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From: "Peter Christiansen" <>
Date: Tue, 05 Mar 2002 16:59:25 -0600

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Progress in Search for Genetic Trigger of Pancreatic Cancer



 From these data, it became clear that four generations ago one man with 
this inherited locus passed the gene it contained on to five of his six 
sons, all of whom died of pancreatic cancer, but not before they passed it 
on to future generations," said HHMI investigator Leonid Kruglyak.



February 28, 2002  Researchers are reporting progress in the search for a 
gene mutation that triggers pancreatic cancer, the fifth leading cause of 
cancer death in the United States. Genetic studies of a family that has a 
long history of pancreatic cancer have led researchers to a region of 
chromosome 4 that is the likely location of a gene mutation that causes 
cancer in members of this family.

Pancreatic cancer is difficult to detect, spreads quickly, and kills almost 
all affected patients within six months of diagnosis. Of an estimated 29,200 
cases of pancreatic cancer diagnosed each year in the United States, 28,900 
patients succumb to the disease, usually within four to six months of 
diagnosis.

Identification of the genomic region, or locus, on chromosome 4 that 
contains the gene will be published in the April 2002 issue of the American 
Journal of Human Genetics. The research team included Teresa A. Brentnall of 
the University of Washington Medical Center, Howard Hughes Medical Institute 
investigator Leonid Kruglyak and Michael Eberle of the Fred Hutchinson 
Cancer Research Center, David C. Whitcomb and Roland Pf tzer of the 
University of Pittsburgh and the VA Pittsburgh Health Care System.

One of the keys to finding the gene locus was Family X, whose members have 
inherited a gene mutation that predisposes them to pancreatic cancer. 
Brentnall and her colleagues have studied Family X for more than seven 
years, observing that the pancreatic cancer usually occurs in members of 
this family by age 43.

 There have certainly been cases of family clustering of pancreatic cancer,  
said Kruglyak.  But this is the largest family yet found where pancreatic 
cancer segregates in a clearly Mendelian fashion in an autosomal-dominant 
pattern.  Autosomal dominance occurs when one of the two copies of a gene 
has a variation that is sufficient for expression of a specific trait.

Pancreatic cancer has also been associated with hereditary predisposition to 
other cancers   including some colon and breast cancers and melanomas   as 
well as inflammatory pancreatitis. But approximately ten percent of cases of 
pancreatic cancer are inherited in an autosomal dominant fashion in families 
like Family X that don t have another disease.

As promising as the study of Family X appeared to be, Kruglyak said that 
tracking members of the far-flung family, collecting blood samples for 
analysis and monitoring the family for precancerous signs using endoscopic 
techniques proved highly challenging.  It has taken a lot of very hard work 
by Teri Brentnall and her colleagues to trace the complex branches of this 
family and obtain material for study,  he said.

Kruglyak, who made the decision to study pancreatic cancer after his cousin 
died of the disease, set out to pinpoint the location of the mutated gene 
carried by members of Family X. By doing detailed analysis of genomic 
landmarks, called  microsatellite markers,  that span the entire genomes of 
family members, Kruglyak and his colleagues identified landmarks that were 
consistently passed down through the generations along with the gene 
mutation that conferred a predisposition to pancreatic cancer.

The scientists first analyzed a subset of the family to detect regions of 
the genome that were consistently inherited together with the disease. That 
initial study revealed that a region of chromosome 4 showed the best 
evidence of such  segregation.  The researchers next added more family 
members and additional markers in the target region, obtaining a highly 
significant association of inheritance of the chromosome 4 region with the 
disease.

 We typed all of the available family members for the initial and new 
markers just in that area, and we got a clear statistical signal, way above 
chance, that this region cleanly segregated with the disease,  said 
Kruglyak.

 From these data, it became clear that four generations ago one man with 
this inherited locus passed the gene it contained on to five of his six 
sons, all of whom died of pancreatic cancer,  said Kruglyak.  But not before 
they passed it on to future generations. And critically important, none of 
the unaffected individuals in the family inherited this locus. 

The discovery of the pancreatic cancer susceptibility locus on chromosome 4 
has led to an intense effort to identify the specific gene mutation that 
causes the disease, said Kruglyak. Identification of the gene should be of 
immediate benefit to members of Family X because it will enable earlier 
identification of family members who will develop cancer later in life.

 So far, that s the only direct impact,  he said.  But we hope that once we 
pinpoint the gene, its identity will suggest many more research avenues.  
For example, he said, spontaneous mutations in the susceptibility gene 
itself might play a role in triggering sporadic, or non-inherited, 
pancreatic cancer. Also, identification of the gene might reveal a pathway 
in which other malfunctions may also cause the sporadic form of the disease. 
While the existence of such a pancreatic cancer pathway is still 
speculative, said Kruglyak, the genes involved in such a pathway might be 
targets for drugs that could prevent pancreatic cancer.


Photo: Fred Hutchinson Cancer Research Center



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