Associations between the neuron-specific glucocorticoid receptor (NR3C1) Bcl-1 polymorphisms and suicide in cancer patie
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Behavioral and Brain Functions Open Access
RESEARCH
Associations between the neuron‑specific glucocorticoid receptor (NR3C1) Bcl‑1 polymorphisms and suicide in cancer patients within the first year of diagnosis Subin Park1†, Jin Pyo Hong2†, Jong‑Keuk Lee3, Young‑Mi Park3, Yangsoon Park4, Juri Jeon2, Myeong Hee Ahn5 and Se Chang Yoon2*
Abstract Background: Cancer diagnosis is associated with an increased suicide risk, particularly within the first 1 year after diagnosis of cancer. Abnormal function of the hypothalamic–pituitary–adrenal axis has been implicated in the patho‑ physiology of depression and suicide. We examined genetic associations of the functional Bcl-1 polymorphism of (rs41423247) neuron-specific glucocorticoid receptor (NR3C1) gene, with death by suicide in cancer patients. Suicides occurring within a year of cancer diagnosis (‘early suicide’) were considered separately from those suicides during the second or subsequent year (‘late suicide’) after cancer diagnosis. Methods: The subjects consisted of 343 cancer patients admitted to a general hospital in Seoul, South Korea from 1996 to 2009, of which 182 had died by suicide and 161 were alive on December 31, 2009. Genomic DNA was extracted from formalin-fixed paraffin-embedded tissue sample of patients with cancer. We conducted a case-control association analysis of Bcl-1 polymorphism of NR3C1 gene. Results: Subjects carrying the GG genotype of Bcl-1 polymorphism were at increased risk of early suicide when com‑ pared to those carrying the CC genotype (OR 3.80, 95 % CI 1.02–14.16, p = .047). Similarly, those individuals carrying the GG genotype (recessive mode) had an increased risk of early suicide relative to the CC or CG genotype (OR 3.71, 95 % CI 1.03–13.43, p = .045). However, there were no differences in the genotype distributions of the NR3C1 Bcl-1 polymorphism between late suicide cases and controls. Conclusions: Our findings suggest that the NR3C1 Bcl-1 polymorphisms may be involved in the susceptibility to suicide within the first year after cancer diagnosis among cancer patients in Korean population. Keywords: Cancer, Suicide, NR3C1, Genetics Background Cancer diagnosis is associated with an increased suicide risk [1–6]. Suicide risk is the highest within the first 1 year after diagnosis of cancer [1, 2, 7–9]. There was a significant decrease in the relative suicide risk over decades, *Correspondence: [email protected] † Subin Park and Jin Pyo Hong contributed equally to this work 2 Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon‑Ro Gangnam‑gu, Seoul 135‑710, Republic of Korea Full list of author information is available at the end of the article
and 5 years after diagnosis, the risk should be about the same as for the general population [10]. This highest suicide risk in early period after cancer diagnosis may be associated with emotional distress induced by diagnosis of cancer, progressive and life-threatening illness [11, 12]. Based on diathesis-stress model of suici
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