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叶酸相关的DNA甲基化与结直肠癌患者化疗引起的毒性反应

Folate-Associated DNA Methylation and Chemotherapy-Induced Toxicities in Patients With Colorectal Cancer.

作者信息

Zwart Nienke R K, Kok Dieuwertje E, Ariyaratne Sajini N H, McKay Jill A

机构信息

Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.

Department of Applied Sciences, Northumbria University, Newcastle upon Tyne, UK.

出版信息

Mol Nutr Food Res. 2025 Jul;69(14):e70127. doi: 10.1002/mnfr.70127. Epub 2025 May 27.


DOI:10.1002/mnfr.70127
PMID:40420697
Abstract

Patients with stage II-III colorectal cancer (CRC) often receive fluoropyrimidine-based chemotherapy, usually combined with other regimens, of which ∼50% experience severe chemotherapy-induced toxicities. The B-vitamin folate has been associated with toxicity risk, possibly through effects on DNA methylation. Here, we examined the potential role of folate-associated DNA methylation in the context of chemotherapy-induced toxicities. Systematic literature searches were conducted to identify studies investigating either DNA methylation profiles associated with folate status/intake or with toxicities. Overlapping CpG sites and genes across studies investigating associations for "folate-DNA methylation" and "DNA methylation-toxicities" were identified. The probability of overlap was tested using hypergeometric tests and Gene Ontology and KEGG pathway analyses were performed. Six studies were included. A significant number of CpGs and genes overlapped with altered methylation in response to both folate and hand-foot syndrome (HFS) or thrombocytopenia. Moreover, methylation of genes within the KEGG pathway "focal adhesion" was related to folate status/intake and occurrence of HFS, thrombocytopenia, and neutropenia. We identified some overlapping DNA methylation profiles related to both folate exposures and toxicities. This provides preliminary evidence implying folate-associated DNA methylation may determine risk of toxicities, and therefore may be considered a modifiable factor for improving patient outcomes.

摘要

II - III期结直肠癌(CRC)患者常接受基于氟嘧啶的化疗,通常与其他方案联合使用,其中约50%的患者会出现严重的化疗诱导毒性。B族维生素叶酸与毒性风险有关,可能是通过对DNA甲基化的影响。在此,我们研究了叶酸相关DNA甲基化在化疗诱导毒性中的潜在作用。进行了系统的文献检索,以确定研究叶酸状态/摄入量相关的DNA甲基化谱或与毒性相关的DNA甲基化谱的研究。确定了在研究“叶酸 - DNA甲基化”和“DNA甲基化 - 毒性”关联的研究中重叠的CpG位点和基因。使用超几何检验测试重叠的概率,并进行基因本体论和KEGG通路分析。纳入了六项研究。大量的CpG和基因在对叶酸和手足综合征(HFS)或血小板减少症的反应中甲基化发生改变。此外,KEGG通路“粘着斑”内基因的甲基化与叶酸状态/摄入量以及HFS、血小板减少症和中性粒细胞减少症的发生有关。我们确定了一些与叶酸暴露和毒性均相关的重叠DNA甲基化谱。这提供了初步证据,表明叶酸相关的DNA甲基化可能决定毒性风险,因此可能被视为改善患者预后的一个可调节因素。

相似文献

[1]
Folate-Associated DNA Methylation and Chemotherapy-Induced Toxicities in Patients With Colorectal Cancer.

Mol Nutr Food Res. 2025-7

[2]
A rapid and systematic review of the clinical effectiveness and cost-effectiveness of topotecan for ovarian cancer.

Health Technol Assess. 2001

[3]
Meta Analysis of Methylenetetrahydrofolate Reductase (MTHFR) C677T polymorphism and its association with folate and colorectal cancer.

BMC Cancer. 2025-1-29

[4]
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Cochrane Database Syst Rev. 2018-2-6

[5]
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Syst Rev. 2024-11-26

[6]
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Cochrane Database Syst Rev. 2021-10-18

[7]
Folic acid with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people.

Cochrane Database Syst Rev. 2008-10-8

[8]
Irinotecan chemotherapy combined with fluoropyrimidines versus irinotecan alone for overall survival and progression-free survival in patients with advanced and/or metastatic colorectal cancer.

Cochrane Database Syst Rev. 2016-2-12

[9]
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Cochrane Database Syst Rev. 2018-3-16

[10]
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Cochrane Database Syst Rev. 2022-7-12

本文引用的文献

[1]
Intake and biomarkers of folate and folic acid as determinants of chemotherapy-induced toxicities in patients with colorectal cancer: a cohort study.

Am J Clin Nutr. 2024-2

[2]
Personalizing adjuvant therapy for patients with colorectal cancer.

Nat Rev Clin Oncol. 2024-1

[3]
Folic Acid Supplementation to Prevent Neural Tube Defects: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

JAMA. 2023-8-1

[4]
Folate, folic acid, and chemotherapy-induced toxicities: A systematic literature review.

Crit Rev Oncol Hematol. 2023-8

[5]
Healthy lifestyle, DNA methylation age acceleration, and incident risk of coronary heart disease.

Clin Epigenetics. 2023-3-28

[6]
Prevalence of hand-foot syndrome following chemotherapy for colorectal cancer: a systematic review and meta-analysis.

Int J Colorectal Dis. 2023-3-6

[7]
KEGG for taxonomy-based analysis of pathways and genomes.

Nucleic Acids Res. 2023-1-6

[8]
Characterisation of ethnic differences in DNA methylation between UK-resident South Asians and Europeans.

Clin Epigenetics. 2022-10-15

[9]
Identification of Genes Related to 5-Fluorouracil Based Chemotherapy for Colorectal Cancer.

Front Immunol. 2022

[10]
DNA methylation patterns reflect individual's lifestyle independent of obesity.

Clin Transl Med. 2022-6

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