Guanine Repeats Research Articles

THERAPEUTIC HOTLINE: Genetic variations in the androgen receptor gene and finasteride response in women with androgenetic alopecia mediated by epigenetics

When studies of postmenopausal women with hair loss failed to reveal a response to the 5 alpha reductase inhibitor, finasteride, researchers began to question the existence of androgenetic alopecia in women and renamed the clinical entity female pattern hair loss. However, recently published reports of finasteride response in some women with hair loss suggest that an androgenic mechanism is mediating response in this group. Variant repeat nucleotide sequences in exon 1 of the androgen receptor (AR) gene have been shown to determine androgen sensitivity in a variety of androgenic conditions in men and women. In an effort to identify whether this AR variant may help determine which women are likely to respond to finasteride therapy, a pilot study was undertaken. In our 6-month pilot of 13 patients, women with greater androgen sensitivity (<24 cytosine, adenine, and guanine (CAG) repeats) were likely to have a significant response to finasteride 1 mg/day compared with patients treated with placebo, and compared with patients with normal androgen sensitivity (≥24 CAG repeats) based on epigenetic weighted evaluation of the CAG alleles. Results of the present pilot study support the hypothesis that AR-CAG repeats, in conjunction with epigenetic factors, can help determine which women with hair loss will respond to finasteride therapy.

Mutation and haplotype analysis of oculopharyngeal muscular dystrophy in Thai patients

Oculopharyngeal muscular dystrophy (OPMD) is an inherited neuromuscular disease associated with a short trinucleotide repeat expansion in Exon 1 of the PABPN1 gene. OPMD is uncommon in East Asian populations, and there have been no previous reports of Thai patients. We studied clinical and molecular genetic features of six unrelated Thai patients with autosomal dominant OPMD. All patients had expansions of the guanine–cytosine–guanine (GCG) repeat ranging from three to seven additional repeats in the PABPN1 gene. Haplotype analysis showed that these mutations might have originated independently. Analysis of the size of the GCG repeat in the PABPN1 gene in 200 Thai control patients showed that 0.5% of the control subjects possessed (GCG) 7, thereby suggesting that the prevalence of autosomal recessive OPMD in the Thai population was approximately 1 in 160,000. In conclusion, our data suggest that OPMD in Thailand may be more common than previously thought.

Clinical and genetic study of one DRPLA case

Objective To investigate the clinical and genetic features of dentatorubral ⁃ pallidoluysian atrophy (DRPLA). Methods The trinucleotide repeats of spinocerebellar ataxia (SCA) disease genes were detected by polymerase chain reaction (PCR) initially in 388 SCA cases which included 234 cases with autosomal dominant inheritance and 154 sporadic cases. Fragment analysis with laser ⁃ induced fluorescence in capillary electrophoresis was performed for the samples with 2 bands detected by agarose gel electrophoresis (AGE). The repeat numbers of the positive or suspicious samples were verified by the pUC18⁃T vector cloning and sequencing. Results Based on the 2 methods, the cytosine⁃adenine⁃ guanine (CAG) repeat expansion of DRPLA gene was detected in one female case with mild ataxia and suspected seizure. The repeat numbers of the 2 alleles were 14 and 54 by fragment analysis, and 15 and 58 by cloning sequencing. The 2 members of her family had a history of seizure, but no obvious ataxia. The CAG repeat numbers of the other 19 cases without abnormal expansions ranged from 7 to 20, of which 9 was common. Conclusion The patient's atypical manifestations suggests that clinical variation may exist in DRPLA. Only one case of DRPLA is found in 388 SCA cases, indicating that DRPLA may be a relatively rare subtype of SCA in Chinese population. The secondary structure of DNA owing to the highly repetitive sequences will induce DNA polymerase sliding during the amplification, which will reduce the fidelity in DNA replication. This problem exists in both fragment analysis and cloning sequencing. For the latter method, the instability also appears in the process of cloning. Therefore, the repeat numbers need to be mutually verified by the 2 methods. DOI：10.3969/j.issn.1672-6731.2010.06.012

Increased temporal dispersion of myocardial repolarization in myotonic dystrophy Type 1: Beyond the cardiac conduction system

