: THE TEN MOST COMMONLY DOWNREGULATED GENES FOLLOWING CHRONIC CSE EXPOSURE OF HAEC AND SHOW PROMOTER HYPERMETHYLATION IN LUAD WERE SELECTED. AMONG THESE, EXPRESSION OF CCNA1, SNCA, AND ZNF549 WAS SIGNIFICANTLY REDUCED IN LUNG TISSUES FROM COPD COMPARED WITH NON-COPD CASES WHILE EXPRESSION OF CCNA1 AND SNCA WAS FURTHER DOWNREGULATED IN TUMORS WITH COPD. THE PROMOTER REGIONS OF ALL THREE GENES WERE HYPERMETHYLATED IN LUAD BUT NOT NORMAL OR COPD LUNGS. THE REDUCED EXPRESSION AND ABERRANT PROMOTER HYPERMETHYLATION OF THESE GENES IN LUAD WERE INDEPENDENTLY VALIDATED USING DATA FROM THE CANCER GENOME ATLAS PROJECT. IMPORTANTLY, SNCA AND ZNF549 METHYLATION DETECTED IN SPUTUM DNA FROM LUAD (52% AND 38%) CASES WERE MORE PREVALENT COMPARED TO CANCER-FREE SMOKERS (26% AND 15%), RESPECTIVELY (P < 0.02). CONCLUSIONS: OUR DATA SHOW THAT SUPPRESSION OF CCNA1, SNCA, AND ZNF549 IN LUNG CANCER AND COPD OCCURS WITH OR WITHOUT PROMOTER HYPERMETHYLATION, RESPECTIVELY. DETECTING METHYLATION OF THESE AND PREVIOUSLY IDENTIFIED GENES IN SPUTUM OF CANCER-FREE SMOKERS MAY SERVE AS NON-INVASIVE BIOMARKERS FOR EARLY DETECTION OF LUNG CANCER AMONG HIGH RISK SMOKERS INCLUDING COPD PATIENTS. 2020 11 1550 37 DNA METHYLATION IS ASSOCIATED WITH AIRFLOW OBSTRUCTION IN PATIENTS LIVING WITH HIV. INTRODUCTION: PEOPLE LIVING WITH HIV (PLWH) SUFFER FROM AGE-RELATED COMORBIDITIES SUCH AS COPD. THE PROCESSES RESPONSIBLE FOR REDUCED LUNG FUNCTION IN PLWH ARE LARGELY UNKNOWN. WE PERFORMED AN EPIGENOME-WIDE ASSOCIATION STUDY TO INVESTIGATE WHETHER BLOOD DNA METHYLATION IS ASSOCIATED WITH IMPAIRED LUNG FUNCTION IN PLWH. METHODS: USING BLOOD DNA METHYLATION PROFILES FROM 161 PLWH, WE TESTED THE EFFECT OF METHYLATION ON FEV(1), FEV(1)/FVC RATIO AND FEV(1) DECLINE OVER A MEDIAN OF 5 YEARS. WE EVALUATED THE GLOBAL METHYLATION OF PLWH WITH AIRFLOW OBSTRUCTION BY TESTING THE DIFFERENTIAL METHYLATION OF TRANSPOSABLE ELEMENTS ALU AND LINE-1, A WELL-DESCRIBED MARKER OF EPIGENETIC AGEING. RESULTS: AIRFLOW OBSTRUCTION AS DEFINED BY A FEV(1)/FVC<0.70 WAS ASSOCIATED WITH 1393 DIFFERENTIALLY METHYLATED POSITIONS (DMPS), WHILE 4676 WERE ASSOCIATED WITH AIRFLOW OBSTRUCTION BASED ON THE FEV(1)/FVC65 YEARS, BMP3, RASSF1A, BNC1, MESTV2, TFPI2, APC, SFRP1 AND SFRP2) WAS VALIDATED ALONE AND IN COMBINATION WITH SERUM CA 19-9 IN THIS EXTERNAL PATIENT COHORT. RESULTS: PATIENTS WITH PDAC HAD A HIGHER NUMBER OF HYPERMETHYLATED GENES (MEAN 8.11, 95% CI 7.70-8.52) THAN PATIENTS WITH CHRONIC PANCREATITIS (MEAN 5.60, 95% CI 4.42-6.78, P = 0.011). VALIDATION OF THE DIAGNOSTIC PREDICTION MODEL YIELDED AN AUC OF 0.77 (95% CI 0.69-0.84). THE COMBINATION OF SERUM CA 19-9 AND OUR TEST HAD AN AUC OF 0.93 (95% CI 0.89-0.96) IN THE PRIMARY STUDY AND 0.85 (95% CI 0.79-0.91) IN THE VALIDATION STUDY. CONCLUSION: IN THIS VALIDATION STUDY, PDAC WAS ASSOCIATED WITH A HIGHER NUMBER OF HYPERMETHYLATED GENES IN SERUM CFDNA THAN CHRONIC PANCREATITIS. OUR DIAGNOSTIC TEST WAS SUPERIOR TO THE PREDICTIVE VALUE OF SERUM CA 19-9 ALONE IN BOTH THE PRIMARY AND THE VALIDATION STUDY. THE COMBINATION OF OUR TEST WITH CA 19-9 MAY SERVE AS A CLINICALLY USEFUL DIAGNOSTIC BIOMARKER FOR PDAC. 2021