Dietary antioxidant and mineral intake in humans is associated with reduced risk of esophageal adenocarcinoma but not reflux esophagitis or Barrett's esophagus

The role of antioxidants in the pathogenesis of reflux esophagitis (RE), Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) remains unknown. We evaluated the associations among dietary antioxidant intake and these diseases. We performed an assessment of dietary antioxidant intake in a case control study of RE (n = 219), BE (n = 220), EAC (n = 224), and matched population controls (n = 256) (the Factors Influencing the Barrett's Adenocarcinoma Relationship study) using a modification of a validated FFQ. We found that overall antioxidant index, a measure of the combined intake of vitamin C, vitamin E, total carotenoids, and selenium, was associated with a reduced risk of EAC [odds ratio (OR) = 0.57; 95% CI = 0.33-0.98], but not BE (OR = 0.95; 95% CI = 0.53-1.71) or RE (OR = 1.60; 95% CI = 0.86-2.98), for those in the highest compared with lowest category of intake. Those in the highest category of vitamin C intake had a lower risk of EAC (OR = 0.37; 95% CI = 0.21-0.66; P-trend = 0.001) and RE (OR = 0.46; 95% CI = 0.24-0.90; P-trend = 0.03) compared with those in the lowest category. Vitamin C intake was not associated with BE, and intake of vitamin E, total carotenoids, zinc, copper, or selenium was not associated with EAC, BE, or RE. In conclusion, the overall antioxidant index was associated with a reduced risk of EAC. Higher dietary intake of vitamin C was associated with a reduced risk of EAC and RE. These results suggest that antioxidants may play a role in the pathogenesis of RE and EAC and may be more important in terms of progression rather than initiation of the disease process.

Iron intake and markers of iron status and risk of Barrett's esophagus and esophageal adenocarcinoma

Objective To investigate the association between iron intake and iron status with Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC).

Association of dietary fat intakes with risk of esophageal and gastric cancer in the NIH-AARP diet and health study

The aim of our study was to investigate whether intakes of total fat and fat subtypes were associated with esophageal adenocarcinoma (EAC), esophageal squamous cell carcinoma (ESCC), gastric cardia or gastric noncardia adenocarcinoma. From 1995–1996, dietary intake data was reported by 494,978 participants of the NIH-AARP cohort. The 630 EAC, 215 ESCC, 454 gastric cardia and 501 gastric noncardia adenocarcinomas accrued to the cohort. Cox proportional hazards regression was used to examine the association between the dietary fat intakes, whilst adjusting for potential confounders. Although apparent associations were observed in energy-adjusted models, multivariate adjustment attenuated results to null [e.g., EAC energy adjusted hazard ratio (HR) and 95% confidence interval (95% CI) 1.66 (1.27–2.18) p for trend <0.01; EAC multivariate adjusted HR (95% CI) 1.17 (0.84–1.64) p for trend 5 0.58]. Similar patterns were also observed for fat subtypes [e.g., EAC saturated fat, energy adjusted HR (95% CI) 1.79 (1.37–2.33) p for trend <0.01; EAC saturated fat, multivariate adjusted HR (95% CI) 1.27 (0.91–1.78) p for trend 5 0.28]. However, in multivariate models an inverse association for polyunsaturated fat (continuous) was seen for EAC in subjects with a body mass index (BMI) in the normal range (18.5–<25 kg/m2) [HR (95% CI) 0.76 (0.63–0.92)], that was not present in overweight subjects [HR (95% CI) 1.04 (0.96–1.14)], or in unstratified analysis [HR (95% CI) 0.97 (0.90–1.05)]. p for interaction 5 0.02. Overall, we found null associations between the dietary fat intakes with esophageal or gastric cancer risk; although a protective effect of polyunsaturated fat intake was seen for EAC in subjects with a normal BMI.