Background and objectivesThe most frequently mechanism underlying sudden cardiac death in myotonic dystrophy type 1 (DM1) is bradyarrhythmias due to cardiac conduction abnormalities. However the risk of ventricular tachyarrhythmias remains a concern in clinical management as well as in its determinant. We therefore assessed autonomic nervous system activity aiming to disclose differences in the QT variability index (QTVI)—a marker of temporal myocardial repolarization lability—between DM1 patients and healthy controls. We also investigated the possible differences within DM1 patients by subdividing them according either to the presence of first degree atrioventricular block (1st AVB) or to the cytosine–thymine–guanine (CTG) repeat expansion size. MethodsSixty-two DM1 patients and 20 healthy subjects underwent neurological and cardiological examinations, the latter including ECG, echocardiography and 24-hour Holter monitoring. All underwent a 5-minute ECG recording to assess heart rate variability power spectral components, and the QTVI values. ResultsPower spectral data, namely total power, low frequency power and high frequency power, were lower, whereas QTVI values were higher in DM1 patients than in controls (p<.0001). Higher QTVI values were found in DM1 subgroups with 1st AVB (p=.009) and more than 500 CTG repeat (p=.014) with respect to DM1 patients without 1st AVB and CTG<500. Spectral data did not significantly differ. At multivariable analysis, QTVI and age were independently associated with PR interval and CTG repeat. ConclusionsThe increased values of QTVI argue in favour of an important heart involvement extending beyond the conduction system. Whether QTVI could be useful in predicting clinical course of DM1 clearly requires larger prospective studies.

Long-term follow-up of pallidal deep brain stimulation in two cases of Huntington's disease

BackgroundDeep brain stimulator (DBS) implantation has been shown to be effective in the treatment of various movement disorders including Parkinson's disease, essential tremor and dystonia. However, there is limited information...

CTG repeat lengths of the DMPK gene in myotonic dystrophy patients compared to healthy controls in Thailand

Myotonic dystrophy (DM) is frequently associated with large expansions of the cytosine–thymine–guanine (CTG) repeat in the myotonic dystrophy protein kinase gene ( DMPK). The frequency of distribution of the CTG repeat length in normal alleles of several populations is well correlated with the prevalence of DM. Therefore, we studied the CTG repeat length of the DMPK gene in DM patients and controls in Thailand. Only seven typical patients with DM from six unrelated families were identified, all with large pathological CTG repeat expansions (>400 repeats) in the DMPK gene. Only 2.75% of controls had normal CTG repeat alleles >18 repeats. The frequency distribution of the CTG-repeat alleles in the normal Thai population is similar to that of the Taiwanese population (χ 2 with Yates correction = 1.393; p = 0.2379). These data suggest that the incidence of DM might be rare in Thailand, where the risk of developing DM is possibly similar to that in Taiwan.

Characterization of Oxidative Guanine Damage and Repair in Mammalian Telomeres

8-oxo-7,8-dihydroguanine (8-oxoG) and 2,6-diamino-4-hydroxy-5-formamidopyrimidine (FapyG) are among the most common oxidative DNA lesions and are substrates for 8-oxoguanine DNA glycosylase (OGG1)–initiated DNA base excision repair (BER). Mammalian telomeres consist of triple guanine repeats and are subject to oxidative guanine damage. Here, we investigated the impact of oxidative guanine damage and its repair by OGG1 on telomere integrity in mice. The mouse cells were analyzed for telomere integrity by telomere quantitative fluorescence in situ hybridization (telomere–FISH), by chromosome orientation–FISH (CO–FISH), and by indirect immunofluorescence in combination with telomere–FISH and for oxidative base lesions by Fpg-incision/Southern blot assay. In comparison to the wild type, telomere lengthening was observed in Ogg1 null (Ogg1−/−) mouse tissues and primary embryonic fibroblasts (MEFs) cultivated in hypoxia condition (3% oxygen), whereas telomere shortening was detected in Ogg1−/− mouse hematopoietic cells and primary MEFs cultivated in normoxia condition (20% oxygen) or in the presence of an oxidant. In addition, telomere length abnormalities were accompanied by altered telomere sister chromatid exchanges, increased telomere single- and double-strand breaks, and preferential telomere lagging- or G-strand losses in Ogg1−/− mouse cells. Oxidative guanine lesions were increased in telomeres in Ogg1−/− mice with aging and primary MEFs cultivated in 20% oxygen. Furthermore, oxidative guanine lesions persisted at high level in Ogg1−/− MEFs after acute exposure to hydrogen peroxide, while they rapidly returned to basal level in wild-type MEFs. These findings indicate that oxidative guanine damage can arise in telomeres where it affects length homeostasis, recombination, DNA replication, and DNA breakage repair. Our studies demonstrate that BER pathway is required in repairing oxidative guanine damage in telomeres and maintaining telomere integrity in mammals.

