Abstract

Folate exists as functionally diverse species within cells. Although folate deficiency may contribute to DNA hypomethylation in colorectal cancer, findings on the association between total folate concentration and global DNA methylation have been inconsistent. This study determined global, LINE-1, and Alu DNA methylation in blood and colon of healthy and colorectal cancer patients and their relationship to folate distribution. Blood and normal mucosa from 112 colorectal cancer patients and 114 healthy people were analyzed for global DNA methylation and folate species distribution using liquid chromatography tandem mass spectrometry. Repeat element methylation was determined using end-specific PCR. Colorectal mucosa had lower global and repeat element DNA methylation compared with peripheral blood (P < 0.0001). After adjusting for age, sex and smoking history, global but not repeat element methylation was marginally higher in normal mucosa from colorectal cancer patients compared with healthy individuals. Colorectal mucosa from colorectal cancer subjects had lower 5-methyltetrahydrofolate and higher tetrahydrofolate and formyltetrahydrofolate levels than blood from the same individual. Blood folate levels should not be used as a surrogate for the levels in colorectal mucosa because there are marked differences in folate species distribution between the two tissues. Similarly, repeat element methylation is not a good surrogate measure of global DNA methylation in both blood and colonic mucosa. There was no evidence that mucosal global DNA methylation or folate distribution was related to the presence of cancer per se, suggesting that if abnormalities exist, they are confined to individual cells rather than the entire colon.

Highlights

  • IntroductionMathematical modeling [1] and in vivo studies [2] have shown that DNA methylation competes with DNA synthesis pathways for folate species

  • Folate is an important methyl donor and essential for DNA methylation

  • We have developed a biochemical assay based on liquid chromatography tandem mass spectrometry (LC-MS/MS), which accurately measures these individual folate species in diverse biologic samples, including colorectal mucosa [17]

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Summary

Introduction

Mathematical modeling [1] and in vivo studies [2] have shown that DNA methylation competes with DNA synthesis pathways for folate species. In proliferative tissues such as colorectal epithelium, adequate folate is important in maintaining normal 5-methylcytosine levels. It has been hypothesized that folate deficiency may contribute to colonic DNA hypomethylation and increased colorectal cancer risk [6]. This effect could occur within individual epithelial cells or through "field defects" generated within apparently normal colorectal mucosa [7]

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