Plasma p53 protein and anti-p53 antibody expression in vinyl chloride monomer workers in Taiwan

Plastics and carcinogenesis: The example of vinyl chloride

The manufacture, use and disposal of various plastics can pose numerous health risks, including the risk of cancer. A model example of carcinogenic risk from plastics is provided by polyvinyl chloride, since it is composed of the known human carcinogen vinyl chloride (VC). In recent years, much has been learned about the molecular biological pathways of VC carcinogenesis. This has led to molecular epidemiologic studies of VC carcinogenesis in exposed human populations which have identified useful biomarkers of exposure, effect and susceptibility for VC. These studies have in turn provided the basis for new molecular approaches for the prevention and treatment of VC cancers. This model could have much wider applicability for many other carcinogenic exposures and many other human cancers.

Pollutant effects on genotoxic parameters and tumor-associated protein levels in adults: a cross sectional study

BACKGROUND

This study intended to investigate whether residence in areas polluted by heavy industry, waste incineration, a high density of traffic and housing or intensive use of pesticides, could contribute to the high incidence of cancer observed in Flanders.

METHODS

Subjects were 1583 residents aged 50-65 from 9 areas with different types of pollution. Cadmium, lead, p,p'-DDE, hexachlorobenzene, PCBs and dioxin-like activity (Calux test) were measured in blood, and cadmium, t,t'-muconic acid and 1-hydroxypyrene in urine. Effect biomarkers were prostate specific antigen, carcinoembryonic antigen and p53 protein serum levels, number of micronuclei per 1000 binucleated peripheral blood cells, DNA damage (comet assay) in peripheral blood cells and 8-hydroxy-deoxyguanosine in urine. Confounding factors were taken into account.

RESULTS

Overall significant differences between areas were found for carcinoembryonic antigen, micronuclei, 8-hydroxy-deoxyguanosine and DNA damage. Compared to a rural area with mainly fruit production, effect biomarkers were often significantly elevated around waste incinerators, in the cities of Antwerp and Ghent, in industrial areas and also in other rural areas. Within an industrial area DNA strand break levels were almost three times higher close to industrial installations than 5 kilometres upwind of the main industrial installations (p < 0.0001). Positive exposure-effect relationships were found for carcinoembryonic antigen (urinary cadmium, t,t'-muconic acid, 1-hydroxypyrene and blood lead), micronuclei (PCB118), DNA damage (PCB118) and 8-hydroxy-deoxyguanosine (t,t'-muconic acid, 1-hydroxypyrene). Also, we found significant associations between values of PSA above the p90 and higher values of urinary cadmium, between values of p53 above the p90 and higher serum levels of p,p'-DDE, hexachlorobenzene and marker PCBs (PCB 138, 153 and 180) and between serum levels of p,p'-DDE above the p90 and higher serum values of carcinoembryonic antigen. Significant associations were also found between effect biomarkers and occupational or lifestyle parameters.

CONCLUSION

Levels of internal exposure, and residence near waste incinerators, in cities, or close to important industries, but not in areas with intensive use of pesticides, showed positive correlations with biomarkers associated with carcinogenesis and thus probably contribute to risk of cancer. In some rural areas, the levels of these biomarkers were not lower than in the rest of Flanders.

Air pollution by carcinogenic PAHs and plasma levels of p53 and p21(WAF1) proteins

We analyzed the effect of exposure to carcinogenic polycyclic aromatic hydrocarbons (c-PAHs) in ambient air on the plasma levels of p53 and p21(WAF1) proteins among city policemen, bus drivers and controls in three European cities: Prague (Czech Republic), Kosice (Slovakia) and Sofia (Bulgaria). p53 and p21(WAF1) proteins are key regulators of the cell cycle and are accepted as universal markers of genotoxic stress and DNA damage. In total 204 exposed subjects (100 smokers, 104 nonsmokers) and 152 controls (54 smokers, 98 nonsmokers) were analyzed. Personal exposure to c-PAHs was evaluated using personal samplers during the working shift. The levels of p53 and p21(WAF1) proteins were assessed by ELISA assay. There were no differences between the levels of either protein between exposed and controls, or smokers and nonsmokers, in any city. However, we observed significant differences in p53 plasma levels in all subjects regardless of the exposure status between the individual cities (median values: 5, 31, 234pg/ml, p<0.001, for Prague, Kosice and Sofia, respectively). The levels correspond to the differences in exposure levels to c-PAHs and benzo[a]pyrene (B[a]P) in the individual cities. A multiple linear regression analysis confirmed that c-PAHs exposure is a variable significantly affecting levels of both proteins in all locations. When all subjects were divided into the group exposed to below-median levels of c-PAHs and the group exposed to above-median levels of c-PAHs we found significantly higher p53, as well as p21(WAF1) levels in the above-median exposure group (p53, 167pg/ml versus 25pg/ml, p<0.001; p21(WAF1), 2690pg/ml versus 2600pg/ml, p<0.05). Among all subjects p53 plasma levels were positively correlated with p21(WAF1) levels, exposure to B[a]P, c-PAHs and levels of total DNA adducts; for p21(WAF1) levels we observed the positive correlation with cotinine, c-PAHs exposure, total and B[a]P-like DNA adduct levels. In conclusion our results suggest that p53 and p21(WAF1) proteins plasma levels may be useful biomarkers of c-PAHs environmental exposure.