Clinical and genetic study of a Chinese family with spinocerebellar ataxia type 7

Spinocerebellar ataxia 7 (SCA7) is a rare disease, and only few SCA7 families have been reported, especially from East Asia. Clinical features of a genetically confirmed SCA7 Chinese family were evaluated. The onset of the disease varied from 4 years to 48 years, and the initial presenting feature was cerebellar ataxia or visual impairment, or both. There were abnormal findings on fundus photography, electroretinogram, flash visual evoked potential and oscillatory potentials. Abnormal mitochondria were also found in skeletal muscle or liver biopsies. The number of cytosine adenine guanine (CAG) repeats ranged from 50 to 97, and the length of CAG repeat was inversely correlated with the age of onset (r=-0.867, P=0.025). The clinical manifestations and SCA7 gene of SCA7 patients were homogeneous in this study. Larger CAG repeats had not only resulted in earlier onset, but also related to the rapid progression and severity of the disease. Abnormal mitochondria may be a common finding in biopsy studies of various organs in SCA7 patients.

A double blind evaluation of cognitive decline in a Norwegian cohort of asymptomatic carriers of Huntington's disease

Previous studies investigating subclinical signs of cognitive decline in presymptomatic carriers of Huntington's disease (HD) have shown conflicting results. The current study examines cognition in 105 at-risk individuals, using a broad neuropsychological test battery and adopting strict inclusion criteria for attaining a homogeneous sample. Results obtained by analyses of variance and effect size calculations indicate no clinical evidence of significant cognitive decline in asymptomatic HD carriers very far from onset of illness compared to noncarriers. Closeness to disease onset amongst gene carriers influenced cognition negatively whereas cytosine–adenine–guanine (CAG) repeat size did not. The findings call for longitudinal follow-up studies using a combination of clinical instruments and experimental paradigms to pinpoint when subtle cognitive deficits occur and within which of the cognitive domains.

Examination of the Effect of the Annealing Cation on Higher Order Structures Containing Guanine or Isoguanine Repeats

Isoguanine (2-oxo-6-amino-guanine), a natural but non-standard base, exhibits unique self-association properties compared to its isomer, guanine, and results in formation of different higher order DNA structures. In this work, the higher order structures formed by oligonucleotides containing guanine repeats or isoguanine repeats after annealing in solutions containing various cations are evaluated by electrospray ionization mass spectrometry (ESI-MS) and circular dichroism (CD) spectroscopy. The guanine-containing strand (G9) consistently formed quadruplexes upon annealing, whereas the isoguanine strand (Ig9) formed both pentaplexes and quadruplexes depending on the annealing cation. Quadruplex formation with G9 showed some dependence on the identity of the cation present during annealing with high relative quadruplex formation detected with six of ten cations. Analogous annealing experiments with Ig9 resulted in complex formation with all ten cations, and the majority of the resulting complexes were pentaplexes. CD results indicated most of the original complexes survived the desalting process necessary for ESI-MS analysis. In addition, several complexes, especially the pentaplexes, were found to be capable of cation exchange with ammonium ions. Ab initio calculations were conducted for isoguanine tetrads and pentads coordinated with all ten cations to predict the most energetically stable structures of the complexes in the gas phase. The observed preference of forming quadruplexes versus pentaplexes as a function of the coordinated cation can be interpreted by the calculated reaction energies of both the tetrads and pentads in combination with the distortion energies of tetrads.

Risk factors for perioperative adverse events in children with myotonic dystrophy

