Abstract
In 1981, the Spanish toxic oil syndrome (TOS) affected more than 20,000 people, and over 300 deaths were registered. Assessment of genetic polymorphisms on xenobiotic metabolism would indicate the potential metabolic capacity of the victims at the time of the disaster. Thus, impaired metabolic pathways may have contributed to the clearance of the toxicant(s) leading to a low detoxification or accumulation of toxic metabolites contributing to the disease. We conducted a matched case-control study using 72 cases (54 females, 18 males) registered in the Official Census of Affected Patients maintained by the Spanish government. Controls were nonaffected siblings (n =72) living in the same household in 1981 and nonaffected nonrelatives (n = 70) living in the neighborhood at that time, with no ties to TOS. Genotype analyses were performed to assess the metabolic capacity of phase I [cytochrome P450 1A1 (CYP1A1), CYP2D6] and phase II [arylamine N-acetyltransferase-2 (NAT2), GSTM1 (glutathione S-transferase M1) and GSTT1] enzyme polymorphisms. The degree of association of the five metabolic pathways was estimated by calculating their odds ratios (ORs) using conditional logistic regression analysis. In the final model, cases compared with siblings (72 pairs) showed no differences either in CYP2D6 or CYP1A1 polymorphisms, or in conjugation enzyme polymorphisms, whereas cases compared with the unrelated controls (70 pairs) showed an increase in NAT2 defective alleles [OR = 6.96, 95% confidence interval (CI), 1.46-33.20] adjusted by age and sex. Glutathione transferase genetic polymorphisms (GSTM1, GSTT1) showed no association with cases compared with their siblings or unrelated controls. These findings suggest a possible role of impaired acetylation mediating susceptibility in TOS.
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- Abaitua Borda I., Philen R. M., Posada de la Paz M., Gómez de la Cámara A., Díez Ruiz-Navarro M., Giménez Ribota O., Alvargonzález Soldevilla J., Terracini B., Severiano Peña S., Fuentes Leal C. Toxic oil syndrome mortality: the first 13 years. Int J Epidemiol. 1998 Dec;27(6):1057–1063. doi: 10.1093/ije/27.6.1057. [DOI] [PubMed] [Google Scholar]
- Agúndez J. A., Martínez C., Ledesma M. C., Ladona M. G., Ladero J. M., Benítez J. Genetic basis for differences in debrisoquin polymorphism between a Spanish and other white populations. Clin Pharmacol Ther. 1994 Apr;55(4):412–417. doi: 10.1038/clpt.1994.50. [DOI] [PubMed] [Google Scholar]
- Agúndez J. A., Martínez C., Olivera M., Ledesma M. C., Ladero J. M., Benítez J. Molecular analysis of the arylamine N-acetyltransferase polymorphism in a Spanish population. Clin Pharmacol Ther. 1994 Aug;56(2):202–209. doi: 10.1038/clpt.1994.124. [DOI] [PubMed] [Google Scholar]
- Alonso-Ruiz A., Calabozo M., Perez-Ruiz F., Mancebo L. Toxic oil syndrome. A long-term follow-up of a cohort of 332 patients. Medicine (Baltimore) 1993 Sep;72(5):285–295. doi: 10.1097/00005792-199309000-00001. [DOI] [PubMed] [Google Scholar]
- Austin H., Hill H. A., Flanders W. D., Greenberg R. S. Limitations in the application of case-control methodology. Epidemiol Rev. 1994;16(1):65–76. doi: 10.1093/oxfordjournals.epirev.a036146. [DOI] [PubMed] [Google Scholar]
