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Epidemiology and Prevention |
Chemoprevention Program, Division of Nutritional Carcinogenesis, American Health Foundation, Valhalla, New York 10595
| ABSTRACT |
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-6 fatty acids promote colon tumorigenesis, whereas
-3 fatty acids lack promoting activity. Fat intake in the United States traditionally includes high amounts (30% of total caloric intake) of saturated fat rather than
-6 fatty acids. Therefore, the present study was designed to compare the modulatory effects of a high-fat diet containing mixed lipids (HFML), a diet rich in saturated fatty acids (the average American diet), a diet with fish oil (HFFO) that is rich in
-3 fatty acids, and a low-fat corn oil diet (LFCO) on the formation of chemically induced colonic aberrant crypt foci (ACF) and tumors, cyclooxygenase (COX)-2 activity, and apoptosis during experimental colon carcinogenesis. At 5 weeks of age, groups of male F344 rats were fed a 5% corn oil diet (LFCO). At 7 weeks of age, rats intended for carcinogen treatment received s.c. injections of azoxymethane at a dose level of 15 mg/kg of body weight once weekly for 2 weeks. Beginning 1 day after the carcinogen treatment, groups of rats were then maintained on experimental diets containing 20% HFML or 20% HFFO. Rats were killed at 8, 23, or 38 weeks after azoxymethane treatment. Colonic ACF and tumors were evaluated histopathologically, and apoptosis was evaluated by the terminal deoxynucleotidyl transferase-mediated nick end labeling method. Colonic mucosae and tumor samples harvested at week 38 were analyzed for COX-2 synthetic activity and expression. The rats fed the HFML diet showed significantly increased total colonic ACF (P < 0.0010.0001) with a multiplicity of
4 aberrant crypts/focus (P < 0.0001) compared with the effects of the HFFO or LFCO diets at week 8, 23, and 38. Interestingly, there was a 2- to 3-fold increase (
4) in multicrypt foci in rats given the HFML diet as compared with such foci in rats fed the HFFO or LFCO diets. By week 23, the HFML diet had significantly increased the incidence of colonic tumors (3060%) and their multiplicity (100141%) when compared with the effects of the LFCO or HFFO diets. At week 38, the HFML diet had induced 100% colon tumor incidence and a 4-fold multiplicity of adenocarcinomas compared with the LFCO and HFFO diets. At weeks 23 and 38, a significantly lower percentage of apoptotic colonic epithelial cells were observed in the tumors of animals fed the HFML diet as compared with those fed the HFFO diet. The HFML diet caused significantly increased levels of COX-2 activity in colon tumors (P < 0.050.01), and these tumors had enhanced levels of COX-2 expression as compared with those in assays with LFCO or HFFO diets. These observations demonstrate for the first time that HFML diets containing high levels of saturated fatty acids (such as those in Western diets) promote colon carcinogenesis. Although the mechanisms involved in colon tumor promotion by a HFML diet are not fully known, our results indicate that the modulation of eicosanoid production via the influence on COX activity and the suppression of apoptosis may play a key role in HFML diet-induced colon tumorigenesis. | INTRODUCTION |
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-3 fatty acids) may decrease the risk of colorectal cancer has been hypothesized in relation to fish and fish oil (9)
. Caygill et al. (12)
reported an inverse correlation between fish and fish oil consumption and colorectal cancer. On the basis of epidemiological evidence from ecological and case-control studies, it is reasonable to suggest that diets high in total fat, and especially in saturated fat, increase the risk of colorectal cancers, whereas diets high in fish and fish oil reduce it.
Laboratory animal model studies in our laboratory and elsewhere have consistently provided evidence to link the colon tumor-promoting effect of dietary fat depend on both the type and amount of dietary fat (13, 14, 15, 16, 17)
. Diets rich in
-3 fatty acids (marine oils) reduce the risk of chemically induced colon carcinogenesis compared with diets high in
-6 fatty acids and/or saturated fatty acids. This suggests that the composition of ingested dietary fatty acids is more critical to colon cancer risk than is the total amount of fat (18, 19, 20)
. In addition, laboratory animal model assays have indicated that the influence of type and amount of dietary fat is exerted foremost during the postinitiation phase of carcinogenesis (15
, 21)
. In a Phase II clinical trial of patients with colonic polyps, dietary fish oil supplements have in fact inhibited cell proliferation in the colonic mucosa (22)
. In general, the overall evidence from studies with laboratory animals is consistent with the epidemiological data.