This study was conducted to identify patient-related, surgical, and anesthetic factors that would help predict adverse events and allow for better planning of perioperative care in children with myotonic dystrophy. This is a retrospective chart review from a large tertiary pediatric hospital. Data were collected on demographics, disease severity, surgical procedure, and anesthetic technique. Perioperative adverse events were recorded. Records on 27 patients having 78 anesthetics over a 17.5-year period were reviewed. The overall frequency of postoperative respiratory complications was 10%. Significant risk factors were high muscular impairment rating scale (MIRS) grade (P = 0.007), at least 2300 cytosine, thymine, guanine (CTG) repeats on the protein kinase gene of chromosome 19q (P = 0.009), a longer duration of surgery (RR = 14.0 for surgery lasting at least 1 h; P = 0.002), perioperative morphine use (RR = 7.7, 95% CI 2.2-12.8; P = 0.005), intubation (P = 0.02), and the use of muscle relaxant without reversal (RR = 15.5, P = 0.0002). Using a multivariate risk model, only MIRS grade and the use of muscle relaxant without reversal were shown to be significant independent risk factors (RR = 24.9, P < 0.0001). The MIRS is a statistically significant and clinically useful tool for predicting high perioperative risk. Patients with a high MIRS grade should therefore be considered for postoperative intensive care. The use of muscle relaxant without reversal was also shown to be a significant risk factor. Patients who require morphine infusions postoperatively might also be most safely managed in a high dependency unit.

Predictive models in external beam radiotherapy for clinically localized prostate cancer

Predictive models are being used increasingly in effort to allow physician and patient expectations to be aligned with outcomes that are based on available data. Most predictive models for men who receive external beam radiotherapy for clinically localized prostate cancer are based on Gleason score, clinical tumor classification, and prostate-specific antigen (PSA) levels. More sophisticated models also have been developed that incorporate treatment-related variables, such as the dose of radiation and the use of androgen-deprivation therapy. Most of the predictive models applied to prostate cancer were derived using PSA recurrence rates as the major endpoint, but clinical endpoints have been incorporated increasingly into predictive models. Biomarkers also are increasingly being added to predictive models in an effort to strengthen them. The Radiation Therapy Oncology Group (RTOG) has completed studies on a wide range of markers using tissue from 2 phase 3 trials (RTOG 8610 and 9202). To date, preliminary assessments of p53; DNA ploidy; p16/retinoblastoma 1 protein; Ki-67; mouse double-minute p53 binding protein homolog; Bcl-2/Bcl-2-associated X protein; cytosine, adenine, and guanine repeats; cyclooxygenase-2; signal transducer and activator of transcription 3; cytochrome P450 3A4; and protein kinase A have been completed. Although they are not ready for widespread, routine use, there are reasons to believe that future models will combine these markers with traditional pretreatment and treatment-related variables and will improve our ability to predict outcome and select the optimal treatment. Cancer 2009;115(13 suppl):3112-20. (c) 2009 American Cancer Society.

Aptamer evolution for array-based diagnostics

Closed loop aptameric directed evolution, (CLADE) is a technique enabling simultaneous discovery, evolution, and optimization of aptamers. It was previously demonstrated using a fluorescent protein, and here we extend its applicability with the generation of surface-bound aptamers for targets containing no natural fluorescence. Starting from a random population, in four generations CLADE produced a new aptamer to thrombin with high specificity and affinity. The best aptameric sequence was void of the set of four guanine repeats typifying thrombin aptamers and, thus, highlights the benefits of evolution performed in an environment closely mimicking the final diagnostic application.

Evaluation of binding selectivities and affinities of platinum‐based quadruplex interactive complexes by electrospray ionization mass spectrometry

The quadruplex binding affinities and selectivities of two large pi-surface Pt(II) phenanthroimidazole complexes, as well as a smaller pi-surface platinum bipyridine complex and a larger Ru(II) complex, were evaluated by electrospray ionization mass spectrometry. Circular dichroism (CD) spectroscopy was used to determine the structures of various quadruplexes and to study the thermal denaturation of the quadruplexes in the absence and presence of the metal complexes. In addition, chemical probe reactions with glyoxal were used to monitor the changes in the quadruplex conformation because of association with the complexes. The platinum phenanthroimidazole complexes show increased affinity for several of the quadruplexes with elongated loops between guanine repeats. Quadruplexes with shorter loops exhibited insubstantial binding to the transition metal complexes. Similarly binding to duplex and single strand oligonucleotides was low overall. Although the ruthenium-based metal complex showed somewhat enhanced quadruplex binding, the Pt(II) complexes had higher quadruplex affinities and selectivities that are attributed to their square planar geometries. The chemical probe reactions using glyoxal indicated increased reactivity when the platinum phenanthroimidazole complexes were bound to the quadruplexes, thus suggesting a conformational change that alters guanine accessibility.