- Berking C., Hobbs M. V., Chatelain R., Meurer M., Bell S. A. Strain-dependent cytokine profile and susceptibility to oleic acid anilide in a murine model of the toxic oil syndrome. Toxicol Appl Pharmacol. 1998 Feb;148(2):222–228. doi: 10.1006/taap.1997.8327. [DOI] [PubMed] [Google Scholar]
- Blum M., Demierre A., Grant D. M., Heim M., Meyer U. A. Molecular mechanism of slow acetylation of drugs and carcinogens in humans. Proc Natl Acad Sci U S A. 1991 Jun 15;88(12):5237–5241. doi: 10.1073/pnas.88.12.5237. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Broly F., Gaedigk A., Heim M., Eichelbaum M., Morike K., Meyer U. A. Debrisoquine/sparteine hydroxylation genotype and phenotype: analysis of common mutations and alleles of CYP2D6 in a European population. DNA Cell Biol. 1991 Oct;10(8):545–558. doi: 10.1089/dna.1991.10.545. [DOI] [PubMed] [Google Scholar]
- Cascorbi I., Drakoulis N., Brockmöller J., Maurer A., Sperling K., Roots I. Arylamine N-acetyltransferase (NAT2) mutations and their allelic linkage in unrelated Caucasian individuals: correlation with phenotypic activity. Am J Hum Genet. 1995 Sep;57(3):581–592. [PMC free article] [PubMed] [Google Scholar]
- Cañas R., Kilbourne E. M. Oil ingestion and the toxic-oil syndrome: results of a survey of residents of the Orcasur neighbourhood in Madrid, Spain. Int J Epidemiol. 1987 Mar;16(1):3–6. doi: 10.1093/ije/16.1.3. [DOI] [PubMed] [Google Scholar]
- Crofts F., Cosma G. N., Currie D., Taioli E., Toniolo P., Garte S. J. A novel CYP1A1 gene polymorphism in African-Americans. Carcinogenesis. 1993 Sep;14(9):1729–1731. doi: 10.1093/carcin/14.9.1729. [DOI] [PubMed] [Google Scholar]
- Daly A. K., Brockmöller J., Broly F., Eichelbaum M., Evans W. E., Gonzalez F. J., Huang J. D., Idle J. R., Ingelman-Sundberg M., Ishizaki T. Nomenclature for human CYP2D6 alleles. Pharmacogenetics. 1996 Jun;6(3):193–201. doi: 10.1097/00008571-199606000-00001. [DOI] [PubMed] [Google Scholar]
- Diaz de Rojas F., Castro García M., Abaitua Borda I., Alonso Gordo J. M., Posada de la Paz M., Kilbourne E. M., Tabuenca Oliver J. M. The association of oil ingestion with toxic oil syndrome in two convents. Am J Epidemiol. 1987 May;125(5):907–911. doi: 10.1093/oxfordjournals.aje.a114608. [DOI] [PubMed] [Google Scholar]
- Dwyer D. M., Strickler H., Goodman R. A., Armenian H. K. Use of case-control studies in outbreak investigations. Epidemiol Rev. 1994;16(1):109–123. doi: 10.1093/oxfordjournals.epirev.a036137. [DOI] [PubMed] [Google Scholar]
- Gallardo S., del Pozo V., Cárdaba B., de Andrés B., Martín-Orozco E., Fernandez J. C., Tramón P., Posada M., Abaitua I., Palomino P. Immunological basis of toxic oil syndrome (TOS). Toxicology. 1994 Nov 11;93(2-3):289–299. doi: 10.1016/0300-483x(94)90085-x. [DOI] [PubMed] [Google Scholar]
- Gawrońska-Szklarz B., Luszawska-Kutrzeba T., Czaja-Bulsa G., Kurzawski G. Relationship between acetylation polymorphism and risk of atopic diseases. Clin Pharmacol Ther. 1999 May;65(5):562–569. doi: 10.1016/S0009-9236(99)70076-7. [DOI] [PubMed] [Google Scholar]
- Gough A. C., Miles J. S., Spurr N. K., Moss J. E., Gaedigk A., Eichelbaum M., Wolf C. R. Identification of the primary gene defect at the cytochrome P450 CYP2D locus. Nature. 1990 Oct 25;347(6295):773–776. doi: 10.1038/347773a0. [DOI] [PubMed] [Google Scholar]
