Chapter 29: Translating DNA Adduct Knowledge to Human Prevention Trials

Rigorous chemical studies have provided the structural identification of DNA and other macromolecular adducts arising from environmental carcinogen exposures that are now being deployed as biomarkers of exposure, dose, effect and efficacy endpoints in intervention studies. The analytical chemical methodologies have attained the requisite sensitivity and specificity to measure these damaged products in human samples and with appropriate study design and higher throughput, their application will continue to grow. The studies described herein with the human carcinogen aflatoxin provides a template for many other agents of concern that impact human health. The aflatoxin set of investigations span the discovery and identification of DNA and protein adducts to their use both in experimental models and human epidemiology. Findings from these investigations have also been utilized in risk assessment modeling. Collectively, these molecular epidemiologic investigations when partnered with the advances in other genomic technologies offer future opportunities for personalized and community-based prevention activities.