Dietary reference values of individual micronutrients and nutriomes for DNA damage prevention

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1 AICR Conference Washington October 2010 Fenech MF, Am J Clin Nutr. 2010; 91(5):1438S-1454S Dietary reference values of individual micronutrients and nutriomes for DNA damage prevention Current status and a road map to the future Michael Fenech CSIRO Food and Nutritional Sciences GENOME HEALTH NUTRIGENOMICS LABORATORY michael.fenech@csiro.au

2 Overview Biomarkers used to study DNA damage in humans Association of DNA damage with developmental and degenerative disease Current knowledge of nutritional requirements for genome maintenance and stability Effect of nutrient-nutrient and nutrient-genotype interaction on DNA integrity Strategies to determine DRVs of single micronutrients and micronutrient combinations (nutriomes) for DNA damage prevention

3 A NUCLEOCENTRIC VIEW OF AGEING FROM WOMB TO TOMB

4 BIOMARKERS OF DNA DAMAGE NPB dicentric MN Gene expression arrays γh2ax

5 The principal structural chromosomal aberrations which contribute acentric fragments (AF) to form micronuclei (MN) and nucleoplasmic bridges (NPB) Acknowledgement John RK Savage Atlas Genet Cytogenet Oncol Haematol. July 2000

6 Genome damage Micronuclei CYTOKINESIS-BLOCK MICRONUCLEUS (CBMN) ASSAY Oxidative stress Nutrient deficiency Excess calories Strand breaks in DNA Chromosome malsegregation DNA hypomethylation Telomere shortening Human cells with damaged & unstable genomes

7 Increased lymphocyte micronucleus frequency in early pregnancy is associated prospectively with pre-eclampsia and/or intrauterine growth restriction (PEIUGR) RISK GROUPS PREGNANCY OUTCOME GROUPS LRN N=38 D.L.F FurnesS, G.A Dekker, W.M Hague T. Y Khong and M.F Fenech Mutagenesis (2010) LOW RISK N=45 ADVERSE N=7 PEIUGR N=36 HIGH RISK N=91 ADVERSE N=67 LYMPHOCYTE MICRONUCLEI MEASURED AT 18 WKS GESTATION OAO N=38 HRN N=24 Odds Ratio PROSPECTIVE ODDS RATIO OF PEIUGR FOR ALL COHORT P=0.003 P=0.006 >19.3 >28.0 >36.7 MN-BN P=0.001

8 Risk of cancer increases with higher MN frequency PROBABILITY OF SURVIVING WITHOUT CANCER FOLLOW UP TIME IN YEARS 6,983 subjects 275 cancer cases HUMN project ( Bonassi et al (Carcinogenesis 2007)

9 Lymphocyte Micronucleus frequency is associated prospectively with cardiovascular disease mortality in both the general population and those with known coronary artery disease MN>1 MN< subjects 111 deaths 39 due to CVD Mean age 65 y Federici C et al MN frequency 178 CAD patients Mean age 62 y

10 GENOME DAMAGE INCREASED IN LYMPHOCYTES OF ALZHEIMER AND PARKINSON S S DISEASE PATIENTS DNA DAMAGE IN LYMPHOCYTES MN PER 1000 BNCs 20 * * P<0.001 * AD PD CONTROL % DISTRIBUTION OF TYPE OF MICRONUCLEI MN (CHROM. LOSS) MN (CHROM. BREAK) p < AD PD CONTROL Petrozzi et al. Neurol. Sci. 2002

11 DNA damage increases with age...or.. poor choices of nutrition, life-style, physical and socio-psychological environments? MN per 1000 BN cells What is the threshold of DNA damage we should allow? Can we design exposomes that enable us to stay below this threshold? Fenech et al AGE (years)

12 CAUSES AND EFFECTS OF GENOME DAMAGE E X P O S O M E MALNUTRITION LIFE-STYLE GENOTOXINS PSYCHOLOGICAL STRESS ENVIRONMENTAL GENOTOXINS GENETIC AND ACQUIRED SUSCEPT- IBILITY GENOME DAMAGE IN: GERMLINE EMBRYO FOETUS BABY CHILD TEENAGER HIGHER RISK DEVELOPMENTAL DEGENERATIVE DISEASES YOUNG ADULT OLDER ADULT LOWER RISK