- Graf T., Broly F., Hoffmann F., Probst M., Meyer U. A., Howald H. Prediction of phenotype for acetylation and for debrisoquine hydroxylation by DNA-tests in healthy human volunteers. Eur J Clin Pharmacol. 1992;43(4):399–403. doi: 10.1007/BF02220616. [DOI] [PubMed] [Google Scholar]
- Griem P., Wulferink M., Sachs B., González J. B., Gleichmann E. Allergic and autoimmune reactions to xenobiotics: how do they arise? Immunol Today. 1998 Mar;19(3):133–141. doi: 10.1016/s0167-5699(97)01219-x. [DOI] [PubMed] [Google Scholar]
- Gómez de la Cámara A., Abaitua Borda I., Posada de la Paz M. Toxicologists versus toxicological disasters: toxic oil syndrome, clinical aspects. Arch Toxicol Suppl. 1997;19:31–40. doi: 10.1007/978-3-642-60682-3_3. [DOI] [PubMed] [Google Scholar]
- Gómez de la Cámara A., Posada de la Paz M., Abaitua Borda I., Barainca Oyagüe M. T., Abraira Santos V., Ruiz-Navarro M. D., Terracini B. Health status measurement in Toxic Oil Syndrome. J Clin Epidemiol. 1998 Oct;51(10):867–873. doi: 10.1016/s0895-4356(98)00062-6. [DOI] [PubMed] [Google Scholar]
- Hayashi S., Watanabe J., Nakachi K., Kawajiri K. Genetic linkage of lung cancer-associated MspI polymorphisms with amino acid replacement in the heme binding region of the human cytochrome P450IA1 gene. J Biochem. 1991 Sep;110(3):407–411. doi: 10.1093/oxfordjournals.jbchem.a123594. [DOI] [PubMed] [Google Scholar]
- Heim M., Meyer U. A. Genotyping of poor metabolisers of debrisoquine by allele-specific PCR amplification. Lancet. 1990 Sep 1;336(8714):529–532. doi: 10.1016/0140-6736(90)92086-w. [DOI] [PubMed] [Google Scholar]
- Hickman D., Sim E. N-acetyltransferase polymorphism. Comparison of phenotype and genotype in humans. Biochem Pharmacol. 1991 Aug 8;42(5):1007–1014. doi: 10.1016/0006-2952(91)90282-a. [DOI] [PubMed] [Google Scholar]
- Hill R. H., Jr, Schurz H. H., Posada de la Paz M., Abaitua Borda I., Philen R. M., Kilbourne E. M., Head S. L., Bailey S. L., Driskell W. J., Barr J. R. Possible etiologic agents for toxic oil syndrome: fatty acid esters of 3-(N-phenylamino)-1,2-propanediol. Arch Environ Contam Toxicol. 1995 Feb;28(2):259–264. doi: 10.1007/BF00217625. [DOI] [PubMed] [Google Scholar]
- Kalow W. Pharmacogenetics: its biologic roots and the medical challenge. Clin Pharmacol Ther. 1993 Sep;54(3):235–241. doi: 10.1038/clpt.1993.142. [DOI] [PubMed] [Google Scholar]
- Kaufman L. D., Izquierdo Martinez M., Serrano J. M., Gomez-Reino J. J. 12-year followup study of epidemic Spanish toxic oil syndrome. J Rheumatol. 1995 Feb;22(2):282–288. [PubMed] [Google Scholar]
- Kilbourne E. M., Bernert J. T., Jr, Posada de la Paz M., Hill R. H., Jr, Abaitua Borda I., Kilbourne B. W., Zack M. M. Chemical correlates of pathogenicity of oils related to the toxic oil syndrome epidemic in Spain. Am J Epidemiol. 1988 Jun;127(6):1210–1227. doi: 10.1093/oxfordjournals.aje.a114914. [DOI] [PubMed] [Google Scholar]
- Ladona M. G., Abildúa R. E., Ladero J. M., Román J. M., Plaza M. A., Agúndez J. A., Muñoz J. J., Benítez J. CYP2D6 genotypes in Spanish women with breast cancer. Cancer Lett. 1996 Jan 19;99(1):23–28. doi: 10.1016/0304-3835(95)04033-1. [DOI] [PubMed] [Google Scholar]
