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ISSN: 2157-7412
Journal of Genetic Syndromes & Gene Therapy

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Genetic Variability within ADA Gene and Endometrium Cancer

Gloria-Bottini F1*, Nicotra M2, Benedetti-Panici PL2, Pietropolli A1, Saccucci P1, Ambrosi S2, Bottini E1 and Magrini A1

1Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

2Department of Gynecologic, Obstetric and Urologic Sciences, University of Rome La Sapienza, Rome, Italy

*Corresponding Author:
Fulvia Gloria-Bottini
Department of Biomedicine and Prevention
University of Rome Tor Vergata
Via Montpellier, 100133 Rome, Italy
Tel: +39+6 30889514
E-mail: [email protected]

Received date: July 02, 2013; Accepted date:July 11, 2013; Published date: July 13, 2013

Citation: Gloria-Bottini F, Nicotra M, Benedetti-Panici PL, Pietropolli A, Saccucci P, et al. (2013) Genetic Variability within ADA Gene and Endometrium Cancer. J Genet Syndr Gene Ther 4:160. doi:10.4172/2157-7412.1000160

Copyright: © 2013 Gloria-Bottini F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Adenosine Deaminase (ADA) is a polymorphic enzyme that degrades irreversibly adenosine to inosine and
is present in cell cytoplasm and in interstitial fluid was it acts as ecto-ADA. Ecto-ADA shows also extra-enzymatic
activity acting as co- stimulatory molecule of adenosine receptors .Adenosine is a purine nucleoside that hasan
important role in cancer development.In solid tumors high level of this substance is determined by hypoxia resulting
in inhibition of T cell killer activation .
We have recently found an association between colon cancer and ADA genetic polymorphism. We studied three
polymorphic sites ADA1, ADA2 and ADA6 and found that ADA1 *2/ ADA2 *1 haplotype is more represented, while ADA1
*2/ ADA2 *2 is less represented in cancer than in controls. ADA2 *2/ ADA6 *2 is less represented in patients than in
controls. The present note reports a study in endometrium cancer.
We have studied 70 women with endometrium cancer from the White population of Rome.Data on 109 subjects
with colon cancer and on 246 blood donors reported in a previous paper are also shown.
The three polymorphisc sites of ADA gene (ADA1, ADA2 and ADA6) were analyzed. Genotypes were determined
by RFLP-PCR.
Statistical analyses were carried out by SPSS package. Haplotype frequencies are maximum likelihood
estimates.
No statistically significant difference is observed in the distribution of ADA haplotypes between the two cancers.
In both cancers ADA1 *2/ ADA2 *1 haplotype is more represented while ADA1 *2/ ADA2 *2 is less represented than
in controls. ADA2 *2/ ADA6 *2 haplotype is less represented in both cancers than in controls. A border line difference
between the two classes of cancers is observed in the distribution of ADA1/ADA6 haplotypes.
The present study was suggested by the following: i) High levels of adenosine in cancer inhibits T cell killer
activation, ii) ADA contributes to control level of adenosine, iii) Polymorphic sites of ADA may influence extraenzymatic
function of ecto-ADA. Our data confirm the association observed between ADA and colon cancer making
unlikely the possibility of a mere sampling chance artifact and suggest that genetic polymorphisms within the ADA
gene may have an important role in susceptibility to cancer.

Keywords

Cancer genetics; ADA gene; Endometrium cancer

Introduction

Adenosine is a purine nucleoside that hasan important role in cancerdevelopment of. High level of adenosine is determined by hypoxia in solid tumors resulting in inhibition of T cell killer activation [1]. The intra and extra cellular concentration (about 100 nM) of adenosine is controlled by adenosine deaminase (ADA) and adenosine kinase activities.

