Tesis sobre el tema "Methylenetetrahydrofolate Reductase (NADPH2) – deficiency"

Development of specific DNA methylation patterns is required for normal spermatogenesis. DNA methyltransferases (DNMTs) use S-adenosylmethionine (SAM) produced in a pathway requiring 5,10-methylenetetrahydrofolate reductase (MTHFR). This thesis describes: testicular phenotype differences derived from Mthfr-deficiency in different mouse strains; the cellular Mthfr expression pattern during male germ cell development; and finally, changes to the DNA methylation of Mthfr-deficient sperm. Mthfr-deficient BALB/c, but not C57BL/6, mice have reduced neonatal germ cell proliferation but both have abnormal germ cells as adults. Germ cell MTHFR expression differed developmentally in parallel with DNMTs associated with de novo methylation. Sperm from mice with reduced Mthfr levels or dietary folate deficiency had differential DNA methylation at multiple loci, compared to wildtype mice, indicating that maintenance as well as acquisition of methylation can be altered by SAM-reduction. These results highlight the important role of folate in sperm development throughout life.

Disruptions in folate metabolism are known to increase the risk for neural tube defects (NTD) and this is preventable by folic acid supplementation. However, the relationship between folate metabolism and cardiac development remains unclear. The interaction between other folate pathway nutrients, choline and riboflavin, and folate metabolism was studied in a murine model of methylenetetrahydrofolate reductase (MTHFR) deficiency. Maternal choline deficiency, riboflavin deficiency and MTHFR deficiency adversely affected embryonic or heart development. The promoters of MTHFR were also examined for interactions with GATA-4, TBX5, MEF2A and NKX-2.5, known transcription factors of cardiac development. Upstream promoter activity was increased in the presence of GATA-4 and this interaction was further enhanced upon the addition of MEF2A. TBX5 appeared to decrease upstream promoter activity. GATA-4 modestly increased downstream promoter activity. These results highlight the importance of adequate nutrient intake during pregnancy and provide a link between folate metabolism and cardiac development.

Epidemiological evidence linking dietary folate deficiency and risk for colorectal cancer is conflicting. Studies using animal models indicate that timing, dose and presence of pre-malignant lesions will influence whether folate deficiency prevents or promotes tumor formation. In this thesis a new model of spontaneous tumor formation due to long-term dietary folate deficiency alone, in non-transgenic mice and without carcinogen induction, is developed. The mechanisms by which folate deficiency might influence cancer risk are also examined.
BALB/c mice, with or without a null allele in a key folate-metabolizing enzyme, Methylenetetrahydrofolate reductase (Mthfr ), develop intestinal tumors due to dietary folate deficiency alone. On folate-deficient (FD) diets, 12.5% of Mthfr+/+ mice and 28.1% of Mthfr+/- mice developed tumors; mice on control diet (CD) did not. C57B1/6 mice (a strain resistant to other methods of tumor induction) placed on the same diets for the same amount of time did not develop any tumors. To investigate possible mechanisms the levels of DNA damage (dUTP/dTTP ratio and p-H2AX staining) and DNA methylation (thin layer chromatography) were examined. FD BALB/c, but not C57B1/6 mice, had a trend towards increased dUTP/dTTP and DNA double-strand breaks and decreased global DNA methylation compared to CD mice. To determine why the FD diet affects the BALB/c and not the C57Bl/6 strain, the expression of genes involved in folate metabolism was examined. Several changes in gene expression were observed. In particular, BALB/c mice had increased Mthfr expression and MTHFR activity compared to C57Bl/6 mice. Increased MTHFR activity may deplete 5,10-methylenetetrahydrofolate supplies for the dTMP synthesis, increasing the dUMP levels and, possibly, DNA damage. The levels of several DNA repair genes were also examined. Two genes involved in base excision repair, Thymine DNA glycosylase (Tdg) and Apurinic/apyrimidinic endonuclease 1 (Apex1), were increased in FD C57B1/6 compared to FD BALB/c mice suggesting increased DNA repair capacity.
These results support the evidence that dietary folate deficiency promotes intestinal tumor formation possibly through increased DNA damage, with subsequent defects in DNA repair.