Population-based study reveals new risk-stratification biomarker panel for Barrett's esophagus

BACKGROUND & AIMS: The risk of progression of Barrett's esophagus (BE) to esophageal adenocarcinoma (EAC) is low and difficult to calculate. Accurate tools to determine risk are needed to optimize surveillance and intervention. We assessed the ability of candidate biomarkers to predict which cases of BE will progress to EAC or high-grade dysplasia and identified those that can be measured in formalin-fixed tissues. METHODS: We analyzed data from a nested case-control study performed using the population-based Northern Ireland BE Register (1993-2005). Cases who progressed to EAC (n = 89) or high-grade dysplasia =6 months after diagnosis with BE were matched to controls (nonprogressors, n = 291), for age, sex, and year of BE diagnosis. Established biomarkers (abnormal DNA content, p53, and cyclin A expression) and new biomarkers (levels of sialyl Lewis(a), Lewis(x), and Aspergillus oryzae lectin [AOL] and binding of wheat germ agglutinin) were assessed in paraffin-embedded tissue samples from patients with a first diagnosis of BE. Conditional logistic regression analysis was applied to assess odds of progression for patients with dysplastic and nondysplastic BE, based on biomarker status. RESULTS: Low-grade dysplasia and all biomarkers tested, other than Lewis(x), were associated with risk of EAC or high-grade dysplasia. In backward selection, a panel comprising low-grade dysplasia, abnormal DNA ploidy, and AOL most accurately identified progressors and nonprogressors. The adjusted odds ratio for progression of patients with BE with low-grade dysplasia was 3.74 (95% confidence interval, 2.43-5.79) for each additional biomarker and the risk increased by 2.99 for each additional factor (95% confidence interval, 1.72-5.20) in patients without dysplasia. CONCLUSIONS: Low-grade dysplasia, abnormal DNA ploidy, and AOL can be used to identify patients with BE most likely to develop EAC or high-grade dysplasia.

A population-based association study of SNPs of GSTP1, MnSOD, GPX2 and Barrett's esophagus and esophageal adenocarcinoma

Oxidative stress appears to be important in the pathogenesis of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC). Single-nucleotide polymorphisms (SNPs) of antioxidant enzyme genes may play a part in determining individual susceptibility to these diseases. The Factors Influencing the Barrett's Adenocarcinoma Relationship (FINBAR) study is a population-based, case-control study of BE and EAC in Ireland. DNA from EAC (n = 207), BE (> or =3 cm BE at endoscopy with specialized intestinal metaplasia on biopsy, n = 189) and normal population controls (n = 223) were analyzed. Several SNPs spanning the genes for glutathione S-transferase P1 (GSTP1), manganese superoxide dismutase (MnSOD) and glutathione peroxidase 2 (GPX2) were genotyped using multiplex polymerase chain reaction and SNaPshottrade mark. The chi(2) test was used to compare genotype and allele frequencies between case and control subjects. Linkage disequilibrium between SNPs was quantified using Lewontin's D' value and haplotype frequency estimates obtained using Haploview. Eleven SNPs were genotyped (six for GSTP1, three for MnSOD and two for GPX2); all were in Hardy-Weinberg equilibrium. None was significantly associated with EAC or BE even before Bonferroni correction. Odds ratios for EAC for individual SNPs ranged from 0.68 [95% confidence interval (CI) 0.43-1.08] to 1.25 (95% CI 0.73-2.16), and for BE from 0.84 (95% CI 0.52-1.30) to 1.30 (95% CI 0.85-1.97). SNPs in all three genes were in strong linkage disequilibrium (D' > 0.887) but haplotype analysis did not show any significant association with EAC or BE. SNPs involving the GSTP1, MnSOD and GPX2 genes were not associated with BE or EAC. Further studies aimed at identifying susceptibility genes should focus on different antioxidant genes or different pathways.

Common variants at the MHC locus and at chromosome 16q24.1 predispose to Barrett's esophagus

Barrett's esophagus is an increasingly common disease that is strongly associated with reflux of stomach acid and usually a hiatus hernia, and it strongly predisposes to esophageal adenocarcinoma (EAC), a tumor with a very poor prognosis. We report the first genome-wide association study on Barrett's esophagus, comprising 1,852 UK cases and 5,172 UK controls in the discovery stage and 5,986 cases and 12,825 controls in the replication stage. Variants at two loci were associated with disease risk: chromosome 6p21, rs9257809 (P(combined) = 4.09 × 10(-9); odds ratio (OR) = 1.21, 95% confidence interval (CI) =1.13-1.28), within the major histocompatibility complex locus, and chromosome 16q24, rs9936833 (P(combined) = 2.74 × 10(-10); OR = 1.14, 95% CI = 1.10-1.19), for which the closest protein-coding gene is FOXF1, which is implicated in esophageal development and structure. We found evidence that many common variants of small effect contribute to genetic susceptibility to Barrett's esophagus and that SNP alleles predisposing to obesity also increase risk for Barrett's esophagus.