Adenosine deaminase (ADA) is a polymorphic enzyme that degrades irreversibly adenosine to inosine and is present in cell cytoplasm and in interstitial fluid was it acts as ecto-ADA. Ecto-ADA shows also extra-enzymatic activity acting as co- stimulatory molecule of adenosine receptors [2]. The polymorphism of ADA was discovered by Spencer et al. [3] and is due to the presence of two codominant alleles ADA1*1 and ADA1*2 at an autosomal locus. Correspondingly there are three phenotypes ADA11, ADA121, ADA12 with enzymatic activity decreasing in the order ADA11>ADA121>ADA12.

With the introduction of DNA analysis the structure of ADA gene (chromosome 20) has been elucidated and several intragenic single nucleotide polymorphism have been found [4]. The polymorphism associated to functional variation discovered by Spencer et al. is due to G>A transition at nt 40-52 (exon 1). The role of this extensive variability within the ADA gene has not been yet elucidated. Both enzymatic and extra-enzymatic activities could be influenced by this variability with important effect on susceptibility and clinical course of diseases.

We have recently found an association between colon cancer and ADA genetic polymorphism [5]. We studied three polymorphic sites ADA1, ADA2 and ADA6. The three polymorphic sites spanning approximately 28 Kb can be genotyped using known RFLP-PCR protocols based on the presence/absence of a Taq I site (ADA1) (nt 4050- 4053, exon 1), a Pst I site (ADA2) (nt 19465-19470, intron 2), and a Mlu NI site (ADA6) (nt 31230-31235, exon 6) respectively. Only the ADA1 site at exon 1 leads to a functional variation, as the G>A transition at nt 4052 results both in the loss of the Taq I site (TCGA/TCAA) and in the substitution of asparagine for aspartic acid at codon 8. The Asp8/Asn mutation is the molecular genetic basis for the common biochemical polymorphism at the ADA1 locus reported by Spencer et al. [3].

In colon cancer we have analyzed ADA haplotypes and found that ADA1 *2/ ADA2 *1 haplotype is more represented, while ADA1 *2/ ADA2 *2 is less represented than in controls. ADA2 *2/ ADA6 *2 is less represented in patients than in controls [1]. The present note reports a study in endometrium cancer that confirms the association observed in colon cancer.

Materials and Methods

Subjects

We have studied 70 women with endometrium cancer from the White population of Rome. Clinical and demographic characteristics are described in Table 1. Verbal informed consent was obtained from these women to participate to the study that was approved by I.R.B. Data on 109 subjects with colon cancer and on 246 blood donors reported in a previous paper [5] are also shown.

Determination of ADA genotypes

Three polymorphisc sites of ADA gene: ADA1, ADA2 and ADA6 were analyzed. Genotypes were determined by RFLP-PCR as previously described [5]. Genomic DNA was extracted from venous blood samples collected in NaEDTA. PCR amplification was carried out as described by Hirschhorn et al. [4] with slight modifications. Briefly, the PCR volume was 25 µl containing 100 ng of DNA, 1.5 mM MgCl2 , 2,5x reaction buffer, 10 pmols of each primer, 50 mM each dNTP, 2 U of Supertherm DNA polymerase (LPI FISCHER). Thirty cycles (1 min. at 95°C, 1 min and 30 sec. at 65°C, 2 min. at 72°C) were performed using a DNA Thermal Cycler (Perkin Elmer). Sense and antisense primers for the Taq I polymorphism (ADA1) was respectively:

5’- ACCGAGCCGGCAGAGACCCAC-3’

5’-ACTTGACAGACAGCGAAACTGAGACCCAGA-3’

Sense and antisense primers for the Pst I polymorphism (ADA2 ) were respectively:

5’- GAGCACAAGCTTTGGAATTGGGCTTGGGTT-3’

5’- ACACCAGGAGGACAAGACTCAGAGGCCCAGAA-3’

Sense and antisense primers for the MluNI polymorphism (ADA6) were respectively:

5’- CATAGCAGTTAGGATTTGAAGACACTGAGCCC-3’

5’- AGGAGACACCATGGTCCCTGGTTCTTGTGAT.

