Epigenome-wide association study of lung cancer among never smokers in two prospective cohorts in Shanghai, China

• Published in: Thorax Vol. 79; no. 8; pp. 735 - 744
• Main Authors: Rahman, Mohammad L, Breeze, Charles E, Shu, Xiao-Ou, Wong, Jason Y Y, Blechter, Batel, Cardenas, Andres, Wang, Xuting, Ji, Bu-Tian, Hu, Wei, Cai, Qiuyin, Hosgood, H Dean, Yang, Gong, Shi, Jianxin, Long, Jirong, Gao, Yu-Tang, Bell, Douglas A, Zheng, Wei, Rothman, Nathaniel, Lan, Qing
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and British Thoracic Society 01.08.2024; BMJ Publishing Group LTD
• Subjects: Age; Aged; Aging; Biomarkers; Blood; Body fluids; Carcinogens; Case-Control Studies; China - epidemiology; DNA Methylation; Environmental aspects; Epidemiology; Epigenesis, Genetic; Epigenetics; Epigenome; Female; Genome-Wide Association Study; Health risks; Human exposure; Humans; Lung cancer; Lung Neoplasms - genetics; Male; Medical diagnosis; Medical prognosis; Middle Aged; non-small cell lung cancer; Prospective Studies; Sample size; Signal transduction; Smoking; tobacco and the lung; Womens health; China; Shanghai China; United States > US; lung cancer; non-small cell lung cancer; tobacco and the lung; smoking
• ISSN: 0040-6376; 1468-3296; 1468-3296
• DOI: 10.1136/thorax-2023-220352

BackgroundThe aetiology of lung cancer among individuals who never smoked remains elusive, despite 15% of lung cancer cases in men and 53% in women worldwide being unrelated to smoking. Epigenetic alterations, particularly DNA methylation (DNAm) changes, have emerged as potential drivers. Yet, few prospective epigenome-wide association studies (EWAS), primarily focusing on peripheral blood DNAm with limited representation of never smokers, have been conducted.MethodsWe conducted a nested case-control study of 80 never-smoking incident lung cancer cases and 83 never-smoking controls within the Shanghai Women’s Health Study and Shanghai Men’s Health Study. DNAm was measured in prediagnostic oral rinse samples using Illumina MethylationEPIC array. Initially, we conducted an EWAS to identify differentially methylated positions (DMPs) associated with lung cancer in the discovery sample of 101 subjects. The top 50 DMPs were further evaluated in a replication sample of 62 subjects, and results were pooled using fixed-effect meta-analysis.ResultsOur study identified three DMPs significantly associated with lung cancer at the epigenome-wide significance level of p<8.22×10−8. These DMPs were identified as cg09198866 (MYH9; TXN2), cg01411366 (SLC9A10) and cg12787323. Furthermore, examination of the top 1000 DMPs indicated significant enrichment in epithelial regulatory regions and their involvement in small GTPase-mediated signal transduction pathways. Additionally, GrimAge acceleration was identified as a risk factor for lung cancer (OR=1.19 per year; 95% CI 1.06 to 1.34).ConclusionsWhile replication in a larger sample size is necessary, our findings suggest that DNAm patterns in prediagnostic oral rinse samples could provide novel insights into the underlying mechanisms of lung cancer in never smokers.