Neuromuscular excitability properties in myotonic dystrophy type 1

Objective To study neuromuscular excitability in patients with dystrophia myotonica type 1 (DM1). Methods The neuromuscular recovery cycle following motor nerve stimulation was assessed in 16 DM1 patients who had no sign of peripheral neuropathy or diabetes. Compound muscle action potentials were recorded from the adductor digiti minimi muscle to ulnar nerve stimulation at the wrist. Paired pulses were delivered, consisting of a conditioning stimulus of supramaximal intensity, followed by a submaximal test stimulus. Interstimuli intervals (ISIs) ranged between 1 and 8 ms. Durations of the absolute and relative refractory periods (ARP, RRP) and percentages of refractoriness and supernormality at ISIs of 2.6 and 7 ms, respectively, were computed using a subtraction method. The results obtained in the series of DM1 patients were compared to those obtained in six patients with other forms of myotonia and to normative values established in a series of age-matched healthy subjects. Correlations were made between excitability parameters, the number of cytosine–thymine–guanine (CTG) repeats, and the severity of myotonia, scored clinically. Results Compared to controls, DM1 patients presented prolonged durations of ARP and RRP, increased refractoriness and reduced supernormality. The decrease in refractoriness correlated with both the number of CTG repeats and the severity of myotonia. Conclusions Changes in the recovery cycle following supramaximal motor nerve stimulation revealed the existence of subtle alterations of neuromuscular excitability in DM1 patients. Significance Increase in refractoriness together with a reduced supernormality was consistent with a process of membrane depolarization. Such a depolarization may be related to the loss of chloride channels or to alterations in sodium conductance in the motor axon or the muscle fiber.

Hyperandrogenism, mediated by obesity and receptor polymorphisms, promotes aggressive epithelial ovarian cancer biology

Objective. Epidemiologic data suggest that aberrant androgen homeostasis may promote aggressive epithelial ovarian cancer biology. Hyperandrogenism results from both obesity and expression of polymorphic androgen receptor (AR) allelotypes harboring short cytosine–adenine–guanine (CAG) repeat sequences; both have been shown to independently correlate with poor overall survival in ovarian cancer. We have hypothesized that the combination of these factors further manifests an aggressive ovarian cancer phenotype. Methods. Genotype analysis of the AR CAG polymorphism was performed on 81 patients with papillary serous epithelial ovarian cancer. Medical records were reviewed for body mass index (BMI), clinico-pathologic factors, and survival. Data were examined using the Fishers exact test, Kaplan–Meier survival, and Cox regression analyses. Results. Overweight or obese women (BMI ≥ 25) with a short AR allele (≤ 19 CAG repeats) demonstrated statistically shorter progression-free survival (9 months) when compared to underweight or ideal body weight women (BMI < 25) and a long AR allele (> 19 CAG repeats; 26 months, p = 0.0002). Overweight/obese women with a short AR allele also demonstrated shorter overall survival (34 months) when compared to underweight/ideal body weight women with a long AR allele (59 months, p = 0.036). On multivariate analyses, the combination of a short AR allele and BMI > 25 was an independent poor prognostic factor after controlling for age, stage, grade, optimal cytoreduction, and AR allele length and BMI independently ( p = 0.05). Conclusion. These data provide further evidence that suggest that hyperandrogenism promotes an aggressive epithelial ovarian cancer phenotype.

Identification and functional analysis of common sequence variants in the DFNA15 gene, Brn-3c

A rare mutation in Brn-3c ( Brn3.1, POU4F3) underlies adult onset hearing loss (DFNA15) and targeted deletion of this gene in mice leads to complete deafness due to loss of sensory hair cells from the cochlea. Therefore the aim of our study was to identify and characterise common functional variation in the Brn-3c gene, which could potentially be a genetic risk for more common forms of adult onset hearing loss. We identified seven sequence variants at the Brn-3c locus. One of these, a novel, common variant at position − 3432 was extremely complex consisting of a variable guanine repeat that also exhibited single nucleotide substitutions within the poly-guanine repeat: − 3432 poly-G polymorphism. In-vitro studies show that this polymorphism modifies binding affinity for the SP1 transcription factor. Furthermore, reporter constructs of the Brn-3c 5′-flanking region containing different − 3432 poly-G alleles show altered transcriptional activity when endogenous SP1 levels are reduced using a dominant negative approach. Results also indicate that this effect is influenced by the length of a novel polymorphic (GT) n repeat at position − 566 in the Brn-3c 5′-flanking region. In summary, our data show there are common sequence variants in the Brn-3c 5′-flanking region that affect transcriptional regulation in vitro; these variants are candidates for large-scale population based association analysis as they could potentially affect the genetic risk for more common types of adult onset hearing loss.