Methylenetetrahydrofolate reductase (MTHFR) reduces 5,10-methylene THF to 5-methyl THF, the carbon donor for the methylation of homocysteine to methionine. Patients with severe MTHFR deficiency (MRD) have neurologic abnormalities while a milder form (a thermolabile MTHFR variant) has been shown to be associated with coronary artery disease (CAD). Ten MRD patients, with reduced or non-detectable activity, were studied to characterize the nature of the mutation. Southern, Northern and Western analysis did not reveal any defects in the patients. These results suggest that the mutations may be minor insertions/deletions or single base substitutions that affect catalytic activity. Single strand conformation polymorphism (SSCP) analysis was used to detect base substitutions; 3 RFLPs were identified with this protocol. One was in the coding region (SphI) while the other two were in the 3$ sp prime$ untranslated region (MaeIII and MnlI). A difference in frequency of the SphI RFLP was found between control subjects and a small sample of CAD patients whose homocysteine levels were greater than the 99th percentile.

Orientadores: Ricardo Barini, Egle Cristina Couto de Carvalho
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Objetivo: determinar a prevalência dos fatores trombofílicos em mulheres inférteis. Método: estudo de corte transversal, no qual foram admitidas mulheres inférteis (atendidas em clínica privada) e submetidas à investigação de trombofilia, conforme protocolo da referida clínica, no período de março de 2003 a março de 2005. Foram incluídas mulheres em idade fértil com história de infertilidade, definida como um ano de coito sem método contraceptivo e sem concepção. Foram excluídas mulheres com hepatopatia e dados incompletos em prontuário, obtendo-se a amostra de 144 mulheres. Os fatores trombofílicos avaliados foram: o anticorpo anticardiolipina (ACL) e o anticoagulante lúpico (ACGL); a deficiência de proteína C (DPC), a deficiência de proteína S (DPS), a deficiência de antitrombina III (DAT), a presença do fator V de Leiden, uma mutação no gene da protrombina e a mutação da metileno tetrahidrofolato redutase (MTHFR). Resultados: os valores de prevalência obtidos para ACL e ACGL foram de 2%. A prevalência dos fatores trombofílicos hereditários foram: DPC 4%, DPS 6%, DAT 5%, fator V de Leiden 3%, mutação da protrombina 3%, mutação MTHFR 57%. Conclusões: das 144 pacientes selecionadas, 105 mulheres, ou seja, 72,9% apresentavam pelo menos um fator trombofílico presente. Isto reforça a importância e justifica a necessidade da investigação neste grupo
Abstract: Purpose: to establish the prevalence of thrombophilic factors in infertile women. Methods: a cross-sectional study was performed, in which infertile women were included, seen in a private clinic with investigation for thrombophilia, according to the protocol of the clinic, between March 2003 and March 2005, after the approval of the Research Ethics Committee of UNICAMP. One hundred and forty four infertile women without any liver disease were evaluated. Infertility is defined as one year of unprotected sexual intercourse without contraception and with no conception. The acquired and/or inherited thrombophilic factors are: anticardiolipin antibody (aCL) and lupus anticoagulant (LA); protein C deficiency (PCD), protein S deficiency (PSD), antithrombin III deficiency (ATD), presence of the factor V Leiden, mutation in the prothrombin gene, and mutation of Methylene tetrahydrofolate reductase (MTHFR). Results: the prevalence values obtained for aCL and LA were 2%. The prevalence of hereditary thrombophilic factors were: PCD 4%, PSD 6%, ATD 5%, factor V Leiden 3%, prothrombin mutation 3%, MTHFR mutation 57%. Out of the selected 144 patients, 105 women (72, 9%) presented at least one thrombophilic factor. This reinforces the importance and justifies the need of investigation in this grou
Mestrado
Tocoginecologia
Mestre em Tocoginecologia

