Abstract
Association of angiotensin converting enzyme (ACE) gene polymorphisms with lung cancer susceptibility remains uncertain and varies with ethnicity. Northeast India represents a geographically, culturally, and ethnically isolated population. The area reports an especially high rate of tobacco usage in a variety of ways of consumption, compared with the rest of the Indian population. We conducted a population based case control study in two major high risk region for lung cancer from Northeast India. A total of 151 consecutive lung cancer cases diagnosed histopathologically and equal numbers of controls were recruited with record of relevant sociodemographic information. Blood samples were collected and processed to identify ACE gene polymorphism. Significantly higher (40.4 % vs 29.1%, OR=1.97, CI=1.04-3.72; p=0.037) prevalence of the ACE II genotype was observed among lung cancer cases. Smoking was significantly associated with increased risk of lung cancer (OR=1.70, CI=1.02-2.81; p=0.041). An enhanced risk was also observed for interaction of ACE II genotype with tobacco smoking (OR=4.09, CI=1.51-11.05; p=0.005) and chewing (OR=3.68, CI=1.22-11.13; p=0.021). The present study indicates significant association s of the ACE II genotype with lung cancer in high risk Northeast India.
Highlights
Polymorphisms of gene encoding Angiotensin Converting Enzyme (ACE) and the risk of development of lung cancer have gained special attention in current years (Nacak et al, 2010)
Significantly higher (40.4 % vs 29.1%, OR=1.97, CI=1.04-3.72; p=0.037) prevalence of the angiotensin converting enzyme (ACE) insertion homozygous (II) genotype was observed among lung cancer cases
An enhanced risk was observed for interaction of ACE II genotype with tobacco smoking (OR=4.09, CI=1.51-11.05; p=0.005) and chewing (OR=3.68, CI=1.22-11.13; p=0.021)
Summary
Polymorphisms of gene encoding Angiotensin Converting Enzyme (ACE) and the risk of development of lung cancer have gained special attention in current years (Nacak et al, 2010). ACE is a membrane-bound dipeptidyl carboxypeptidase enzyme of the renin angiotensin system (RAS) (Goto et al, 2005) It acts as an important regulator of blood pressure and cardiovascular homeostasis by converting angiotensin I into the potent vasoconstrictor angiotensin II and inactivating the known vasodilator bradykinin (BK) (van der Knaap et al, 2008; Pei and Li, 2012). Population based cancer registries in India revealed a high incidence of lung cancer in Mizoram, North East India (AAR -28.3 per 100,000 in males and AAR -28.7 per 100,000 in females) (NCRP, 2013). Considering the extensive role of ACE in the pathogenesis of cancers and a very high incidence of lung cancer in North East, the present study was conducted to explore the association of ACE polymorphisms and its interaction with tobacco smoking and chewing and risk of lung cancer
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