7 µl of each reaction was digested with 2U of the specific enzyme according to manufacturer’s instructions. Each digestion was resolved on 3% agarose gel in TAE (Tris/acetate/EDTA) buffer pH 8.0. Following electrophoresis, the gel was stained with ethidium bromide and the fragments were visualized by U.V.

The alleles corresponding to the presence (+) and absence (-) of the restriction sites have been signed as allele *1 and as allele *2 respectively. Figures 1-6 show a representative RFLP-PCR picture of the polymorphic sites studied.

Statistical analysis

Statistical analyses were carried out by SPSS package [6,7]. Haplotype frequencies are maximum likelihood estimates (MENDEL program, Dept. of Biostatistics, University of Michigan, Ann Harbor, MI).

Variable Proportion (%) Mean ± S.E.
Pregnancies 78.8%  
Abortions 52.9%  
Smoking 23.5%  
Age (years)   61.7 ± 1.09
Menopause (years)   49.9 ±1.15
BMI   28.65 ± 0.63
Duration of menstrual cycle   29.18 ± 0.18

Table 1: Clinical and demographic data on patients with endometrial cancer.

genetic-syndromes-gene-therapy-fragment-amplification

Figure 1: Amplification by PCR from genomic DNA of exons 1 of ADA gene. The fragment of amplification in all subjects is 365 bp.

genetic-syndromes-gene-therapy-fourth-twelfth

Figure 2:Fragments of amplified ADA1 after digestion with Taq I. Are visible from left to right, respectively, fourth, twelfth and seventeenth line, three heterozygotes ADA1 1-2, others are homozygous ADA1 1-1. In this picture there isnât the homozygous ADA1 2-2. The dimension of bands is 365 bp, 278 bp and 78 bp but the latter is not visible.

genetic-syndromes-gene-therapy-fragment-amplification

Figure 3:Amplification by PCR from genomic DNA of intron 2 of ADA gene. The fragment of amplification in all subjects is 690 bp.

genetic-syndromes-gene-therapy-three-subjects

Figure 4:Fragments of amplified ADA2 after digestion with Pst I. Are visible from left to right, respectively, three subjects ADA2 2-2, ADA2 1-2 and ADA2 1-1. The dimension of bands is 690 bp, 635 bp and 65 bp but the latter is not visible.

genetic-syndromes-gene-therapy-all-subjects

Figure 5:Amplification by PCR from genomic DNA of intron 6 of ADA gene. The fragment ofamplification in all subjects is 371 bp.

genetic-syndromes-gene-therapy-dimension-bands

Figure 6:Fragments of amplified ADA6 after digestion with Mlu NI. Are visible from left to right, respectively, three subjects ADA6 1-2, ADA6 2-2 and ADA6 1-1. The dimension of bands is 371 bp, 196 bp and 175 bp.

Results

Table 1 shows demographic and clinical characteristics of the sample study. There is a tendency of overweight and a moderate propensity to smoking in women with endometrium cancer.

Table 2 shows the distribution of ADA alleles in patients with cancer and in controls. In all ADA sites no statistically significant difference is observed between colon and endometrium cancer. No difference is observed in ADA1 site between cancers and controls. ADA*2 allele of ADA2 site is less represented in cancers than in controls (p=0.053), while ADA*1 allele of ADA6 site is more represented in cases that in controls (p=0.043).

Table 3 shows the distribution of ADA haplotypes in cancer and in controls. No statistically significant difference is observed in the distribution of ADA1-ADA2 and ADA2-ADA6 haplotypes between the two cancers. In both cancers ADA1 *2/ ADA2 *1 haplotype is more represented than in controls (p=0.03, O.R. 2.25; 95% C.I. 1.07-4.80). On the contrary, in both cancers ADA1 *2/ ADA2 *2 haplotype is less represented than in controls (p=0.024, O.R. 0.26; 95% C.I. 0.072- 0.868). ADA2 *2/ ADA6 *2 haplotype is less represented in both cancers than in controls (p=0.013, O.R. 0.56; 95% C.I. 0.354-0.891). A border line difference between the two classes of cancers is observed in the distribution of ADA1/ADA6 haplotypes (p=0.062).