13 Italy Germany Poland Mexico Bhutan Chad USA Ecquador Egypt Dietary patterns & 1 week s food

14 The new frontier in nutrition NUTRIOME H E A L T H GENOME Nutrition designed for diverse genetic backgrounds to optimise genome maintenance and prevent diseases caused by DNA damage

15 The following genomic stability processes are modulated by vitamins or micronutrients: DNA oxidation prevention Vit C, Vit E, Se, polyphenols DNA methylation,, synthesis folate, Vit B12, Zn, Mg DNA repair Gene expression Chromosome segregation Telomere length Necrosis/Apoptosis niacin, Zn, folate folate, Vit D, Vit A folate, Vit A, Mg niacin? via PARP, folate niacin, Zn, Vit E, Vit D, Vit C Vit A, Vit K2.

16 Folate, B12, B6 and B2 and genome maintenance FOLIC ACID METHIONINE THF DHF dump SAM MTR VIT B12 (CoIII) SHMT1 VIT B6 TS DNA MTRR MTR VIT B12 (CoI) MTHFR VIT B2 5,10-MeTHF dtmp HOMOCYSTEINE 5-MeTHF DNA METHYLATION DNA REPAIR & SYNTHESIS

17 Minimally invasive High-Throughput Nutrient Array screening for Genome-Protective agents. 20ul blood Seed Lymphocytes Mitogen Nutrients Cytochalasin B (cytokinesis blocking agent) 1 h 20 h 44 h Image acquisition and analysis +/- Genotoxin +/- Genotoxin 72h Nuclear stain/fix Micronucleus Development of automated CBMN Cytome assay: MN, NPB, NBUDs, Necrosis, Apoptosis, NDI + FISH + Protein expression Targeted Cell Selected Nuclei

18 Fenech M (2007) Nature Protocols A B C A,B, C NUCLEAR DIVISION INDEX D CBMN CYTOME ASSAY E D,E CELL DEATH F G H F, G, H DNA DAMAGE

19 [A] MICRONUCLEATED CELLS [B] NUCLEAR BUDS MNed BNs/1000 BNs * ANOVA P < ** Buds/1000 BNs * ANOVA P< ** folic acid in medium (nm) folic acid in medium (nm) [C] NUCLEOPLASMIC BRIDGES [D] URACIL NPB/1000 BNs * ANOVA P< ** pg uracil / g DNA * * ANOVA P < [folic acid] in medium (nm) Crott et al. Carcinogenesis [folic acid] in medium (nm)

20 Genome damage induction by Folic acid deficiency is of a similar magnitude as that induced by unsafe doses of ionising radiation IAEA annual safe exposure limit ie equivalent to rad X-rays 35 MNed BNs/1000 BNs Crott & Fenech 2002 Fenech & Morley, rad X-rays nm folic acid normal serum folate concentration

21 Randomised, placebo-controlled controlled dietary intervention PLACEBO FOLB12 ROUND 1 ROUND 1 CEREAL CEREAL + ONLY 7ug B ug FOL ROUND 2 ROUND 2 TABLET TABLET PLACEBO 20ug B ug FOL ROUND 3 ROUND 3 BASE-LINE LINE* 12 WEEKS* 24 WEEKS* * blood sample Fenech et al Carcinogenesis

22 Supplementation with 3.5 times RDI folic acid & vit B12 reduces micronucleus index by 25 % in subjects with above average chromosome instability Low MNed cell freq. at R1. [N = 17] ANOVA P = 0.65 High MNed cell freq. at R1. [N = 16] ANOVA P < MNed cells per 1000 BN cells * * R1 R1 R2 R2 R3 R3 Fenech et al Carcinogenesis Base-line 7ug B12 700ug FA 20ug B12 2mg FA