Differences in tumor-associated protein levels among middle-age Flemish women in association with area of residence and exposure to pollutants

We measured tumor-associated proteins (TAPs) and pollutants in blood, serum, and urine of 200 nonsmoking women 50-65 years of age, residing in the rural municipality of Peer or in Hoboken or Wilrijk, industrial suburbs of Antwerp, Belgium. Persons with occupational exposures or commuting to other towns were excluded. Residents from Hoboken had significantly higher levels of blood lead and serum zinc and polychlorinated biphenyls. Surprisingly, residents of Peer had significantly higher levels of serum cadmium, dioxin-like activity in blood fat, and urinary 1-hydroxypyrene. For 5 of the 12 TAPs assessed in this study, we observed significant differences in serum levels among residents of the three municipalities after adjusting for personal or lifestyle parameters. Although we found levels of internal exposure to pollutants to be quite homogeneous in Flanders, we found significantly higher levels of TAPs only in the industrial suburbs. In multiple regression with all 29 available personal, lifestyle, and internal exposure parameters, blood lead levels showed a positive association with serum levels of anti-p53, carcino-embryonic antigen (CEA), and tissue polypeptide-specific antigen (TPS) and with an index for mean TAP level (I(tap)); dioxin-like activity in serum and serum copper showed a positive association with serum CA 125 (cancer antigen 125); and serum zinc showed a positive association with serum levels of c-erbB-2 ectodomain and TPS. An index of internal exposure showed a positive association with serum levels of both CEA and anti-p53 and with I(tap). This study provides some evidence that levels of internal exposure such as those present in Flanders, in particular concerning lead, are indeed associated with biologic effects.

Plasma Mutant-p53 Protein and Anti-p53 Antibody as a Marker: An Experience in Vinyl Chloride Workers in Italy

OBJECTIVE

The objective of this study was to examine the presence of mutant-p53 protein (p53Ag) and antibodies to p53 protein (p53Ab) in a population of workers exposed to vinyl chloride (VC).

METHOD

We have investigated the presence of two cancer markers in the plasma of 151 subjects exposed to varying concentrations of VC (4-2823 ppm). The investigation took place in two sessions: in 1999, the analysis was limited to p53Ab, and in 2000, the analysis was repeated and extended to include also the mutant-p53Ag. The available information on the subjects in this study includes age, total years of employment in the VC polymerization industry, exposure concentration, results of abdominal ultrasonogram, hepatitis status, smoking and alcohol drinking status, and clinical records. Logistic regression analyses were performed to calculate the association between prevalence of positivity for p53Ab or mutant-p53Ag and cumulative VC exposure concentration after adjustment for confounding factors. t test and chi analyses were performed to test significant differences among groups.

RESULTS

Three (1.9%) of the 151 workers exposed to VC resulted seropositive for the mutant-p53Ag and five (3.3%) for the p53Ab. All seropositive subjects are distributed in the highest exposure classes (>1000 ppm). No seropositivity was found among controls. The stratified relationship between seropositivity and exposure appeared statistically significant (chi = 23.65 for mutant-p53Ag and 30.35 for p53Ab).

CONCLUSIONS

revealing its presence in subjects having a history of VC exposure greater than 1000 ppm. On the basis of this study, and the clinical experience of the authors, the presence of a minimum threshold for the carcinogenic effects of VC is hypothesized.