Thus far, progress has been made with regard to the relationship between dietary fat intake and colon cancer risk, in that we know of the tumor-promoting effects of diets rich in
-6 fatty acids and saturated fatty acids, and the lack of such effects by
-3 fatty acid-rich diets (23, 24, 25, 26, 27, 28, 29)
. However, among the sources of dietary fat, animal fat with its high saturated fatty acid content is by far the most important contributor (>60%) to the Western diet. Importantly, consumption of dietary fat in the United States and Canada consists predominately of a mixture of saturated, monounsaturated, and polyunsaturated fats, whereby the ratio of polyunsaturated to saturated fat is 0.55 (7
, 30)
. Despite the high dietary intake of mixed lipids in Western populations, not much attention has been placed on understanding the role of such mixed-lipid diets in colon tumor promotion. A recent assay in mice demonstrated that administration of a high-fat diet simulating the mixed-lipid composition of the average American diet produces dysplastic lesions in the colon, indicative of tumorigenesis (31)
.
With regard to the mode of action of saturated fats,
-6 PUFAs3
, and
-3 PUFAs in colon tumorigenesis, several studies indicate that diets high in lard, beef tallow, or corn oil increase the concentration of colonic luminal secondary bile acids, whereas dietary fish oil at high concentrations had no such enhancing effect (23, 24, 25, 26, 27, 28)
. Secondary bile acids have been shown to induce cell proliferation and to act as promoters in colon carcinogenesis (32)
. Additionally, the high intake of dietary fat, specifically of saturated fats and
-6 fatty acids, increases colon tumor promotion by altering membrane phospholipid turnover, releasing membrane AA from phospholipids, and affecting prostaglandin synthesis via COX enzyme (27
, 28)
. It is noteworthy that elevated levels of COX isoforms, particularly COX-2, have been observed in human colon tumors and in chemically induced colon tumors in rodents (33, 34, 35)
. This indicates the significance of COX enzymes in colon tumor growth. Tsujji and DuBois (36)
have shown that overexpression of the COX-2 gene in colonic epithelial cells leads to altered adhesion properties and resistance to apoptosis. Recent studies suggest that the regulation of apoptosis is central to tumor growth (37, 38, 39, 40, 41, 42)
. Many tumor promoters, such as HFCO diets and chemopreventive agents, have been shown to modulate the processes of apoptosis (43
, 44)
. Thus, it is fairly clear that colon tumor promotion by high dietary fat intake is associated with the inhibition of apoptosis and modulation of COX activities.
ACF, which are recognized as early preneoplastic lesions, have consistently been observed in experimentally induced colon carcinogenesis in laboratory animals (45) . Pretlow et al. (46) , who demonstrated the occurrence of these lesions in the colonic mucosa of patients with colon cancer, suggested that aberrant crypts are putative precursor lesions from which adenoma and carcinoma develop in the colon. There is also evidence that several inhibitors of ACF development reduce colon tumorigenesis in laboratory animals (47) .
In view of the significance of mixed lipids in colon carcinogenesis, and because of potential tumor-inhibitor properties of
-3 fatty acids, the present study was designed to examine the effects of high-fat diets that contain mixed lipids rich in saturated fatty acids and to compare them with the effects of fish oil (rich in
-3 fatty acids) during the different stages of AOM-induced colon carcinogenesis in male F344 rats. Colonic ACF and colon tumors serve as end points. In addition, we assessed the effects of these diets on colonic tumor cell apoptosis. We examined AA metabolism and expression of COX-isoforms to provide an understanding of the effects of these types of dietary fats on the modulation of morphological, cellular, and molecular events relevant to colon carcinogenesis.
| MATERIALS AND METHODS |
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Animals and Diets.