Discussion

The present observation confirms the association observed between ADA and colon cancer making unlikely the possibility of a mere sampling chance artifact.

The rationale of the present observation was suggested by: i) High levels of adenosine in cancer inhibits T cell killer activation, ii) ADA contributes to control level of adenosine, iii) Polymorphic sites of ADA may influence extra-enzymatic function of ecto-ADA.

ADA2 is an intronic polymorphism and ADA6 is a synonymous substitution so these alterations do not change the protein sequence, but could influence its tissue-specific expression in various cells. Moreover, these sites may not be causal but only markers of DNA sequences responsible for the observed associations.

The degradation of extracellular adenosine could contribute to make killer T cell resistant to inhibitory effect of adenosine. Polymorphic sites of ADA could be involved in the susceptibility to cancer influencing ADA activity and in turn adenosine concentration. A role of genetic variability of ADA gene in the control of activity as ecto-enzyme is also possible: polymorphic sites of ADA gene could influence amino acid sequences involved in the binding of ecto-ADA on the surface of the cell with important effect on susceptibility to cancer. The immune suppressive activity of adenosine represents an impediment to immunotherapy, therefore, an increased activity of ecto-ADA could have protective effect against cancer development and evolution. More extensive studies on the relationship between ADA gene variability and cancer are warranted.

    Endometrium cancer Colon cancer Controls
Loci Alleles % Proportion % Proportion % Proportion
ADA1
  *1
*2
Total n°
88
12
138
92
8
218
89
11
492
ADA2
  *1
*2
Total n°
76
24
136
78
22
206
71
29
492
ADA6
  *1
*2
Total n°
22
78
140
25
75
198
18
82
490

Table 2: Distribution of ADA alleles in patients with endometrial cancer in patients with colon cancer and in controls.

Loci  (Haplotypes) Haplotypes  % proportion Total n°
*1/*1 *1/*2 *2/*1 *2/*2
ADA1/ADA2 Colon cancer 71.7% 20.7% 7.1% 0.5% 198
Endometrium cancer 66.4% 21.4% 10.1% 2.1% 132
Controls 69.7% 22.0% 3.9% 4.3% 316
  Chi square test of independence                    χ2         df         p
Colon cancer vs endometrium cancer       3.088        3        0.378
ODDS RATIO ANALYSIS         
*2/*1 vs other haplotypes/all patients vs controls    OR=2.25  95% CI  1.07-4.80   (p=0.030)
*2/*2 vs other haplotypes/all patients vs controls    OR=0.26  95% CI  0.072-0.868 (p=0.024)
ADA1/ADA6 Colon cancer 20.0% 72.6% 4.7% 2.7% 190
Endometrium cancer 19.5% 68.7% 2.6% 9.2% 136
Controls 17.1% 74.2% 3.4% 5.2% 312
  Chi square test of independence       χ2         df             p
Colon cancer vs endometrium cancer   
All haplotypes                               7.346        3        0.062
ADA2/ADA6 Colon cancer 18.9% 63.5% 7.0% 10.6% 176
Endometrium cancer 13.3% 62.8% 7.6% 16.3% 134
Controls 14.0% 58.3% 6.4% 21.5% 272
  Chi square test of independence                    χ2             df              p
Colon cancer vs endometrium cancer        3.181              3        0.364
ODDS RATIO ANALYSIS  
*2/*2 vs other haplotypes/all patients vs controls   OR=0.56  95% CI  0.354-0.891(p=0.013)

Table 3: Distribution of ADA haplotypes in patients and controls.

A limitation of the present study is represented by the small number of women with endometrium cancer studied.

References


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