Methylenetetrahydrofolate reductase (MTHFR), an important enzyme in folate metabolism, mediates the conversion of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate which serves as the carbon donor for the conversion of homocysteine to methionine. It is also inhibited by S-adenosylmethionine which has shown to be actively demethylated to form S-adenosylhomocysteine, which is hydrolysed to homocysteine. MTHFR deficiency exhibits well-documented clinical and biochemical symptoms. The human MTHFR cDNA was isolated by Goyette et al (1994), and fifteen mutations have been identified at this locus.
An animal model would prove to be useful for designing therapeutic approaches for understanding the pathogenesis of this genetic disease at the molecular level. The mouse MTHFR gene and cDNA have been isolated and partially characterized. Four genomic clones were isolated by library screening. One of these clones (clone 3) contained the 5$ sp prime$ end of the gene and was completely characterized. The clone was shown to have no rearrangements and is to be used to design targeting vectors for 'knockout mice' and mice carrying a common mutation which has been postulated to be a genetic risk factor for cardiovascular disease. The other three clones contain the remaining 3$ sp prime$ portion of the gene. The coding portion has approximately 90% homology with the human cDNA and also shows a similar gene structure.
A 2.2 Kb mouse MTHFR cDNA was isolated by library screening and was found to contain a 320 base pair extension at the 5$ sp prime$ end which has not been found in the human cDNA. The cDNA contains exons -1 -3, but also contains two possibly unspliced introns. A portion of this cDNA can however still be used to rescreen libraries to isolate a full length cDNA. The above research is the first genetic data on the mouse MTHFR gene and provides the basis for future research involving mouse models of MTHFR deficiency.

Methylenetetrahydrofolate reductase catalyzes the reduction of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate, a carbon donor for the remethylation of homocysteine to methionine. Patients with severe MTHFR deficiency have $<$20% residual enzyme activity, moderate hyperhomocysteinemia, vascular lesions and neurological dysfunction. Mildly-deficient individuals with a thermolabile enzyme are at increased risk for developing cardiovascular disease.
Two MTHFR sequence changes were identified. The first was a C to T transition at bp 764 altering a proline to a leucine codon; this change was found in one severely-deficient patient. The second was a C to T transition at bp 677, substituting a valine for a highly-conserved alanine codon. The $ rm A to V$ substitution was identified on 35-40% of chromosomes. Expression of the $ rm A to V$ mutation in prokaryotic cells revealed increased thermolability over the wild-type enzyme. Genotyping for the $ rm A to V$ mutation in three vascular disease studies showed that it was associated with mild hyperhomocysteinemia, a risk factor for vascular disease.
The preventative effects of folate supplementation on the occurrence and recurrence of neural tube defects (NTDs) have been repeatedly demonstrated. The curly-tail (ct) mouse model for NTDs was used to investigate the involvement of MTHFR in these defects. Ct mice had significantly increased homocysteine levels although differences in MTHFR activity were not demonstrated. The mouse MTHFR gene was mapped to distal chromosome 4, close to the major gene for NTDs in ct. MTHFR is suggested as a candidate locus for the ct defect.

Hyperhomocysteinemia is a risk factor for cardiovascular disease and stroke. Nutritional and/or genetic disruptions in homocysteine metabolism can cause hyperhomocysteinemia. Mild methylenetetrahydrofolate reductase (MTHFR) deficiency due to the 677C → T mutation in the MTHFR gene is the most common genetic cause of hyperhomocysteinemia. The 677C → T variant is associated with an increased risk for neural tube defects, pregnancy complications, schizophrenia and Down syndrome, and with a decreased risk for colon cancer and leukemia. This variant is also a potential risk factor for vascular disease. Severe MTHFR deficiency results in homocystinuria, an inborn error of metabolism with neurological and vascular complications. We have generated mice with a knockout of the Mthfr gene. The Mthfr-deficient mice exhibit hyperhomocysteinemia and decreased methylation capacity. The Mthfr+/- mice appear normal, whereas the Mthfr-/- mice are smaller and have reduced survival. Abnormal external granule neuron development associated with increased cell death in the cerebellum was observed in the Mthfr-/- mice.
Evidence for cardiovascular pathology was obtained in several ways. Impaired aortic relaxation response to acetylcholine was seen in the Mthfr +/- mice fed a high methionine diet. Both Mthfr+/- and Mthfr-/- mice fed a low folate high methionine diet developed myocardial fibrosis in the left ventricle. Abnormal lipid deposition in the proximal portion of the aorta was observed in older Mthfr+/- and Mthfr-/- mice. After crossing Mthfr -deficient mice with apoE-null mice, we demonstrated that MTHFR deficiency promoted atherogenesis and its progression in the apoE-null mice.
Gene expression in brain of Mthfr-deficient mice was investigated via microarray analysis. Five genes with altered expression in the brain of Mthfr-/- mouse were validated by RT-PCR. In biochemical studies of human MTHFR, both FAD and folate were shown to stabilize the purified recombinant wild type and mutant MTHFRs from the baculovirus expression system against heat inactivation. The effect of folate appeared to be secondary to that of FAD, and S-adenosylmethionine (SAM) inhibited purified wild type and mutant MTHFRs with similar efficiency.
This dissertation will significantly contribute to our understanding of the role of MTHFR in human disease.

