DNA adducts, micronuclei and leukoplakias as intermediate endpoints in intervention trials.

Internal dosimeters that can provide information about responses to chemopreventive agents in a short time would be invaluable for planning treatment protocols for large-scale intervention trials. Micronuclei meet many of the prerequisites of a good intermediate endpoint. They can be quantified in cultured cells, animal tissues and human exfoliated cells and biopsies. With image scanning, up to 10(5) cells can be screened for micronuclei within a few minutes. The predictive value of micronuclei has been demonstrated using cultured cells exposed to carcinogens and chemopreventive agents and using oral mucosa of betel-quid chewers. DNA adducts, as detected by 32P-postlabelling techniques, could conceivably be another potentially useful marker. However, prior to their use in intervention trials, interindividual variations in their levels in primary, secondary and nontarget tissues and the relationship with doses of carcinogens must be established. The wide scatter of DNA adduct levels in the bronchial mucosa of smokers and of nonsmokers reveals one difficulty that can be encountered using this marker in intervention trials.