23 serum B12 vs MN frequency in men aged years who were not vitamin B12 deficient MICRONUCLEUS FREQUENCY IS MINIMISED WHEN HOMOCYSTEINE < 7.5umol/l and B12 > 300pmol/l serum B12 (pmol/l) plasma HC ( mol/l) YOUNG ADULTS 18-32Y N = 48 R = P = MNed cells per 1000 BN cells N = 48 R = P = MNed cells per 1000 BN cells Fenech et al Carcinogenesis plasma HC [ mol/l] serum B12 [pmol/l] MEN AGED 50-70Y R = P = N = 62 N=62 R=-0.31 P==0.013 MN frequency vs plasma HC in men (50-70years) who were not MN deficient frequency in per B or folate BN cells R = P = N = MN frequency per 1000 BN cells Fenech et al. (1997) Carcinogenesis

24 Eussen SJ et al times recommended intake of B12 is required to normalise holotc,, MMA and homocysteine in >70 year olds

25 Future Challenges: We have started to determine the impact of common polymorphisms in folate metabolism genes on chromosome damage in Australians *age & gender adjusted Dhillon et al Mutation Res Fund Mech 2009

26 MICRONUTRIENTS AND GENOME DAMAGE RESULTS OF ANALYSIS OF FOOD FREQUENCY QUESTIONNAIRE AND GENOME DAMAGE DATABASE % variation in genome damage with increased intake relative to lowest tertile of intake % variation in MN freq Vitamin E * P < * * * * * * Calcium Folate Retinol Nicotinic acid * -Carotene * Riboflavin * * Pantothenic acid * Biotin mid-tertile highest tertile Fenech et al. Carcinogenesis (2005)

27 Fenech et al 2005 Carcinogenesis; Fenech 2010 AJCN NUTRIENT-NUTRIENT INTERACTION ON CHROMOSOME DAMAGE (a) COMBINED EFFECT OF FOLATE AND CALCIUM INTAKE ON MN FREQUENCY (b) COMBINED EFFECT OF FOLATE AND RIBOFLAVIN INTAKE ON MN FREQUENCY % VARIATION * * * * * * low tertile mid tertile high tertile FOLATE INTAKE low tertile mid tertile high tertile % VARIATION * * * * low tertile mid tertile high tertile RIBOFLAVIN INTAKE low tertile mid tertile high tertile CALCIUM INTAKE FOLATE INTAKE The combined effect of (a) calcium and folate intake and (b) riboflavin and folate intake on MN frequency. Results shown are the % variation relative to the combined lowest tertiles of intake in the pair of nutrients examined. * P < 0.05 for comparison with the referent value for the combined lowest tertile of intake for the pair of nutrients examined. MORE RIBOFLAVIN IN A LOW FOLATE BACKGROUND MAY BE GENOTOXIC

28 Q. Which dietary pattern will work for your genotype? AMOUNTS IN 100g EXPRESSED AS % OF MIMIMUM REQUIREMENT FOR OPTIMUM GENOME HEALTH A. It depends on the nutriome of the foods you prefer to eat CALCIUM FOLATE NIACIN VITAMIN E BETA-CAROTENE RETINOL 0 ALMONDS WHEATBRAN CHEDDAR CHEESE BROCCOLI (BOILED) TUNA (CANNED) BEEF (COOKED) BANANA Fenech, Food Chem Tox 2008

29 Folate content of vegetables (DFE µg per 100g)* *Data from USDA National Nutrient data base. DFE = dietary folate equivalent. DFE values are shown in brackets.. High Folate (HF) Vegetables Low Folate (LF) Vegetables Pulses Red Kidney beans (130) Mung beans (60) Chickpeas (171) Leafy or cruciferous vegetables Roots or Tubers Fruit Vegetables Broccoli (93) Onions (16) Tomato (15) Brussel sprouts (60) Potato (22) Pumpkin (9) Cabbage (43) Turnip (9) Cucumber (6) Lentils (180) Endive (142) Parsnip (57) Capsicum (11) Peas (59) Spinach (146) Swede (21) Eggplant (14) Lima beans (50) Lettuce (73) Carrot (14) Olives (0) Mean (108) Mean (93) Mean (23) Mean (10) Mean (100) Mean (16) Eating the wrong vegetables could lead to folate deficiency Folate RDA 400μg requires eating: 2.5Kg LF veg/d or 0.4Kg HF veg/d