- Ladona M. G., Bujons J., Messeguer A., Ampurdanés C., Morató A., Corbella J. Biotransformation and clearance of 3-(phenylamino)propane-1,2-diol, a compound present in samples related to toxic oil syndrome, in C57BL/6 and A/J mice. Chem Res Toxicol. 1999 Dec;12(12):1127–1137. doi: 10.1021/tx990105j. [DOI] [PubMed] [Google Scholar]
- Lasky T., Stolley P. D. Selection of cases and controls. Epidemiol Rev. 1994;16(1):6–17. doi: 10.1093/oxfordjournals.epirev.a036145. [DOI] [PubMed] [Google Scholar]
- Løvlie R., Daly A. K., Idle J. R., Steen V. M. Characterization of the 16+9 kb and 30+9 kb CYP2D6 XbaI haplotypes. Pharmacogenetics. 1997 Apr;7(2):149–152. doi: 10.1097/00008571-199704000-00009. [DOI] [PubMed] [Google Scholar]
- McLean S., Robinson J., Starmer G. A., Thomas J. The influence of anaesthetic agents on the formation of methaemoglobin induced by aniline in cats. J Pharm Pharmacol. 1967 Dec;19(12):803–809. doi: 10.1111/j.2042-7158.1967.tb09547.x. [DOI] [PubMed] [Google Scholar]
- Nebert D. W., McKinnon R. A., Puga A. Human drug-metabolizing enzyme polymorphisms: effects on risk of toxicity and cancer. DNA Cell Biol. 1996 Apr;15(4):273–280. doi: 10.1089/dna.1996.15.273. [DOI] [PubMed] [Google Scholar]
- Pearson W. R., Vorachek W. R., Xu S. J., Berger R., Hart I., Vannais D., Patterson D. Identification of class-mu glutathione transferase genes GSTM1-GSTM5 on human chromosome 1p13. Am J Hum Genet. 1993 Jul;53(1):220–233. [PMC free article] [PubMed] [Google Scholar]
- Pemble S., Schroeder K. R., Spencer S. R., Meyer D. J., Hallier E., Bolt H. M., Ketterer B., Taylor J. B. Human glutathione S-transferase theta (GSTT1): cDNA cloning and the characterization of a genetic polymorphism. Biochem J. 1994 May 15;300(Pt 1):271–276. doi: 10.1042/bj3000271. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Posada de la Paz M., Philen R. M., Abaitua Borda I., Diez Ruiz-Navarro M., Abraira Santos V., Pozo Rodríguez F., Pla Mestre R., Pollán Santamaría M., Sicilia Socias J. M., Azpeitia Gamazo P. Factors associated with pathogenicity of oils related to the toxic oil syndrome epidemic in Spain. Epidemiology. 1994 Jul;5(4):404–409. doi: 10.1097/00001648-199407000-00005. [DOI] [PubMed] [Google Scholar]
- Posada de la Paz M., Philen R. M., Borda I. A., Sicilia Socias J. M., Gómez de la Cámara A., Kilbourne E. M. Toxic oil syndrome: traceback of the toxic oil and evidence for a point source epidemic. Food Chem Toxicol. 1996 Mar;34(3):251–257. doi: 10.1016/0278-6915(95)00111-5. [DOI] [PubMed] [Google Scholar]
- Posada de la Paz M., Philen R. M., Schurz H., Hill R. H., Jr, Giménez Ribota O., Gómez de la Camara A., Kilbourne E. M., Abaitua I. Epidemiologic evidence for a new class of compounds associated with toxic oil syndrome. Epidemiology. 1999 Mar;10(2):130–134. [PubMed] [Google Scholar]
- Rendic S., Di Carlo F. J. Human cytochrome P450 enzymes: a status report summarizing their reactions, substrates, inducers, and inhibitors. Drug Metab Rev. 1997 Feb-May;29(1-2):413–580. doi: 10.3109/03602539709037591. [DOI] [PubMed] [Google Scholar]
- Rigau-Pérez J. G., Pérez-Alvarez L., Dueñas-Castro S., Choi K., Thacker S. B., Germain J. L., González-de-Andrés G., Cañada-Royo L., Pérez-Gallardo F. Epidemiologic investigation of an oil-associated pneumonic paralytic eosinophilic syndrome in Spain. Am J Epidemiol. 1984 Feb;119(2):250–260. doi: 10.1093/oxfordjournals.aje.a113744. [DOI] [PubMed] [Google Scholar]