A total of 360 male F344 rats received at weaning were quarantined for 7 days and then randomly assigned to one of three dietary groups (LFCO, HFFO, or HFML) of 120 animals each. Each dietary group was then divided into AOM-treated and vehicle-treated subgroups. The rats were housed three to a plastic cage with filter top in a holding room that was maintained under controlled conditions (21°C and 50% relative humidity) in a 12-h light/dark cycle. All rats were fed ad libitum, with fresh food replenished every day.
The composition of the experimental diets (Table 1)
was based on a modified American Institute of Nutrition-76A diet (18)
. The composition of the experimental diets was adjusted so that all diets would offer the same amount of calories, protein, vitamins, minerals, and fiber (18)
. As indicated in Table 1
, LFCO contained 5% corn oil, and HFFO contained 17% fish oil and 3% corn oil. In the HFML diet, 20% fat content was formulated using a slight modification of the American Blend Fat developed by the Institute of Shortening and Edible Oils (30)
. The HFML diet was formulated to simulate the fat content of the American diet with mixed lipids derived from beef tallow (16%), lard (10%), butter fat (12%), hydrogenated soy bean oil (30%), peanut oil (5%), and corn oil (27%). The diets were prepared in our laboratory three times weekly and stored under nitrogen in airtight containers in a cold room at 4°C. Aliquots of the experimental diets were analyzed for their fatty acid composition. As expected, the LFCO diet contained a high percentage of
-6 fatty acids such as linoleic acid, whereas the HFFO diet contained high levels of
-3 fatty acids such as docosahexaenoic acid and eicosapentaenoic acid. The
-6 fatty acid content of the HFFO diet was 8%; the
-3 fatty acid content of HFFO diet was 32%. The level of oleic acid (
-9) in the HFFO diet was 16%, whereas the total saturated fatty acid content was 29%. HFML diets contained
45, 24, and 28% of saturated, monounsaturated (
-7/9) and polyunsaturated (
-6) fatty acids, respectively.
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0.5 cm were cut into halves; one portion of the tumor was analyzed for apoptosis and COX enzyme activity and expression levels, and the other halves of the tumors and neoplasms
0.5 cm were used for histological examination of tumor types. Tumor-free colon samples collected at various time points were also used to assess colonic ACF and apoptosis and to study AA metabolism mediated by COX. For enzyme assays, the colons were rapidly removed and rinsed in ice-cold normal saline. They were slit open longitudinally, freed from all contents, and cleaned with ice-cold normal saline. They were laid flat on a glass plate, and the tumor-free colonic mucosa was scraped off with a microscope glass slide. The mucosal scrapings and portions of the tumors were quickly frozen in liquid nitrogen and stored at -80°C until analyses.
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Intestinal Tumors.
For histopathological evaluation, intestinal tumors harvested at week 23 (24 rats/group) and week 38 (39 rats/group) were fixed in 10% buffered formalin, embedded in paraffin blocks, and processed by routine histological procedures with H&E staining. The stained sections were examined for tumor types according to the classification of Pozharisski (48)
, which is followed routinely in our laboratory. Most of the colon tumors obtained at week 38 were invasive or noninvasive adenocarcinomas. The invasive adenocarcinomas were mostly the signet ring mucinous type, invading muscularis mucosa deep into the intestinal wall and beyond. The noninvasive adenocarcinomas were those growing outward toward the intestinal lumen and not invading the muscularis mucosa. They were usually well differentiated adenocarcinomas.
Apoptosis.
