
LUNG CANCER AND PULMONARY TUBERCULOSIS -A COMPARATIVE POPULATION-GENETIC STUDY Pešut DP1,2,*, Marinkovic DM3 *Corresponding Author: Dragica P. Pešut, Institute of Lung Diseases and Tuberculosis, Research
and Epidemiology Department, Visegraska 26/20, 11000 Belgrade, Serbia; Tel.: +381-11-361-
5561; Fax: +381-11-268-1591; E-mail: dragica.pesut@gmail.com page: 45
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INTRODUCTION
Lung cancer (LC) is the most frequent type of cancer in men [1]. Despite therapeutic possibilities, this devastating disease remains the leading cause of cancer death in the world with more than 1.2 million new cases diagnosed every year [2]. Its etiology has been mentioned as an example of ecogenetics in oncology with tobacco smoking as the major risk factor [3]. Lung cancer is an etiologically complex disease in which multiple genes are involved in the pathogenesis via different pathways [4,5]. Some of the major susceptibility loci which influence LC risk have been localized [5-10]. Such susceptibility genes are of considerable scientific interest, but do not confer high enough risks to be clinically relevant [6].
Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis complex, was declared a global emergency in 1993 and is still a problem due to the increasing number of immune-deficient persons in the world and the development of multi-drug resistant TB [11,12]. It is estimated that one-third of the world population is infected with TB bacillus [11,12]. Often the antibodies present in the human organism are strong enough to prevent the establishment of the disease. Although a variety of studies have suggested that host genetic factors may be a key to determining susceptibility/ resistance to M. tuberculosis, those that have assessed variants of the natural resistance-associated macrophage protein 1 gene (NRAMP1) and their association with TB in humans have yielded conflicting results [13-19]. It is likely that NRAMP1 polymorphisms may be associated with progression to severe forms of pulmonary TB rather than with susceptibility to M. tuberculosis infection [18,19]. Recent findings suggest that persons carrying the monocyte chemo-attractant protein-1 (MCP-1) genotype GG produce high concentrations of MCP-1, which inhibits production of IL-12p40 in response to M. tuberculosis and increases the likelihood that M. tuberculosis infection will progress to active pulmonary TB [20]. Thus, despite the known infectious cause, the etiology of TB remains complex, and several host genes have been shown to contribute to the development of clinical disease [19,21,22]. Our previous population-genetic research indicated a possible role for a dominant factor influence in TB [17]. Although the molecular basis of genetic predisposition to pulmonary TB in adults remains largely elusive, a genome-wide linkage study provided direct molecular evidence that the genetic component involves at least one major locus with a dominant susceptibility allele [21]. Genes which are involved in susceptibility to TB include: 12q14, 2q35, 15q11-q13 (OMIM numbers 607948, 607949, 300259), and 8q12-q13 [23].
In population-genetic investigations, a great number of morpho-physiological characters serve as genetic markers. Individual variation is a phenomenon, which can easily be noticed when we carefully observe the same species of organisms. Thus, human populations vary in regard to face shape, skin pigmentation, height, hair color, blood types as well as functions and abilities. Some of these characters are expressed in a recessive or dominant type and are called qualitative traits [24]. Thus, blue eyes are a recessive trait, brown eyes are a dominant one, and inability to recognize the bitter taste of phenyl-thio-carbamide (PTC), left-handedness and fixed ear lobe are recessive traits. We applied this method to estimate the proportion of a variety of homozygous-recessive characters (HRCs) tests in two groups of patients with respiratory diseases and in a healthy control group.
We hypothesized that there is a difference in the population-genetic structure of LC patients, patients who develop active pulmonary TB and healthy controls. Our aims were a) to analyze and compare the population-genetic structure of these three groups using a number of qualitative morpho-physiological traits; b) to evaluate the degree of genetic homozygosity in these three groups according to the frequency of homozygous-recessive traits; c) to investigate the frequency of independent genetic determinants such as the ABO blood type in these three groups.
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