
CAG REPEAT NUMBER IN THE ANDROGEN RECEPTOR
GENE AND PROSTATE CANCER Madjunkova S, Eftimov A, Georgiev V, Petrovski D, Dimovski AJ, Plaseska-
Karanfi lska D, *Corresponding Author: Professor Dr. Dijana Plaseska-Karanfi lska, Macedonian Academy of Sciences
and Arts, Research Center for Genetic Engineering and Biotechnology “Georgi D. Efremov”, Av. Krste
Misirkov 2, POB 428, 1000 Skopje, Republic of Macedonia; Tel.: +389-2-3235-410; Fax: +389-2-3115-
434; E-mail: dijana@manu.edu.mk page: 31
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INTRODUCTION
Prostate cancer (PC) is the second leading
cause of cancer deaths in men and is the most common
male-specifi c cancer in most Western countries
[1-5]. An expanding body of epidemiological data
suggests several risk factors that predispose to PC
development (for example, advanced age, positive
family history, African ancestry and potentially ethnicity)
[6], but the etiology of PC remains poorly
understood. However, involvement of genetic and
environmental factors, may also contribute to the
ethnic differences in incidence rates [7-9]. The development
and progression of prostate tumors are
infl uenced by androgens [10]. The effects of androgens
on prostatic tissue are mediated by the androgen
receptor (AR) through the AR-androgen complex,
stimulating transcription and expression of a cascade of androgen-responsive genes and genes
involved in the cell cycle control [11].
The AR is a ligand-activated nuclear transcription
factor encoded by the AR gene, which spans
more than 90 kb of the genomic DNA on the X
chromosome (Xq11-12). The gene consists of eight
exons that encode four functional domains of AR
for DNA binding, ligand binding and transcriptional
regulation [12]. Exon 1 encodes the N-terminal
(transactivation) domain that controls its transcriptional
activity. The 5’ end of this exon 1 includes
a CAG polymorphic trinucleotide repeat that codes
for a polyglutamine tract in the N-terminal domain
[13]. The triplet repeat numbers between 8 and 36 in
the normal population [14].
The length of the CAG repeats is inversely related
to the transactivation function of the AR gene
so that shorter CAG repeats increase the transactivation
activity [15]. Many studies have focused
on establishing an association of CAG repeat with
increased risk of developing PC. In these, shorter
repeat lengths have been associated with increased
risk of PC [14,16-18], but this fi nding has not been
consistent [19-21]. The ethnic variation in the CAG
repeat variation in the AR gene suggests that this
may have a role in the substantial racial difference
in PC risk [22-25]. In this study, we have examined
the possible effect of short CAG repeats in the AR
gene on PC risk in Macedonian males.
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