Genes of the Interleukin-18 Pathway Are Associated With Susceptibility to Barrett's Esophagus and Esophageal Adenocarcinoma

To investigate the association of genetic polymorphisms of the interleukin-18 (IL-18) pathway to Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC). Most cases of EAC arise in a background of reflux-induced BE. Genetic influences in this pathway are poorly understood. IL-18 is a multifunctional cytokine implicated in anti-tumor immunity. A number of polymorphisms of the IL-18 and IL-18 receptor-accessory protein (IL-18RAP) genes have been reported to alter gene expression and have recently been linked to inflammatory processes and various tumors, but have not heretofore been studied in BE and EAC.

Dietary fat and meat intakes and risk of reflux esophagitis, Barrett's esophagus and esophageal adenocarcinoma

The aim of our study was to investigate whether dietary fat and meat intakes are associated with reflux esophagitis (RE), Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC). In this all-Ireland case-control study, dietary intake data were collected using a food frequency questionnaire in 219 RE patients, 220 BE patients, 224 EAC patients and 256 frequency-matched controls between 2002 and 2005. Unconditional multiple logistic regression analysis was used to examine the association between dietary variables and disease risk using quartiles of intake, to attain odds ratios (ORs) and 95% confidence intervals (95% CIs), while adjusting for potential confounders. Patients in the highest quartile of total fat intake had a higher risk of RE (OR = 3.54; 95% CI = 1.32-9.46) and EAC (OR = 5.44; 95% CI = 2.08-14.27). A higher risk of RE and EAC was also reported for patients in the highest quartile of saturated fat intake (OR = 2.79; 95% CI = 1.11-7.04; OR = 2.41; 95% CI = 1.14-5.08, respectively) and monounsaturated fat intake (OR = 2.63; 95% CI = 1.01-6.86; OR = 5.35; 95% CI = 2.14-13.34, respectively). Patients in the highest quartile of fresh red meat intake had a higher risk of EAC (OR = 3.15; 95% CI = 1.38-7.20). Patients in the highest category of processed meat intake had a higher risk of RE (OR = 4.67; 95% CI = 1.71-12.74). No consistent associations were seen for BE with either fat or meat intakes. Further studies investigating the association between dietary fat and food sources of fat are needed to confirm these results.

A prospective cohort study of obesity and risk of oesophageal and gastric adenocarcinoma in the NIH-AARP Diet and Health Study

Objective: The incidence of oesophageal adenocarcinoma (EAC) has increased rapidly over the past 40 years and accumulating evidence suggests that obesity, as measured by body mass index (BMI), is a major risk factor. It remains unclear whether abdominal obesity is associated with EAC and gastric adenocarcinoma.

Design: Cox proportional hazards regression was used to examine associations between overall and abdominal obesity with EAC and gastric adenocarcinoma among 218 854 participants in the prospective NIHeAARP cohort.

Results: 253 incident EAC, 191 gastric cardia adenocarcinomas and 125 gastric non-cardia adenocarcinomas accrued to the cohort. Overall obesity (BMI) was positively associated with EAC and gastric
cardia adenocarcinoma risk (highest ($35 kg/m2) vs referent (18.5e<25 kg/m2); HR 2.11, 95% CI 1.09 to 4.09 and HR 3.67, 95% CI 2.00 to 6.71, respectively). Waist circumference was also positively associated with EAC and gastric cardia adenocarcinoma risk (highest vs referent; HR 2.01, 95% CI 1.35 to 3.00 and HR 2.22, 95% CI 1.43 to 3.47, respectively), whereas waist-to-hip ratio (WHR) was positively associated with EAC risk only (highest vs referent; HR 1.81, 95% CI 1.24 to 2.64) and persisted in patients with normal BMI (18.5e<25 kg/m2). Mutual adjustment of WHR and BMI attenuated
both, but did not eliminate the positive associations for either with risk of EAC. In contrast, the majority of the anthropometric variables were not associated with adenocarcinomas of the gastric non-cardia.