30 TELOMERES TELOMERES (TTAGGG repeats) ARE ESSENTIAL FOR CHROMOSOME STABILITY TELOMERE SHORTENING OR DYSFUNCTION INCREASES RISK FOR CANCER AND ACCELERATED SENESCENCE

31 SHORTER TELOMERES ARE ASSOCIATED PROSPECTIVELY WITH INCREASED RISK FOR CANCER MULTIVARIATE HAZARD RATIO FOR CANCER INCIDENCE LONG MEDIUM SHORT st Qtr LEUKOCYTE TELOMERE LENGTH Wong & Collins Lancet 2003 Willeit P et al, JAMA. 2010; 304(1):69-75.

32 Thomas et al, Mech Aging Dev, 2008 Shorter telomeres in WBCs and Buccal cells of Alzheimer s disease (AD) cases compared to controls Absolute telomere length (Kb per diploid genome) a Young controls b Old controls c Younger AD bc Older AD WBC TL <115 Kb per diploid genome OR of being diagnosed with AD is 10.8 specificity 46% sensitivity 92.9%. Absolute telomere length (Kb per diploid genome) a Young controls a Old controls ab Younger AD b Older AD Buccal TL <40 kb per diploid genome OR of being identified with AD is 4.6 specificity 63% sensitivity 72.7%. young controls (N=30), old controls (N=26), younger AD (N=14), older AD (N=18).

33 LONGER FOLATE VITAMIN E VITAMIN D Ω3-FATTY ACIDS CEREAL FIBRE MULTIVITAMIN USE TELOMERES CURRENT KNOWLEDGE SHORTER PUFA OXIDATIVE STRESS OBESITY PSYCHOLOGICAL STRESS PROCESSED MEAT HOMOCYSTEINE Int J Obes (Lond) Aug;34(8):1345-8; Am J Clin Nutr May;91(5): Rejuvenation Res Oct;12(5): ; Rejuvenation Res Jun;12(3): J Nutr Jul;139(7):1273-8; Am J Clin Nutr Jun;89(6): Am J Clin Nutr Nov;86(5):

34 ANTIOXIDANT DEFICIENCY OR OXIDATIVE STRESS 8-OHdG BREAKS IN TELOMERE Bull & Fenech Proc. Br Nutr Soc 2008 FOLATE DEFICIENCY? NIACIN OR NICOTINIC ACID DEFICIENCY? URACIL HYPO- METHYLATED SUBTELOMERE REDUCED TANK1 ACTIVITY? REDUCED TRF1, TRF2 BINDING LOSS OF TELOMERE LENGTH CONTROL DYSFUNCTIONAL AND/OR SHORT TELOMERES; TELOMERE END FUSIONS; AND CIN TELOMERE DAMAGE CASCADE

35 High protein (TWD) or high carbohydrate (HC) weight-loss diets reverse telomere shortening in rectum in over-weight men Telomere length (kb) TWD HC 2 way ANOVA P< O Callaghan, Clifton, Noakes,, Fenech. Rejuvenation Res weeks on diet

36 IS A COMPREHENSIVE SET OF DNA DAMAGE BIOMARKERS NEEDED FOR PERSONALISED NUTRITION AND DRV DETERMINATION FOR GENOME DAMAGE PREVENTION? Fenech M (2010) Am. J. Clin. Nutr. LYMPHOCYTE CBMN ASSAY BUCCAL MN ASSAY RBC MN ASSAY COMET ASSAY TELOMERE LENGTH MITOCHONDRIAL DNA DELETION DNA OXIDATION DNA METHYLATION

37 Validation status of DNA damage biomarkers DNA DAMAGE BIOMARKERS CYTOKINESIS-BLOCK MICRONUCLEUS ASSAY IN LYMPHOCYTES ASSOCIATION WITH NUTRITIONAL STATUS CROSS-SECTIONAL STUDIES PLACEBO- CONTROLLED STUDIES ASSOCIATION WITH DEVELOPMENTAL OR DEGENERATIVE DISEASE OR MORTALITY CASE-CONTROL STUDIES PROSPECTIVE COHORT STUDIES MICRONUCLEUS ASSAY IN BUCCAL CELLS? MICRONUCLEUS ASSAY IN ERYTHROCYTES DNA STRAND BREAKS IN LYMPHOCYTES BY COMET ASSAY DNA OXIDATION DNA METHYLATION TELOMERE LENGTH IN LEUKOCYTES OR LYMPHOCYTES Fenech M (2010) Am. J. Clin. Nutr.????? MITOCHONDRIAL DNA DELETION?