Comparison of p53 levels in lymphocytes and in blood plasma of nuclear power plant workers

p53 levels were assessed in lymphocytes and in blood plasma of workers from two Czech nuclear power plants (NPP): 114 subjects working in Temelin and 108 subjects working in Dukovany. Ionizing radiation (IR) exposure data were available for 64 and 59 subjects working in the monitored zones from the NPP in Temelin and Dukovany, respectively. The short-term doses of IR for these subjects were 0.01 and 0.12 mSv, and the long-term doses were 0.46 and 5.68 mSv, in the Temelin and Dukovany NPP, respectively. As a control group, 46 subjects living in Ceske Budejovice, a city nearby the Temelin NPP, were analyzed. The concentration of p53 in lymphocytes was significantly higher in workers from the monitored zone in the Dukovany NPP (median value 6.4 pg/microg protein, P <0.001) than in workers from the Temelin NPP (3.2 pg/microg) as well as in the control group (3.5 pg/microg). In contrast, plasma levels of p53 were comparable in the control group (median value 116 pg/ml plasma) and workers from the monitored zone of Dukovany NPP (102 pg/ml), but lower in workers from Temelin NPP (5 pg/ml). Other factors affecting p53 levels were studied. Smoking resulted in increased p53 lymphocyte levels. The effect of polymorphisms in metabolic and DNA repair genes on p53 levels was analyzed. The correlation was found between p53 levels in lymphocytes and p53 codon 72 polymorphism in subjects working in NPPs, but not in the control group. The results of measurement p53 levels in lymphocytes suggest that this biomarker could reflect the short-term as well as long-term effects of low doses IR. Its impact on human health should be further explored.

A common polymorphism in XRCC1 as a biomarker of susceptibility for chemically induced genetic damage

We have recently demonstrated a significant dose-response relationship between vinyl chloride exposure and mutant p53 biomarkers in humans. The aim of this study was to examine a common polymorphism in the DNA repair gene XRCC1 as a potential biomarker of susceptibility modifying this relationship, consistent with the known mechanism of production of p53 mutations via vinyl chloride-induced etheno-DNA adducts, which are repaired by XRCC1. A cohort of 211 French vinyl chloride workers were genotyped for the XRCC1 codon 399 polymorphism (CGG>CAG; Arg>Gln). Among the homozygous Arg-Arg individuals, 34% were biomarker positive compared with 47% in the heterozygous Arg-Gln individuals (adjusted odds ratio 1.73, 95% CI0.93-3.22) and 66% in the homozygous Gln-Gln individuals (adjusted odds ratio 3.95, 95% CI 1.68-9.28), with a significant trend for increasing Gln allele dosage (p=0.002). These preliminary results suggest that a common polymorphism in a DNA repair gene can be an important biomarker of susceptibility for chemically induced genetic damage.

TP53 mutations in workers exposed to occupational carcinogens

In some cases, evidence exists that exogenous carcinogenic exposures contribute to the mutation spectrum of the TP53 gene (p53) in human cancers. Although the clearest examples come from dietary and environmental sources, only a restricted number of papers have concentrated specifically on TP53 mutations in tumors from workers exposed to occupational carcinogens. In populations exposed to dietary aflatoxin B1 with liver cancer (AFB1) and ultraviolet (UV)-radiation with skin cancer, a single specific-looking TP53 mutation has been described in some of the tumors. Whether these fingerprints in the TP53 gene can be used to reveal an occupational etiology remains to be shown. In other cases, although differences in the TP53 mutation spectrum exist, they are more diffuse and difficult to interpret at this point. For instance, cigarette smoking seems to induce long-lasting molecular footprints in TP53. However, their use to rule out other occupational exposures as etiological factors in occupational cancers is still very questionable, especially due to the putative synergistic effects of cigarette smoke with other carcinogens. Although interesting implications of possible typical mutation spectra among cancers with other occupational etiologies exist, the data are scanty and await further development of TP53 mutation databases.

The influence of occupational exposure to PAHs on the blood plasma levels of p53 and p21WAF1 proteins

Polycyclic aromatic hydrocarbons (PAHs) are the main source of carcinogenic risk among coke-oven workers. p53 is a tumor suppressor protein that is induced after DNA damage. It regulates the transcription of genes responsible for cell cycle arrest and apoptosis. p21(WAF1) protein is a downstream effector of p53; it induces cell cycle arrest either in the G(1), S, or G(2) phases. It has been shown that carcinogenic PAHs are able to induce the expression of both p53 and p21(WAF1) proteins in vitro. The purpose of the present study was to evaluate the effect of occupational exposure to carcinogenic PAHs on the level of p53 and p21(WAF1) proteins in blood plasma. The exposed group consisted of 66 coke-oven workers (males, average age 41 years, 42% smokers, 58% nonsmokers); the control group consisted of 49 machine workers (males, average age 49 years, 51% smokers, 49% nonsmokers). No difference in the plasma levels of either p53 (using anti-p53 antibody identifying both the mutated and the wild-type form of the protein) or p21(WAF1) protein was found between the exposed and control groups. Smoking had no effect on the levels of either protein in any of the analyzed groups. After stratification of all the subjects into groups according to their exposure to carcinogenic PAHs, a significantly higher level of p53 was found in the group exposed to carcinogenic PAHs <1 microg/m(3) as compared with the group exposed to carcinogenic PAHs >1 microg/m(3). A similar trend was observed for p21(WAF1) protein, even if no correlation between the levels of both proteins was detected. In the overall study a negative correlation between the levels of p53 protein and personal exposure to carcinogenic PAHs was found. These results did not support the expected response. The use of p53 as well as p21(WAF1) protein plasma levels as biomarkers of carcinogenic PAHs exposure requires further studies.