Conclusion Overall obesity was associated with a higher risk of EAC and gastric cardia adenocarcinoma, whereas abdominal obesity was found to be associated with increased EAC risk; even in people with normal BMI

Vitamin D receptor gene variants and esophageal adenocarcinoma risk:A population-based case-control study

Purpose: Polymorphisms in the vitamin D receptor (VDR) gene may be of etiological importance in determining cancer risk. The aim of this study was to assess the association between common VDR gene polymorphisms and esophageal adenocarcinoma (EAC) risk in an all-Ireland population-based case-control study. Methods: EAC cases and frequency-matched controls by age and gender recruited between March 2002 and December 2004 throughout Ireland were included. Participants were interviewed, and a blood sample collected for DNA extraction. Twenty-seven single nucleotide polymorphisms in the VDR gene were genotyped using Sequenom or TaqMan assays while the poly(A) microsatellite was genotyped by fluorescent fragment analysis. Unconditional logistic regression was applied to assess the association between VDR polymorphisms and EAC risk. Results: A total of 224 cases of EAC and 256 controls were involved in analyses. After adjustment for potential confounders, TT homozygotes at rs2238139 and rs2107301 had significantly reduced risks of EAC compared with CC homozygotes. In contrast, SS alleles of the poly(A) microsatellite had significantly elevated risks of EAC compared with SL/LL alleles. However, following permutation analyses to adjust for multiple comparisons, no significant associations were observed between any VDR gene polymorphism and EAC risk. Conclusions: VDR gene polymorphisms were not significantly associated with EAC development in this Irish population. Confirmation is required from larger studies. © Springer Science+Business Media, LLC 2011.

Symptoms and Endoscopic Features at Barrett's Esophagus Diagnosis: Implications for Neoplastic Progression Risk

OBJECTIVES: Risk stratification of Barrett's esophagus (BE) patients based on clinical and endoscopic features may help to optimize surveillance practice for esophageal adenocarcinoma (EAC) development. The aim of this study was to investigate patient symptoms and endoscopic features at index endoscopy and risk of neoplastic progression in a large population-based cohort of BE patients.

METHODS: A retrospective review of hospital records relating to incident BE diagnosis was conducted in a subset of patients with specialized intestinal metaplasia from the Northern Ireland BE register. Patients were matched to the Northern Ireland Cancer Registry to identify progressors to EAC or esophageal high-grade dysplasia (HGD). Cox proportional hazards models were applied to evaluate the association between endoscopic features, symptoms, and neoplastic progression risk.

RESULTS: During 27,997 person-years of follow-up, 128 of 3,148 BE patients progressed to develop HGD/EAC. Ulceration within the Barrett's segment, but not elsewhere in the esophagus, was associated with an increased risk of progression (hazard ratio (HR) 1.72; 95% confidence interval (CI): 1.08–2.76). Long-segment BE carried a significant sevenfold increased risk of progression compared with short-segment BE; none of the latter group developed EAC during the study period. Conversely, the absence of reflux symptoms was associated with an increased risk of cancer progression (HR 1.61; 95% CI: 1.05–2.46).

CONCLUSIONS: BE patients presenting with a long-segment BE or Barrett's ulcer have an increased risk of progressing to HGD/EAC and should be considered for more intense surveillance. The absence of reflux symptoms at BE diagnosis is not associated with a reduced risk of malignant progression, and may carry an increased risk of progression.