38 PROPOSED ROAD-MAP TO DETERMINE DRVs FOR GENOME STABILITY NUTRITION VARIABLES SINGLE MICRONUTRIENT MICRONUTRIENT COMBINATION FUNCTIONAL FOOD FOOD GROUP DIETARY PATTERN STUDY DESIGN IN VITRO MODELS IN VIVO CROSS- SECTIONAL STUDIES PLACEB0- CONTROLLED TRIALS OUTCOME MEASURES PRIMARY DNA DAMAGE BIOMARKERS: MICRONUCLEUS CYTOME ASSAYS COMET ASSAY DNA OXIDATION DNA METHYLATION TELOMERE LENGTH mtdna DELETION SECONDARY TISSUE MICRONUTRIENT CONCENTRATION DRVs FOR GENOME STABILITY DATABASES ON VITAMIN & MINERAL REQUIREMENTS FOR GENOME STABILITY IN DIVERSE GENETIC BACKGROUNDS AT THE VARIOUS LIFE-STAGES Fenech M (2010) Am. J. Clin. Nutr.

39 Huang et al Preventive Medicine 48 (2009) LIFE-STYLE IS ALSO AN IMPORTANT DETERMINANT OF DNA DAMAGE LIFE-STYLE HPI INDEX

40 GENOME HEALTH STATUS OF THE POPULATION NUTRI- GENOMICS TOXICO- GENOMICS PSYCHO- GENOMICS LIFESTYLE GENOMICS

41 RADICAL INNOVATION IN NUTRITION AUTOMATED DIAGNOSTICS GENOME HEALTH - NUTRIENT STATUS - GENOTYPE NUTRIGENOMICS EXPERT ADVICE SYSTEM DATA BASE INDIVIDUALISED NUTRITION DIETARY PATTERNS - FUNCTIONAL FOODS - SUPPLEMENTS FEEDBACK TO DATABASE VERIFICATION OF EFFICACY GENOME HEALTH OPTIMISED DEVELOPMENTAL & DEGENERATIVE DISEASE PREVENTED Funding: Reach 100, NCEFF Fenech M (2005) Mutagenesis 20: ABC Catalyst, DNA Doctor Story

42 We are at the threshold of a new era in which harm to the genome, which is the most fundamental pathology, can be efficiently diagnosed and prevented. A person s DNA damage profile is likely to become the ultimate routine biomarker of health status. Prevention of DNA damage will soon achieve its rightful place as one of the most important objectives of global health strategies. Michael Fenech October 2010

43 Acknowledgements CRC Diagnostics THE GENOME HEALTH NUTRIGENOMICS TEAM CHORI (USA) Bruce Ames, Susan Mashiyama Natl. Ins. Hlth & Nutr Japan Keizo Umegaki, Michiyo Kimura WCH Adelaide Graeme Suthers Peter Baghurst RAH Adelaide Ian Olver, Eric Yeoh FUNDING Kellogs Pty Ltd, MLA Blackmore s, Nutrilite/Amway NHMRC, Cancer Council SA, NIH/NIAID EUCancerRiskBiomarkers Program DPI-Victoria NO CONFLICT OF INTEREST Coordinating Group: Michael Fenech (Australia) Chairman Stefano Bonassi (Italy) Wushou Chang (Taiwan) Nina Holland (USA) Errol Zeiger (USA) Micheline Kirsch-Volders (Belgium) HUMN International Collaborative Project on Micronucleus frequency in human populations Founded Toulouse labs 16 countries >12,000 subjects >70,000 person years Felicia Bulman Julie Turner Carolyn Salisbury Philip Thomas Jimmy Crott Will Greenrod Josy Rinaldi Clare Aitken Sally Record Maryam Hor Theodora Hua Haen Jing Wu Caroline Bull Nathan O Callaghan Wayne Leifert Glen Patten Erin Symonds Bianca Benassi Sasja Beetstra

