Polymorphisms in the glutathione S-transferase class mu and theta genes interact and increase susceptibility to lung cancer in minority populations (Texas, United States)

The genes coding for separate isoforms of both the human glutathione S-transferase class mu and class theta enzymes (GSTM1 and GSTT1) are polymorphic with a variable ethnic distribution. These enzymes detoxify reactive epoxides, including carcinogens produced by tobacco smoke. Because of this, the null polymorphism in the GSTM1 gene (coding for the glutathione S-transferase class mtt enzyme) has been studied widely as a possible source of inherited susceptibility to smoking-related lung cancer. The more recently described null polymorphism in the GSTT1 gene also could contribute to an increased risk of smoking-related lung cancer. As the incidence of lung cancer is known to differ by ethnicity, we have conducted a case-control study in the United States of 108 African-Americans (Blacks) and 60 Mexican-Americans (Hispanics) with lung cancer and 132 African-American (Black) and 146 Mexican-American (Hispanic) controls to investigate the association of the GSTT1 and GSTM1 polymorphisms with lung cancer in minority populations. In the unadjusted data, there was a borderline significant association of the GSTM1 null polymorphism with lung cancer in Mexican-Americans (odds ratio [OR] = 1.8, 95 percent confidence interval [CI] = 1.0-3.3) that was not observed in African-Americans. The GSTT1 null polymorphism also had a higher prevalence in cases than controls in both racial/ethnic groups, but this increase was not statistically significant. When the data were analyzed using logistic regression controlling for age, gender, race, and smoking, no significant association of either trait with lung cancer was observed, with ORs for both traits of approximately 1.3. However, when the prevalence of individuals who were null for both polymorphisms was compared by case status, a significant interaction was observed. Logistic regression models showed the OR for the association of lung cancer and the presence of both null polymorphisms compared with one (either GSTT1 or GSTM1) or no null genotype to be 2.9 (P < 0.04). These results suggest that there may be carcinogenic intermediates in cigarette smoke that are substrates for both the GSTT1 and GSTM1 enzymes, and that lung cancer risk is increased more than additively for individuals who have both GSTT1 and GSTM1 null polymorphisms.