Intakes of dietary folate and other B vitamins are associated with risks of esophageal adenocarcinoma, Barrett's esophagus, and reflux esophagitis

Folate is implicated in carcinogenesis via effects on DNA synthesis, repair, and methylation. Efficient folate metabolism requires other B vitamins and is adversely affected by smoking and alcohol. Esophageal adenocarcinoma (EAC) may develop through a process involving inflammation [reflux esophagitis (RE)] leading to metaplasia [Barrett’s esophagus (BE)] and carcinoma. Within a population-based, case-control study, we investigated associations between dietary folate and related factors and risks of EAC, BE, and RE. EAC and BE cases had histologically confirmed disease; RE cases had endoscopically visible inflammation. Controls, age-sex frequency matched to EAC cases, were selected through population and general practice registers. Participants underwent structured interviews and completed food-frequency questionnaires. Multivariate ORs and 95% CIs were computed using logistic regression. A total of 256 controls and 223 EAC, 220 BE, and 219 RE cases participated. EAC risk decreased with increasing folate intake (OR highest vs. lowest = 0.56; 95% CI: 0.31, 1.00; P-trend < 0.01). Similar trends were found for BE (P-trend < 0.01) and RE (P-trend = 0.01). Vitamin B-6 intake was significantly inversely related to risks of all 3 lesions. Riboflavin intake was inversely associated with RE. Vitamin B-12 intake was positively associated with EAC. For EAC, there was a borderline significant interaction between folate intake and smoking (P-interaction = 0.053); compared with nonsmokers with high (≥median) folate intake, current smokers with low intakes (<median) had an 8-fold increased risk (OR: 8.15; 95% CI: 3.61, 18.40). The same group had increased BE risk (OR: 2.93; 95% CI: 1.24, 6.92; P-interaction = 0.12). Folate and other dietary methyl-group factors are implicated in the etiology of EAC and its precursors.

Polymorphisms near TBX5 and GDF7 are associated with increased risk for Barrett's esophagus

BACKGROUND & AIMS: Barrett's esophagus (BE) increases the risk of esophageal adenocarcinoma (EAC). We found the risk to be BE has been associated with single nucleotide polymorphisms (SNPs) on chromosome 6p21 (within the HLA region) and on 16q23, where the closest protein-coding gene is FOXF1. Subsequently, the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON) identified risk loci for BE and esophageal adenocarcinoma near CRTC1 and BARX1, and within 100 kb of FOXP1. We aimed to identify further SNPs that increased BE risk and to validate previously reported associations.

METHODS: We performed a genome-wide association study (GWAS) to identify variants associated with BE and further analyzed promising variants identified by BEACON by genotyping 10,158 patients with BE and 21,062 controls.

RESULTS: We identified 2 SNPs not previously associated with BE: rs3072 (2p24.1; odds ratio [OR] = 1.14; 95% CI: 1.09-1.18; P = 1.8 × 10(-11)) and rs2701108 (12q24.21; OR = 0.90; 95% CI: 0.86-0.93; P = 7.5 × 10(-9)). The closest protein-coding genes were respectively GDF7 (rs3072), which encodes a ligand in the bone morphogenetic protein pathway, and TBX5 (rs2701108), which encodes a transcription factor that regulates esophageal and cardiac development. Our data also supported in BE cases 3 risk SNPs identified by BEACON (rs2687201, rs11789015, and rs10423674). Meta-analysis of all data identified another SNP associated with BE and esophageal adenocarcinoma: rs3784262, within ALDH1A2 (OR = 0.90; 95% CI: 0.87-0.93; P = 3.72 × 10(-9)).

CONCLUSIONS: We identified 2 loci associated with risk of BE and provided data to support a further locus. The genes we found to be associated with risk for BE encode transcription factors involved in thoracic, diaphragmatic, and esophageal development or proteins involved in the inflammatory response.

Tanzanian scepticism of a militarised East African Federation and underlying military concerns

Attitudes towards a regional military force are of paramount importance when exploring public support for regional integration. Until now, however, scholarly research has not considered the influence of attitudes towards a regional military mechanism in the sub-Saharan African context. Using Afrobarometer data, we demonstrate that military concerns are vital when exploring Tanzanian attitudes towards the proposed political federation of the East African Community (EAC), the East African Federation (EAF). More specifically, opposition to military cooperation strongly influences Tanzanian scepticism of the EAF. This finding is highly relevant given that referendums in the participating member states must be passed to facilitate political integration. Heightened opposition towards military cooperation raises the possibility of the public rejecting a politically integrated EAC. This poses a potential obstacle to the implementation of joint security policies and crucial mechanisms to provide a more stable region at large. We account for alternative explanations of Tanzanian opinion formation and reflect on the strength of military-orientated concerns for investigating public support for the East African project specifically and regional integration in sub-Saharan Africa more widely.