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45 O Callaghan, Clifton, Noakes,, Fenech. Rejuvenation Res REDUCTION IN FAT CORRELATES WITH INCREASE IN TELOMERE LENGTH

46 Telomere length in older men is significantly associated with plasma folate and homocysteine Telomere length is negatively correlated with plasma homocysteine in older men. Telomere length is positively correlated with plasma folate in males but not in females. Males; r = -0.57, p = (n = 24). Females; r = 0.092, p = 0.68 (n = 23) Males; r = 0.42, p = 0.04 (n = 24). Females; r = -0.11, p = 0.61 (n = 23) Bull, O Callaghan, Mayrhofer & Fenech Rejuvenation Res (2009)

47 Prof. Michael Fenech Prof. Michael Fenech Minimally invasive High-Throughput Nutrient Array screening for Genome-Protective agents. Nutritional Genomics and DNA Damage Diagnostics Laboratory CSIRO Food & Nutritional Sciences Seed cells Mitogen Nutrients Cytochalasin B (cytokinesis blocking agent) 9 day culture Nuclear stain/fix Image acquisition and analysis Micronucleus Development of automated CBMN Cytome assay: MN, NPB, NBUDs, Necrosis, Apoptosis, NDI + FISH + Protein expression Targeted Cell Selected Nuclei

48 Is it possible to identify the nutriome that prevents the growth of each cancer? One of the greatest challenges in ageing populations is the need to prevent the proliferation of cancers which accumulate with age. Currently there is no rational advice on the appropriate diet to adopt once a person is diagnosed with cancer because our knowledge on nutrient-gene interaction with respect to cancers is rudimentary. Furthermore there is concern that supplementation with certain nutrients that are required for genome maintenance and cell growth (e.g. folate, methionine) may stimulate the cancer growth

49 FOLATE: A DOUBLE-EDGED EDGED SWORD IN CANCER DEPENDING ON DOSE AND TIMING FOLATE DEFICIENCY <300 mcg/day* FOLATE DEFICIENCY <300 mcg/day* promotes inhibits?? NORMAL ADENOMA CANCER inhibits promotes ADEQUATE FOLATE mcg /day EXCESSIVE FOLATE > 1000mcg/day * folate deficiency increases risk of cancer initiation, dementia, stroke, osteoporosis

50 Metabolism of Folate and Methionine Cell Proliferation Apoptosis Methylthioribose-1-P + Methional Spermidine MTA DNA Synthesis & Repair MTOB Salvage Pathway Spermine Putrescine dcsam Protein Synthesis DHF dtmp Ornithine SAM Methionine Vit. B 12 Cob(III) THF TS CH 3 SAH De Novo Pathway Vit. B 12 Catalytic Pathway MTR MTRR 5,10-Methylene THF dump MTHFR Vit. B2 DNA & Protein Methylation Homocysteine CBS Trans-Sulphuration Pathway Vit. B 12 Cob(I) 5-Methyl THF RFC-1 Folic Acid monoglutamate Cytoplasm Extra Cellular Diet monoglutamate FGCP Folate polyglutamate

51 A nutrient array system could interrogate which nutrient restrictions or supplementations could control any cancer Cancers are genetically and epigenetically very different from normal tissue in the same person and from each other across persons. The multiple mutations in a cancer may make it difficult to rely on genotyping or gene expression patterns to work out an appropriate dietary control strategy. Some cancers amplify the high affinity folate receptor and may benefit from folate restriction. Other cancers may have defects in methionine metabolism making them susceptible to methionine restriction A nutrient array system could identify the appropriate nutriome to control a cancer without knowing its genotype/epigenotype