Methylenetetrahydrofolate reductase (MTHFR) synthesizes 5-methyltetrahydrofolate, a methyl donor for conversion of homocysteine to methionine. A common thermolabile variant causes mild MTHFR deficiency, induces mild hyperhomocysteinemia when plasma folate levels are low and increases risk for neural tube defects (NTD) and pregnancy loss. To increase our understanding of Mthfr regulation, the 5' and 3' regions of the mouse cDNA and gene were characterized. These studies revealed two major promoters, an internal coding exon in the 5'UTR, alternative transcriptional and translational start sites and alternative splicing and polyadenylation. These data suggest that Mthfr regulation is likely to be complex. To investigate the role of Mthfr in NTD, several approaches were taken. First, folate and MTHFR co-factor, flavin adenine dinucleotide, were shown to stabilize normal and thermolabile MTHFR during heat inactivation, suggesting that folate might prevent hyperhomocysteinemia in individuals with thermolabile enzyme through protein stabilization. Next, in situ hybridization of neurulating mouse embryos showed that Mthfr is expressed in the forebrain, hindbrain, branchial arches, blood vessels, gut, and importantly, in the ventral part of the neural tube. Mthfr+/- mice were then used as a model of mild deficiency to address the effects of maternal and embryonic Mthfr deficiency on development. When combined with inadequate dietary folate, Mthfr +/- pregnant females showed a two-fold higher rate of pregnancy loss than Mthfr+/+ pregnant females. As well, a percentage of day 10.5 embryos from only the Mthfr+/- pregnant females were underdeveloped by 2 days. These effects were not apparent when dietary folate was sufficient, consistent with a genetic-nutritional interactive effect. Finally, folate metabolism was investigated in an NTD model, the curly-tail (ct) mouse, since the ct defect and Mthfr were mapped in close proximity. However, Mthfr sequence in ct mice was simila

Methylenetetrahydrofolate reductase (MTHFR) is a critical enzyme in folate metabolism. Severe enzymatic deficiency results in metabolic disease with occasional early demise. Mild deficiency is due to a common polymorphism (A222V) which increases risk for several common disorders. Pharmacogenetic studies of the antifolate methotrexate on Mthfr heterozygous knockout mice (Mthfr +/-), a model of the mild human deficiency, revealed significantly higher apoptosis rates in several tissues compared to wildtype mice (Mthfr +/+). These results suggest that mild MTHFR deficiency is a risk factor for methotrexate toxicity in mice and possibly in humans. A new medication, metafolin, was administered to Mthfr +/- mothers to assess survival of their Mthfr -/- pups. Survival rate of pups at 5 weeks of age from treated mothers was significantly higher than that from untreated mothers (54% versus 20%). The results of this study suggest that metafolin could be useful for treatment of severe MTHFR deficiency in humans.