The Relationship between Libido and Testosterone Levels in Aging Men

Although it is known that serum testosterone (T) concentrations are related to libido, the strength of that relationship in community-dwelling men has not yet been determined. Our objective was to assess the strength and significance of the association between aging men's self-reports of libido and serum T concentrations. Our study was a community-based evaluation of men's health and aging, including three data collection waves: baseline (T1, 1987-1989) and follow-ups (T2, 1995-1997; T3, 2002-2004). Libido was measured on a 14-point scale assessing self-reported frequency of desire and thoughts/fantasies; low libido was defined as a score of less than 7 of 14. We conducted an epidemiological study in greater Boston, Massachusetts. There were 1632 men aged 40-70 yr at baseline, with follow-up on 922 (56%) at 9 yr (T2) and 623 (38%) at 15 yr (T3). We assessed total and calculated bioavailable T . Three hundred eighteen (19%) subjects reported low libido at baseline. Libido and T displayed a significant association. However, the difference in mean T levels between those subjects with low libido and those without was small; analyses indicated a 3.4 ng/dl (0.12 nmol/liter) increase in total T per unit increase in libido. Subjects reporting low libido exhibited an increased but modest probability of exhibiting low T. Dividing T concentrations by the number of androgen receptor gene cytosine, adenine, guanine repeats did not enhance associations. Libido and T concentrations are strongly related at the population level. However, the value of individual patient reports of reduced libido as indicators of low T levels is open to question.

Télomères et télomérase, de nouvelles cibles pour la chimiothérapie anticancéreuse

Telomeres are composed of single-strand DNA rich in guanine which can adopt particular structures such as T-loop or G-quadruples, a four-strand DAN structure formed by guanine repeats. Telomeric single-strand DNA is the substrate of telomerase, an enzyme necessary for telomeric replication which is suppressed in most cancer cells and which participates in tumor genesis. The formation of a telomeric G-quadruplex blocks telomerase activity and offers an original strategy for new anti-cancer agents. Using an original approach combining rational screening and synthesis, several series of compounds have been identified which specifically bind to the telomeric quadruplex. These derivatives, called "G-quadruplex DNA ligands", are able to block telomeric replication in cancer cells and provoke replicative senescence and/or apoptosis after a few cell cycles. Our team is working on characterizing the cellular and molecular mechanisms of action of these ligands. Using mutant cell models resistant to these ligands or expressing a protein cuff covering the telomere in tumor lines, we have demonstrated that the telomere is the principal intracellular target of action of these compounds and the implicit existence of the G-quadruplex structure. In collaboration with academic and industrial partners, optimization of these ligands to develop pharmacologically active products should enable in vivo validation of a new therapeutic concept.

Androgen Receptor Cytosine, Adenine, Guanine Repeats, and Haplotypes in Relation to Ovarian Cancer Risk

Biological and epidemiologic evidence suggest that androgen or its receptor may play a role in ovarian cancer pathogenesis. The most notable genetic factor influencing androgen receptor (AR) activity is the functional cytosine, adenine, guanine (CAG) repeat in which length is inversely proportional to its transactivational activity. Additional genetic variation due to single nucleotide polymorphisms in the AR gene may be captured through haplotypes. We genotyped the CAG microsatellite and six haplotype-tagging single nucleotide polymorphisms (rs962458, rs6152, rs1204038, rs2361634, rs1337080, rs1337082) of the androgen receptor gene in 987 ovarian cancer cases and 1,034 controls from a study conducted in New Hampshire and eastern Massachusetts between May 1992 and July 2003. We estimated haplotype frequencies and calculated odds ratios with 95% confidence intervals to evaluate the association between the haplotypes and the AR CAG microsatellite with ovarian cancer risk. We observed that carriage of two alleles with > or = 22 CAG repeats was associated with an increased risk of ovarian cancer compared with carriage of two alleles with <22 CAG repeats (covariate-adjusted odds ratios, 1.31; 95% confidence intervals, 1.01-1.69). Five common haplotypes in the AR gene were identified, but no association between these and ovarian cancer risk was observed. Our results suggest that possession of two long AR alleles (> or = 22 CAG repeats) may be associated with increased risk of ovarian cancer compared with women with two short AR alleles (<22 CAG repeats).