52 PERSONALISED NUTRIOMES FOR GENOME STABILITY OF STEM CELL & ips CELL CULTURES We now live in an era when stem cells are taken out of the body and expanded in vitro before being returned to the body Stem cell or ips cell cytogenetic abnormalities constitute a roadblock to regenerative therapies because they increase the rate of senescence and the risk of oncogenic transformation. Determining the optimal nutriome in culture medium that prevent chromosomal instability for each stem cell or ips culture is therefore important not only to predict in vivo requirements but also in vitro nutrient requirements for DNA damage prevention

53 REGENERATIVE POTENTIAL OF THE HIPPOCAMPUS REGENERATIVE POTENTIAL OF THE BUCCAL MUCOSA The oral epithelium is a stratified squamous epithelium. It consists of four layers: The keratinised layer at the surface The prickle cell layer The basal layer Lamina propria 7-10 days for cells to migrate from basal layer to keratinised layer Acknowledgement S Thuret (University College London)

54 Buccal Micronucleus Cytome is a powerful diagnostic of accelerated ageing Fenech & Thomas 2007 Mutagenesis 3 MICRONUCLEI p = KARYORRHEXIS p< YOUNGER CONTROLS DOWNS OLDER CONTROLS ALZHEIMER 0 YOUNGER CONTROLS DOWNS OLDER CONTROLS ALZHEIMER CONDENSED CHROMATIN BASAL CELLS p< p< YOUNGER CONTROLS DOWNS OLDER CONTROLS ALZHEIMER 0 YOUNGER CONTROLS DOWNS OLDER CONTROLS ALZHEIMER 0

55 Buccal Micronucleus Cytome Assay & Alzheimer Disease Risk karyorrhexis BIOMARKER PPV = 98%; NPV = 77%; Sensitivity = 82%, Specificity = 97% LR = 25, OR = 140 for Biomarker 1+2 < 41 AD & MCI CONTROLS BIOMARKER 1 Basal cells Fenech & Thomas 2007 Mutagenesis

56 a) Polychromatic erythrocyte Thomas P et al 2008; Wang J et al 2009 Protective effects of grape seed polyphenol and curcumin consumption on A plaque burden in brain section spanning hippocampus and DNA damage in blood and buccal cells of APPSwe/PS1dE9 transgenic mice Effects of polyphenol consumption on Ab plaque burden in brain section spanning hippocampus of APPSwe/PS1dE9 transgenic mice Frequency of buccal cells with MN (% of total cells sampled) One way ANOVA p< Micronucleated cells at 9 months a a a b b WT CON ADCON AD CUR AD GSE AD MGSE 3a) Basal cell 3b) Normal differentiated Cell 3c) Basal with MN 3d) Differentiated with MN 3e) Early karyolytic 3f) Mid karyolytic 3g) late karyolytic DNA damage in Buccal cells Effects of polyphenol consumption on Ab levels in the brain and serum of APPSwe/PS1dE9 transgenic mice Frequency of micronucleate PCE's per 1000 PCE's WT CON One way ANOVA p=0.004 Micronucleated PCE at 9 months a a AD CON ab AD CUR ab AD GSE b AD MGSE Micronuclei in Mature and immature erythrocytes with micronuclei c) Mature erythrocytes with micronuclei b) Polychromatic erythrocyte with micronuclei PCE d) Polychromatic erythrocyte (bright orange) and mature erythrocyte. DNA damage in bone marrow cells

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58 A B C Fenech M 2007 Nature Protocols D CYTOME E F G H NUTRIOME CYTOME & DNA DAMAGE Fenech 2008

59 Folate and mtdna deletions Accumulated lymphocytic mtdna deletions depend upon (a) dietary folate deprivation, (b) depletion of cellular folate storage Lymphocyte mtdna deletions are +vely correlated with brain mtdna deletions (r = 0.917, P < ). Chou and Huang (2009) EJN 48: Department of Nutritional Science, Fu-Jen University, Hsinchuang 242, Taipei County, Taiwan.