Improper acquisition of DNA methylation patterns during the fetal period in germ cells of male mice is associated with impaired meiosis and infertility. MTHFR is a key folate pathway enzyme involved in providing methyl groups for DNA methylation. The goal of these studies was to evaluate DNA methylation patterns in spermatogonia from mice heterozygous for a targeted deletion in Mthfr (Mthfr+/-) as compared to those of their wildtype, Mthfr+/+, littermates. DNA methylation patterns were similar at imprinted genes and intergenic sites across chromosome 9 in neonatal spermatogonia of Mthfr+/+ and Mthfr+/- mice. We then established spermatogonial stem cell (SSC) cultures from Mthfr+/+ and Mthfr+/- mice to examine the stability of DNA methylation patterns over time in culture and determine whether methionine supplementation could restore any DNA methylation defects caused by MTHFR haplosufficiency. There were no differences detected between early and late passages, suggesting DNA methylation patterns in SSC clusters are generally stable in culture. Cultured SSC clusters treated with 20-fold normal medium methionine concentrations showed an overall increase in the levels of DNA methylation across chromosome 9, indicating DNA methylation can be perturbed in culture. Additionally, Mthfr+/- SSC clusters cultured in varying concentrations of methionine demonstrated a significantly increased variance of DNA methylation at multiple loci across chromosome 9 compared to Mthfr+/+ SSC clusters treated the same way. Together our results provide evidence that DNA methylation patterns of SSC clusters are stable in culture but can be perturbed by altered methionine and MTHFR levels.
L'acquisition inexacte de patrons de méthylation d'ADN des cellules germinales pendant la période fœtale chez la souris mâle est associée à des désordres de méiose et d'infertilité. L'enzyme MTHFR joue un rôle clé dans le processus de méthylation d'ADN puisqu'elle est impliquée dans une cascade produisant les groupements méthyles nécessaires à la réaction. L'objectif des travaux présentés dans ce mémoire était d'évaluer les profiles de méthylation d'ADN dans les spermatogonies provenant de souris hétérozygotes pour une suppression ciblée de Mthfr (Mthfr+/-), en comparaison avec celles découlant des compagnons de type sauvage de la même portée (Mthfr +/+). Nous avons déterminé que dans les spermatogonies néonatales de souris Mthfr+/+ et Mthfr+/- les patrons de méthylation sont demeurés similaires au niveau des gènes à empreinte ainsi qu'à divers sites intergéniques retrouvés à travers le chromosome 9. Subséquemment nous avons établi un système de culture de cellules souches spermatogoniales (SSC) à partir de souris Mthfr+/+ et Mthfr+/- afin d'examiner la stabilité des profiles de méthylation en culture et de déterminer si un supplément de méthionine peut restaurer un dérèglement de méthylation d'ADN causé par une haploinsuffisance de MTHFR. La période de culture (nombre de passages faible vs élevé) n'a nullement altérée les patrons de méthylation d'ADN, ce qui suggère que cette modification épigénétique est globalement très stable dans les SSCs en culture. Le traitement de ces même SSCs avec un milieu 20 fois plus élevé en méthionine occasionne par contre une augmentation des niveaux globaux de méthylation d'ADN à travers le chromosome 9, démontrant que cette modification post-traductionnelle peut être perturbée en culture. De plus, la culture des SSCs Mthfr+/- dans diverses concentrations de methionine démontre une augmentation significative de la variance des niveaux de méthylation d'ADN pour une multitude de loci à travers le chromosome 9 comparativement aux SSCs Mthfr+/+ soumis aux mêmes traitements. Ensemble, nos résultats suggèrent que les patrons de méthylation d'ADN des SSCs sont normalement stables en culture mais peuvent cependant être perturbés par les niveaux de méthionine et MTHFR.

Folate deficiency, a prevalent vitamin deficiency in America, can stem from environmental and/or genetic causes. The most common inborn error of folate metabolism is deficiency of methylenetetrahydrofolate reductase (MTHFR), which catalyzes the reduction of 5,10-methylenetetrahydrofolate to 5-methyltetrahydrofolate. Severe MTHFR deficiency results in hyperhomocysteinemia and homocystinuria; patients present with developmental delay, and various neurological and vascular disorders. This thesis describes three mutations identified in the MTHFR locus in patients with severe deficiency: 1025T→C (M→T), 1027T→G (W→G), and 1768G→A (E→K). Genotype-phenotype correlations are described, along with biochemical characterization of three mutations (983A→G (N→S), 1025T→C, 1027T→G). All three mutations exert their effect by decreasing Vmax without changing the enzyme's affinity for its substrate, 5-methyltetrahydrofolate. The 983A→G variant also conferred decreased affinity for FAD, a cofactor.
The more common and mild deficiency observed in the general healthy population is probably due in part to insufficient dietary intake of folate. Folate deficiency has been associated with increased risk for colon cancer. In a pilot study presented here, the impact of altered folate intake on tumor multiplicity in the Min mouse, a model for multiple intestinal neoplasia, was assessed. Folate deficient diets did not produce a consistent change in tumor numbers. However, a linear correlation between S-adenosylmethionine and S-adenosylhomocysteine content of preneoplastic tissue and tumor multiplicity was identified.
This thesis contributes to our understanding of the impact of genetic- and/or dietary-induced folate deficiency on cellular and organismal functions.

