title: DNA adducts and p53 mutations in a patient with aristolochic acid-associated nephropathy.
abstract: BACKGROUND
  Aristolochic acid-associated nephropathy (AAN) is a specific type of renal disease that predisposes patients to a high risk of urothelial carcinoma. The authors have analyzed DNA from a patient who had urothelial malignancy 6 years after presenting with AAN and later had a breast carcinoma that metastasized to the liver.
  
  
  RESULTS
  DNA was isolated from the primary breast tumor, the liver tumor, and the original urothelial malignancy and assayed for aristolochic acid (AA)-DNA adducts and mutations in the p53 gene. The adduct detected was the adenosine adduct of aristolochic acid I 7-(deoxyadenosin-N6-yl)aristolactam I (dA-AAI). In DNA from the breast and liver tumors the authors showed the same missense mutation in codon 245 (GGC-->GAC; Gly-->Asp) of exon 7 of p53. In contrast, DNA extracted from the urothelial tumor showed an AAG to TAG mutation in codon 139 (Lys-->Stop) of exon 5.
  
  
  CONCLUSIONS
  A to T transversions, as observed here, are the typical mutations observed in the H-ras gene of tumors induced when rodents are treated with AA and correspond with DNA adduct formation at adenosine residues. These data indicate the probable molecular mechanism whereby AA causes urothelial malignancy.
authors.affiliation: Division of Renal Medicine and Transplantation, Hammersmith Hospital NHS Trust, London, England UK. glord@hsph.harvard.edu
authors.forename: Graham M
authors.initials: GM
authors.lastname: Lord
authors.forename: Monica
authors.initials: M
authors.lastname: Hollstein
authors.forename: Volker M
authors.initials: VM
authors.lastname: Arlt
authors.forename: Candice
authors.initials: C
authors.lastname: Roufosse
authors.forename: Charles D
authors.initials: CD
authors.lastname: Pusey
authors.forename: Terry
authors.initials: T
authors.lastname: Cook
authors.forename: Heinz H
authors.initials: HH
authors.lastname: Schmeiser
mesh_terms: D030022:Aristolochia / Q000009:adverse effects; D034341:Aristolochic Acids / Q000506:poisoning*; D001943:Breast Neoplasms / Q000209:etiology* / Q000235:genetics; D018736:DNA Adducts; D005260:Female; D016158:Genes, p53; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000150:complications; D008875:Middle Aged; D009153:Mutagens; D009154:Mutation; D010946:Plants, Medicinal / Q000009:adverse effects; D014516:Ureteral Neoplasms / Q000209:etiology* / Q000235:genetics
chemical_list: D034341:Aristolochic Acids; D018736:DNA Adducts; D009153:Mutagens; C000228:aristolochic acid I