60 POSSIBLE MECHANISMS BY WHICH MICRONUTRIENT DEFICIENCY COULD CAUSE DAMAGE TO THE GENOME Folate/B12 choline deficiency Cytosine Hypomethylation Uracil Centromere dysfunction Telomere dysfunction Chromosome Loss or Malsegregation, Micronucleus formation Deficiency of antioxidant Vitamins and Cofactors of Antioxidant enzymes Deficiency of Cofactors of DNA Repair enzymes Oxidised DNA bases Unrepaired DNA adducts DNA break misrepair Unrepaired DNA breaks Telomere shortening mtdna deletion Base Sequence mutation or deletion Dicentric chromosomes Acentric Chromosome fragments Telomere end fusion ACCELERATED SENESCENCE Anaphase bridge formation Micronucleus formation BFB CYCLES CHROMOSOME INSTABILITY PHENOTPYE & ABERRANT KARYOTYPE

61 Ageing causes hypomethylation of satellite DNA which leads to loss of ch 1, 9, 16 and micronucleus formation YOUNG 32PDLs OLD 71PDLs AZAC 33 PDLs Mned cells (%) Bright Mni (%) Suzuki et al Exp. Gerontology

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63 THE HORMESIS HYPOTHESIS OF CALORIC/NUTRIENT RESTRICTION Protein/ Methionine restriction Caloric Restriction Mimetics VISFATIN SIRT1 KNOWN CALORIC RESTRICTION MIMETICS: XENOHORMETIC AGENTS??

64 DISCOVERY OF CALORIC RESTRICTION MIMETICS DECELERATED AGEING HEALTHY GENOME RESVERATROL OPTIMAL FAT LEVEL DNA repair Oncogenes silenced Compact chromatin + SIRTUIN DEACETYLASE ACTIVATION Oxidants Excess Calories DNA misrepair NAD - PPAR-γ DAMAGED GENOME NICOTINIC ACID TRYPTOPHAN EXCESS FAT ACCELERATED AGEING Howitz et al Nature 2004

65 ENVIRONMENTAL STRESSORS (work, home, neighbourhood) MAJOR LIFE EVENTS TRAUMA, ABUSE INDIVIDUAL DIFFERENCES (genes,development, experiences) PERCEIVED STRESS BEHAVIOURAL RESPONSES (fight or flight, smoking, drink, diet, exercise) PHYSIOLOGICAL RESPONSE ALLOSTASIS ADAPTATION ALLOSTATIC LOAD McEwen BS Physiol Rev (2006)

66 Correlations 2010 May 25;5(5):e10826

67 Huang et al Preventive Medicine 48 (2009) LIFE-STYLE IS ALSO AN IMPORTANT DETERMINANT OF DNA DAMAGE LIFE-STYLE HPI INDEX

68 DNA DAMAGE IS THE MOST FUNDAMENTAL DISEASE DNA DAMAGE CAN BE EFFICIENTLY DIAGNOSED DNA DAMAGE CAN BE PREVENTED DNA DAMAGE DIAGNOSTICS SHOULD BECOME ROUTINE IN INTEGRATIVE & PREVENTIVE MEDICINE PRACTICES

69 RADICAL INNOVATION IN NUTRITION AUTOMATED DIAGNOSTICS GENOME HEALTH - NUTRIENT STATUS - GENOTYPE NUTRIGENOMICS EXPERT ADVICE SYSTEM DATA BASE INDIVIDUALISED NUTRITION DIETARY PATTERNS - FUNCTIONAL FOODS - SUPPLEMENTS FEEDBACK TO DATABASE VERIFICATION OF EFFICACY GENOME HEALTH OPTIMISED DEVELOPMENTAL & DEGENERATIVE DISEASE PREVENTED Funding: Reach 100, NCEFF Fenech M (2005) Mutagenesis 20: ABC Catalyst, DNA Doctor Story

70 WHAT IS THE GENE EXPRESSION PATTERN ASSOCIATED WITH MICRONUCLEUS FORMATION? NETWORK OF GENES ASSOCIATED WITH MN Dedicated network showing FORMATION BASED ON DATA IN LITERATURE customised MN-related gene gene interactions with p53 as central hub and validated against actual occurrence of MN in exposed individuals has been constructed Van Leeuwen DM et al Mutagenesis (in press)