Levels and biological effects of selected EDC's in the portuguese coast

Os compostos orgânicos de estanho (OTs), de entre os quais se destaca o tributilestanho (TBT), encontram-se amplamente dispersos no meio aquático devido à sua intensa utilização como agente biocida em tintas antivegetativas. Estudos anteriores sobre a poluição por organoestanhos em Portugal demonstraram que estes compostos se encontram presentes não só na linha de costa mas também em zonas da plataforma, sendo as zonas portuárias (onde se incluem portos comerciais, portos de pesca, marinas e estaleiros navais) os principais focos de poluição. A presente tese tem como objectivo investigar o estado actual da poluição por organoestanhos na costa Portuguesa confirmando se os padrões espaciais acima descritos se mantêm, por meio da quantificação de diversos OTs, nomeadamente, butilestanhos, fenilestanhos e octilestanhos. Assim, os níveis destes compostos foram avaliados em populações de Mytilus galloprovincialis e Nassarius reticulatus ao longo da costa continental Portuguesa, com particular incidência na Ria de Aveiro onde se quantificaram os níveis de OTs em mexilhões, gastrópodes e sedimentos, recolhidos numa malha de amostragem mais densa. A distribuição espacial dos organoestanhos foi determinada utilizando o bivalve M. galloprovincialis como espécie bioindicadora. Os níveis totais de estanho (SnT) foram quantificados nos tecidos do mexilhão e relacionados com os níveis totais de OTs nos mesmos tecidos, incluindo monobutilestanho (MBT), dibutilestanho (DBT), tributilestanho (TBT), difenilestanho (DPhT), trifenilestanho (TPhT), monoctilestanho (MOcT) e dioctilestanho (DOct). A contribuição dos OTs para os valores de estanho total (SnT) foi superior nas estações de amostragem localizadas no interior de portos onde atingiram proporções próximas dos 50%. De entre estes, os butilestanhos (BuTs=MBT+DBT+TBT) contribuíram em média com 98.6% para o valor total de OTs, tendo sido detectados em todas as amostras analisadas. Os valores mais elevados foram registados no interior ou na proximidade de portos, corroborando a ideia anterior de que constituem importantes focos de poluição. A variação das concentrações de TBT no mexilhão situou-se entre os 0,9 e 720 ng Sn.g-1 de peso seco (ps). Estes valores são, em 69% das estações amostradas, superiores ao valor do proposto pela OSPAR (4,9 ng TBT-Sn.g-1 ps) para tecidos de mexilhão o que sugere a forte probabilidade de ocorrência de efeitos adversos sobre os ecossistemas. Os níveis de OTs foram também quantificados em tecidos de N. reticulatus recolhidos ao longo da costa em 2008 Os butilestanhos representaram a maioria dos compostos organoestânicos quantificados e os níveis mais elevados foram novamente detectados no interior ou nas imediações de portos. Os valores de TBT nos tecidos deste gastrópode variaram entre 3,5 e 380 ng Sn.g-1 ps, representando uma percentagem média de 50,4% do total de butilestanhos. Simultaneamente, os níveis de imposex foram também avaliados e relacionados com os valores deste composto nos tecidos. As distribuições espaciais de imposex e de TBT seguiram a mesma tendência, sendo que em todos os locais amostrados foram encontradas fêmeas afectadas. Os valores de VDSI (índice da sequência do vaso deferente) variaram entre 0,2 e 4,4. Em 91% dos locais os valores de VDSI foram superiores a 0,3 (definido pela OSPAR como o valor de VDSI em N. reticulatus acima do qual o objectivo de qualidade ecológica não é atingido), confirmando a suspeição da existência de efeitos adversos nos ecossistemas. Em todos os compartimentos analisados na Ria de Aveiro, os butilestanhos foram os principais contribuintes para estanho orgânico total. A utilização do imposex em N. reticulatus como biomarcador da poluição por TBT permitiu determinar um gradiente decrescente desde o interior da Ria (onde se situa a zona portuária) até zonas costeiras adjacentes. O mesmo gradiente