- Sachse C., Brockmöller J., Bauer S., Roots I. Cytochrome P450 2D6 variants in a Caucasian population: allele frequencies and phenotypic consequences. Am J Hum Genet. 1997 Feb;60(2):284–295. [PMC free article] [PubMed] [Google Scholar]
- Schurz H. H., Hill R. H., Posada de la Paz M., Philen R. M., Borda I. A., Bailey S. L., Needham L. L. Products of aniline and triglycerides in oil samples associated with the toxic oil syndrome. Chem Res Toxicol. 1996 Sep;9(6):1001–1006. doi: 10.1021/tx950181w. [DOI] [PubMed] [Google Scholar]
- Seidegård J., Vorachek W. R., Pero R. W., Pearson W. R. Hereditary differences in the expression of the human glutathione transferase active on trans-stilbene oxide are due to a gene deletion. Proc Natl Acad Sci U S A. 1988 Oct;85(19):7293–7297. doi: 10.1073/pnas.85.19.7293. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Skoda R. C., Gonzalez F. J., Demierre A., Meyer U. A. Two mutant alleles of the human cytochrome P-450db1 gene (P450C2D1) associated with genetically deficient metabolism of debrisoquine and other drugs. Proc Natl Acad Sci U S A. 1988 Jul;85(14):5240–5243. doi: 10.1073/pnas.85.14.5240. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith R. P., Alkaitis A. A., Shafer P. R. Chemically induced methemoglobinemias in the mouse. Biochem Pharmacol. 1967 Feb;16(2):317–328. doi: 10.1016/0006-2952(67)90033-0. [DOI] [PubMed] [Google Scholar]
- Stolk J. M., Smith R. P. Species differences in methemoglobin reductase activity. Biochem Pharmacol. 1966 Mar;15(3):343–351. doi: 10.1016/0006-2952(66)90305-4. [DOI] [PubMed] [Google Scholar]
- Tabuenca J. M. Toxic-allergic syndrome caused by ingestion of rapeseed oil denatured with aniline. Lancet. 1981 Sep 12;2(8246):567–568. doi: 10.1016/s0140-6736(81)90949-1. [DOI] [PubMed] [Google Scholar]
- Taioli E., Crofts F., Trachman J., Bayo S., Toniolo P., Garte S. J. Radical differences in CYP1A1 genotype and function. Toxicol Lett. 1995 May;77(1-3):357–362. doi: 10.1016/0378-4274(95)03318-1. [DOI] [PubMed] [Google Scholar]
- Vázquez Roncero A., Janer del Valle C., Maestro Durán R., Graciani Constante E. New aniline derivatives in cooking oils associated with toxic oil syndrome. Lancet. 1983 Oct 29;2(8357):1024–1025. doi: 10.1016/s0140-6736(83)91005-x. [DOI] [PubMed] [Google Scholar]
- Welch R. M., Conney A. H., Burns J. J. The metabolism of acetophenetidin and N-acetyl-p-aminophenol in the cat. Biochem Pharmacol. 1966 May;15(5):521–531. doi: 10.1016/0006-2952(66)90018-9. [DOI] [PubMed] [Google Scholar]
- del Pozo V., de Andrés B., Gallardo S., Cárdaba B., de Arruda-Chaves E., Cortegano M. I., Jurado A., Palomino P., Oliva H., Aguilera B. Cytokine mRNA expression in lung tissue from toxic oil syndrome patients: a TH2 immunological mechanism. Toxicology. 1997 Mar 14;118(1):61–70. doi: 10.1016/s0300-483x(96)03584-6. [DOI] [PubMed] [Google Scholar]
- von Schmiedeberg S., Fritsche E., Rönnau A. C., Specker C., Golka K., Richter-Hintz D., Schuppe H. C., Lehmann P., Ruzicka T., Esser C. Polymorphisms of the xenobiotic-metabolizing enzymes CYP1A1 and NAT-2 in systemic sclerosis and lupus erythematosus. Adv Exp Med Biol. 1999;455:147–152. doi: 10.1007/978-1-4615-4857-7_21. [DOI] [PubMed] [Google Scholar]