An increased standardised mortality ratio for liver cancer among polyvinyl chloride workers in Taiwan

AIMS

To determine the standardised mortality ratio (SMR) corresponding to different causes of death in workers from polyvinyl chloride polymerisation factories in Taiwan.

METHODS

Retrospective cohort study of workers from six polyvinyl chloride polymerisation factories in Taiwan. A total of 3293 male workers who had been employed for at least one year during the period 1 January 1950 to 31 December 1992, and were alive on 1 January 1985 were included for analysis. Using data acquired from Taiwan's National Mortality Registry, it was found that 144 of these workers died during the period 1985-97. The follow up rate was 99% with a total number of person-years at risk of 40 557.

RESULTS

SMR for all causes of death was 0.78, indicating a possible "healthy worker" effect. The SMR for liver cancer decreased with increasing age of first exposure to vinyl chloride monomer. This association was more prominent for workers who were first employed in the industry prior to 1970 (SMR 4.82). Medical records indicated that most liver cancers in this study were hepatocellular carcinoma.

CONCLUSIONS

Polyvinyl chloride workers may experience a higher risk of developing liver cancer, particularly hepatocelluar carcinoma.

Acrylonitrile exposure: the effect on p53 and p21(WAF1) protein levels in the blood plasma of occupationally exposed workers and in vitro in human diploid lung fibroblasts

Acrylonitrile (ACN) is a compound widely used in the synthesis of a variety of organic products. It has been found that ACN is carcinogenic in rats, and some epidemiological studies also suggest a possible carcinogenic effect of ACN in humans. The aim of the present study was to assess the effect of ACN exposure on the expression of p53 and p21(WAF1) proteins in vitro as well as in vivo. In vitro ACN exposure of human lung fibroblasts resulted in the induction of both p53 and p21(WAF1) proteins. To evaluate the effect of ACN on the levels of p53 and p21(WAF1) proteins in the blood plasma of ACN-exposed workers, samples from 49 subjects (average age 44 years, 88% males, 12% females) exposed to ACN in the petrochemical industry (ACN concentration ranged from 0.05 to 0.3mg/m(3)) were analyzed. Subjects living in the same area (N=24, average age 43 years, 92% males, 8% females), but not working in the petrochemical industry were used as controls. No significant differences in either p53, or p21(WAF1) levels between the exposed and control groups were found. The expression of p53 was significantly higher in exposed non-smokers as compared with smokers (P=0.02). No effect of GSTM1 and GSTT1 genotypes on the expression of either protein was observed. Subjects with an EPHX high activity genotype had significantly higher p21(WAF1) expression as compared with genotypes with low or medium EPHX activity. We conclude that plasma levels of both proteins are not relevant biomarkers for occupational ACN exposure.

Expression of ras (p21) protein in plasma from exposed workers and from patients with lung disease

Oncogenes are involved with the regulation of cellular proliferation and thus could be important in the development of many cancers. Cells transformed in culture by ras genes can be activated either by the introduction of specific point mutations or by overexpression of the normal proto-oncogene. The ras genes encode a protein of 189 amino acids (molecular mass 21 kDa) designated as p21. ras p21 proteins are contained in all eukaryotic cells on the inner surface of the plasma membrane. We measured ras p21 proteins in lung cancer patients, patients with chronic obstructive pulmonary disease (COPD) and workers exposed to emissions from petrochemical plants and 1,3-butadiene and 1,3-butadiene/styrene. Proteins were separated by gel electrophoresis, transferred to a nitrocellulose membrane by Western blotting and detected by chemiluminescence. A monoclonal pan-ras antibody was used as the primary antibody. Optical densities of the peak area of the protein bands were calculated and values which were two standard deviations above negative control means were considered positive. Many of the cancer patients and some of the COPD patients gave positive responses, whilst exposed worker groups did not show statistically significant increases by comparison with the controls. Thus, an increase in ras oncoproteins could be a biomarker for cancer or the disease state in general, but it cannot be ruled out that it is a biomarker for exposure since many of the individuals examined were smokers exposed to cigarette smoke.