foi observado relativamente às concentrações de TBT em tecidos de mexilhão. Para os sedimentos, as concentrações de TBT são bastante variáveis com valores entre 2,7 e 1780 ng Sn.g-1 ps encontrando-se significativamente correlacionadas com o conteúdo em matéria orgânica da amostra. Em todas as amostras analisadas os níveis de TBT são elevados e superiores ao valor inferior (provisório) de EAC (critério de avaliação ambiental) proposto pela OSPAR (0,004 ng TBT-Sn.g-1 ps). A análise da evolução temporal da poluição por TBT ao longo da costa foi concretizada por meio da comparação entre níveis de organoestanhos em N. reticulatus em amostras de 2008 e 2003 e também através da comparação dos níveis de imposex registados em campanhas realizadas naqueles dois anos. Os resultados obtidos indicam a ocorrência de reduções significativas nas concentrações de TBT, DBT e MBT, assim como uma diminuição significativa nos valores de VDSI entre 2003 e 2008. Os resultados obtidos sugerem que a redução verificada se deve à implementação do Regulamento 782/2003 da Comunidade Europeia, que tem por objectivo a erradicação das descargas e emissões de TBT para o ambiente a partir dos sistemas antivegetativos A diminuição da poluição por TBT ao longo dos últimos anos foi acompanhada por um aumento no número de fêmeas com um vaso deferente, mas sem pénis (imposex do tipo b): 3,5% em 2000, 11% em 2003 e 24% em 2008. Um aumento no número de locais onde se registou o fenómeno também é evidente: dois em 2000, sete em 2003 e treze em 2008. A proporção de fêmeas b no estádio 1 de VDS apresentou igual tendência com aumento de 38% em 2000 para 65% em 2008. O aumento no número de fêmeas com esta via parece estar associado à diminuição da poluição por TBT. Face à esperada diminuição da presença do composto no meio ambiente, devido à sua proibição, o aumento de fêmeas com imposex do tipo b é previsível. A ocorrência de compostos xenoestrogénicos no ambiente aquático foi também estudada e os níveis de estrona (E1), 17α-e 17β-estradiol (E2), 17α- etinilestradiol (EE2), bisfenol-A (BPA) e nonilfenol (NP) foram quantificados em efluentes de estações de tratamento de águas residuais (ETARs) localizadas na região de Aveiro, bem como no efluente final descarregado no Oceano Atlântico, através de um emissário submarino (S. Jacinto), sendo amostras recolhidas na entrada da Ria e ao largo usadas como referência. Os níveis de hormonas esteróides e compostos fenólicos registados nos locais de referência são baixos. De entre as hormonas esteróides os níveis mais elevados foram registados para a estrona, com valores máximos de 85.3 ng.L- 1 . Os níveis mais elevados de compostos fenólicos foram detectados em efluentes industriais (máximos de NP e BPA de 2410 ng.L-1 e 897 ng.L-1 , respectivamente). Os resultados obtidos sugerem que os níveis de compostos xenoestrogénicos em locais de referência são baixos e não parecerem acarretar risco ecológico, no entanto o mesmo não será verdadeiro para as imediações do emissário de S. Jacinto que liberta efluentes com concentrações muito elevadas de E1, NP e BPA. Foram realizadas experiências laboratoriais de forma a elucidar o papel do receptor retinóico X (RXR) no mecanismo de indução de imposex (presentemente o mecanismo que demonstra maior promessa na explicação do desencadear deste fenómeno). Fêmeas de Nucella lapillus e N. reticulatus foram injectadas com TBT em etanol ou com ácido 9-cis- retinóico em FBS (soro fetal bovino) tendo-se procedido à sua observação nos 30 dias subsequentes. Tanto o TBT como o 9CRA induziram o desenvolvimento de imposex em N. lapillus e N. reticulatus. Aumentos significativos nos valores de VDSI e FPL entre o controlo de etanol e o tratamento de TBT e o controlo de FBS e o tratamento de 9CRA foram registados. Os resultados obtidos fornecem novas provas do envolvimento da via de sinalização associada ao RXR no desenvolvimento de imposex em ambas as espécies.