Hemoglobin adducts as biomarkers of estrogen homeostasis:Elevation of estrogenquinones as a risk factor for developingbreast cancer in Taiwanese Women

Abstract

The aim of this study was to establish a methodology to analyze estrogen quinone-derived adducts,including 17 -estradiol-2,3-quinone (E2-2,3-Q) and 17 -estradiol-3,4-quinone (E2-3,4-Q), in humanhemoglobin (Hb). The methodology was then used to measure the levels of these adducts in Hb derivedfrom female breast cancer patients (n = 143) as well as controls (n = 147) in Taiwan. Our result confirmedthat both E2-2,3-Q- and E2-3,4-Q-derived adducts, including E2-2,3-Q-4-S-Hb and E2-3,4-Q-2-S-Hb,were detected in all breast cancer patients with median levels at 434 (215–1472) and 913 (559–2384)(pmol/g), respectively. Levels of E2-2,3-Q-4-S-Hb correlated significantly with those of E2-3,4-Q-2-S-Hb(r = 0.622–0.628, p < 0.001). By contrast, median levels of these same estrogen quinone-derived adducts inhealthy controls were 71.8 (35.7–292) and 139 (69.1–453) (pmol/g). This translated to ∼6-fold increasein mean values of E2-2,3-Q-4-S-Hb and E2-3,4-Q-2-S-Hb in breast cancer patients compared to those inthe controls (p < 0.001). Our findings add further support to the theme that cumulative body burden of estrogen quinones is an important indicator of breast cancer risk. We hypothesize that combination ofgenetic events and environmental factors may modulate estrogen homeostasis and enhance the produc-tion of estrogen quinones which lead to subsequent generation of pro-mutagenic DNA lesions in breastcancer patients

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