New research shows that exposure to harmful chemicals and drugs during critical developmental periods early in life may actually "reprogram" the way certain genes respond to the female hormone estrogen. This genetic reprogramming may determine whether people with a genetic predisposition for a disease actually develop the disease.
The new research shows that when rats with a genetic predisposition to uterine tumors also receive an early-life exposure to diethylstilbestrol (DES), a synthetic form of estrogen linked to vaginal cancer, the incidence of uterine tumors rises to almost 100 percent. By comparison, slightly more than half of the unexposed animals, those having only the genetic defect, developed the uterine tumors.
DES is a drug that was prescribed for women from 1938 to 1971 to prevent miscarriages and premature deliveries. Daughters of women who used DES are at increased risk for reproductive tract abnormalities, pregnancy complications such as ectopic pregnancies and preterm deliveries, infertility, and a rare vaginal and cervical cancer called clear-cell adenocarcinoma. Other research conducted by NIEHS scientists indicates that women exposed to DES in utero have a higher risk of uterine fibroids.
The National Institute of Environmental Health Sciences, a component of the National Institutes of Health, provided funding to researchers at the University of Texas M.D. Anderson Cancer Center for the two-year study. The study results will be published in the May 2005 issue of the Proceedings of the National Academy of Sciences.
The discovery is important because it changes conventional thinking about the way in which genetic predisposition and things in the environment interact to increase disease risk. Until now, scientists thought that exposure to harmful agents in the environment caused damage to the gene. This study, however, indicates that an environmental agent can actually change or reprogram the gene so that it functions differently.
"This study is telling us that an environmental reprogramming of a normal response, combined with an inherited gene defect, work together to promote cancer," said NIEHS Director David Schwartz, M.D. "If this model is correct, it will help doctors to determine which individuals are more likely to develop cancers of the uterus, breast and prostate."
The finding should alert doctors to ask more questions about a patient's early-life exposures to chemicals and other harmful agents in order to better predict that person's cancer risk.
"Most people with a family history for a particular disease are concerned about their recent exposures to harmful agents in the environment," said Cheryl Walker, Ph.D., professor of molecular carcinogenesis at the M.D. Anderson Cancer Center and lead author on the study. "We are just beginning to realize that exposures received decades earlier, during critical developmental stages, may be much more important in determining who develops cancer as an adult."
The researchers used a special strain of rats with a defect in a gene called Tsc-2 (tuberous sclerosis complex 2) that made them more susceptible to uterine leiomyomas, benign tumors that are common in women over 30 years of age. These rats were then treated with DES during days 3, 4 and 5 of life, during a critical period of uterine development.