Usefulness of genetic susceptibility and biomarkers for evaluation of environmental health risk

Recent attention is focused on understanding the genetic basis for individu al susceptibility to the development of chronic disease. An emphasis is con centrated on establishing an association between inheritance of polymorphic chemical metabolizing genes and development of environmental cancer (e.g., lung cancer among cigarette smokers). The early reports of such associatio ns have been very encouraging. However, some reported positive associations were not substantiated in subsequent studies using larger sample sizes and different ethnic populations. In this review, some confounding Factors tha t contribute to the discrepancies are presented (e.g., ethnic-dependent dis tribution of variant gene alleles, differential expression of metabolizing genes, and inadequate study design). It is possible that the precision of t he association can be improved if the mentioned investigations are compleme nted with concurrent studies of biological activities/effects. The usefulne ss of integrating metabolic susceptibility with biomarker measurement for u nderstanding the development of lung cancers is presented. The importance o f using adequate sample size and experimental design is emphasized. Develop ment of a reliable approach for prediction of environmental disease not onl y will provide fundamental information regarding the genetic basis of human disease but will be useful for reducing disease burden in the population a nd for advancing patient core. Environ. Mel. Mutagen. 37:215-225, 2001. (C) 2001 Wiley-Liss, Inc.