Introdução: O estudo de polimorfismos genéticos pode permitir maior conhecimento sobre os fatores de risco, progressão e susceptibilidade ao câncer do esôfago. A enzima ciclooxigenase-2 (COX-2) é induzida em resposta ao fator de crescimento e citocinas, sendo expressa nas doenças inflamatórias, lesões pré-malignas e tumores de esôfago. O produto do metabolismo do folato, pela enzima metilenotetrahidrofolato redutase (MTHFR), atua na síntese do DNA. A alteração ou a inibição da atividade desta enzima aumenta a suscetibilidade a mutações, danos e metilação aberrante do DNA, o que altera a expressão gênica de supressores de tumor e proto-oncogenes, potenciais fatores de risco para o câncer de esôfago. Objetivo: Investigar a frequência dos polimorfismos COX-2 (-1195A > G e 8473T > C) e MTHFR (677C > T e 1298C > A) em pacientes com câncer de esôfago, verificar as associações entre a frequência desses polimorfismos com a susceptibilidade à esta doença e aos fatores clínicos, epidemiológicos e patológicos. Metodologia: Inclui-se cento e nove pacientes com o diagnóstico de câncer de esôfago, submetidos à esofagectomia. Cento e dois indivíduos, pareados quanto ao sexo e idade, sem histórico individual ou familial de câncer, constituem o grupo controle. O DNA genômico foi isolado do creme leucocitário de sangue periférico e a genotipagem foi realizada através dos kits TaqMan ® SNP Genotyping Assays, seguida da amplificação pela reação em cadeia da polimerase e análise em tempo real (RT-PCR). Os resultados dos polimorfismos encontrados foram associados aos dados epidemiológicos e clinicopatológicos destes pacientes. Utilizou-se a regressão logística para avaliar as associações entre os polimorfismos e o risco de desenvolver o câncer de esôfago, com intervalos de confiança de 95%. Resultados: A presença do alelo COX-2+8437C (p=0,016) e dos haplótipos COX-21195A/COX2843C (p=0,002) e COX-21195G/COX28437T (p=0,01) indicaram associação com a doença. Os indivíduos com câncer do esôfago portadores do polimorfismo MTHFR 677TT apresentaram maior risco de óbito pela doença (p = 0,045). Conclusão: A presença do alelo COX-2+8437C e dos haplótipos COX21195A/COX2843C e COX-21195G/COX28437T associaram-se ao câncer de esôfago. O genótipo homozigoto polimórfico MTHFR677TT está relacionado ao pior prognóstico em pacientes com câncer de esôfago
Introduction: The study of genetic polymorphisms may allow better understanding of the risk factors, progression and susceptibility to cancer of the esophagus. The cyclooxygenase-2 enzyme (COX-2) is induced in response to growth factors and cytokines and is expressed in inflammatory diseases, premalignant and esophageal tumors. The product of folate metabolism, the enzyme methylenetetrahydrofolate reductase (MTHFR), engaged in DNA synthesis. Changing or inhibiting the activity of this enzyme increases the susceptibility to mutations, damage and aberrant DNA methylation, which alters gene expression of tumor suppressors and proto-oncogenes, potential risk factors for esophageal cancer. Objective: To investigate the frequency of COX-2 (-1195A > G and 8473T > C) and MTHFR (677C > T and 1298C > A) polymorphisms in patients with esophageal cancer, verify the associations between the frequency of these polymorphisms with susceptibility to this disease and clinical, epidemiological and pathological factors. Methodology: This study includes up one hundred nine patients diagnosed with esophageal cancer who underwent esophagectomy. One hundred and two individuals, matched for sex and age, no individual or familial history of cancer, constitute the control group. Genomic DNA was isolated from the peripheral blood buffy coat and genotyping was performed using the TaqMan ® SNP Genotyping Assays kits, followed by amplification by polymerase chain reaction and real-time analysis (RT-PCR). The results of found polymorphisms were associated with epidemiological and clinicopathological these patients. Logistic regression was used to assess associations between polymorphisms and the risk of developing esophageal cancer, with 95% confidence intervals. Results: The presence of COX-2 + 8437C allele (p = 0.016) and haplotypes COX-21195A / COX2843C (p = 0.002) and COX-21195G / COX28437T (p = 0.01) indicated association with the disease. Individuals with esophageal cancer carrying the MTHFR 677TT polymorphism had higher risk of death from the disease (p = 0.045). Conclusion: The presence of COX-2+8437C allele and haplotype COX21195A/ COX2843C and COX-21195G/COX28437T was associated with esophageal cancer. The polymorphic homozygous genotype MTHFR677TT is related to worse prognosis in patients with esophageal cancer