Six-µm sections were cut from colon samples collected at various time points and mounted on slides, rehydrated, and stained using the Tdt-mediated nick end labeling method for the detection of apoptosis (49)
. Briefly, slides were incubated with 3% H2O2 in PBS for 5 min, rinsed, and then incubated in Tdt buffer [140 mM cacodylate (pH 7.2), 30 mM Tris, and 1 mM CoCl2] for 15 min at room temperature. TdT reaction mixture [0.2 unit/µl Tdt, 2
M biotin-11-dUTP, 100 mM cacodylate, 2.5 mM CoCl2, 0.1 mM DTT, and 0.05 mg/ml BSA] was added and incubated for 30 min at 37°C. After blocking with 2% BSA and incubation with avidin-biotin peroxidase complexes, the Tdt-mediated nick end labeling reaction was visualized by chromogenic staining with 3,3'-diaminobenzidine. Slides were counterstained by hematoxylin. Stained crypt epithelial cells were counted manually in a single-blind fashion.
COX Activity.
Because COX enzyme is firmly bound to the luminal surface of the endoplasmic reticulum and nuclear envelope, the particulate fractions of the colonic mucosa and tumor samples were prepared as described previously (50)
. COX activities in colonic samples were assayed by using a slight modification of methods published previously (28)
. Protein was determined with Bio-Rad protein assay reagents (Bio-Rad Laboratories, Richmond, CA) with BSA as the standard. Analysis of COX activity was as follows. Briefly, 150 µl of the reaction mixture containing 12 µM 14C-AA (420,000 dpm), 1 mM epinephrine, 1 mM glutathione in 50 mM of phosphate buffer (pH 7.4), and 5070 µg of microsomal protein were incubated at 37°C for 20 min, and the reaction was terminated by adding 40 µl of 0.2 M HCl. The COX-mediated metabolites of AA were extracted with ethyl acetate (3 x 0.5 ml). The combined extracts were evaporated to dryness under N2, redissolved in chloroform, and subjected to TLC on precoated TLC plastic plates. The TLC plates were developed with a solvent system containing chloroform/methanol/acetic acid/water (100/15/1.25/1, v/v/v/v) and were exposed in an iodide chamber for 5 min to visualize the standards. The metabolites of 14C-AA-derived individual eicosanoids were detected by their comigration with authentic standards. The area of each metabolite was determined in a Bioscan System 200 image scanning counter (Bioscan, Inc., Washington, DC) equipped with ß-detector.
Western Blot Analyses of COX-2.
COX-2 purified protein, which was purchased from Cayman Chemicals, was used as the electrophoresis standard. The protein was separated on 8% PAGE-gel and then electroplated on polyvinylidene difluoride membranes as described (35
, 50)
. The method of analysis of COX-2 was as described previously (51)
. After blocking membranes in 5% nonfat dry milk, they were incubated with antibody of COX-2 for 1 h. The membranes were washed three times and incubated once more with secondary horseradish peroxidase-linked antirabbit IgG antibody at a final concentration of 1:2000. The membranes were developed by the enhanced chemiluminescence system and exposed to Kodak XAR5 film.
Statistical Analysis.
Differences in body weights between rats fed the diets containing different types and amounts of fat were compared by ANOVA. Differences in colon tumor multiplicity, colonic total ACF, crypt multiplicity, and COX activities were compared between the animals fed LFCO, HFFO, and HFML diets. All results were expressed as the mean ± SE and analyzed by Students t test. Tumor incidence was analyzed by Fishers exact probability test. Differences were considered significant at P < 0.05.
| RESULTS |
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4) aberrant foci was significantly higher in the HFML diet group than in the HFFO or LFCO diet groups at weeks 8, 23, and 38 (P < 0.0001; Fig. 4
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97% tumor incidence in the colon and only
3% in the small intestine, whereas those maintained on the LFCO or HFFO diet showed
80% tumors in the colon and 20% in the small intestine (data not shown).
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| DISCUSSION |
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-6 PUFAs and saturated fatty acids, whereas, in contrast,
-3 PUFAs (DHA, EPA) and
-9 monounsaturated fatty acids lack colon tumor-promoting effects (14
, 15
, 17, 18, 19, 20, 21
, 51)
. However, these studies traditionally used a single source of fat as a variable in investigating the role of dietary fat in colon carcinogenesis. Thus, these studies do not reflect the types of fat that are normally consumed in the United States and other Western countries where the risk for colorectal cancer development is high. In the current study, we have formulated the high-fat diet (HFML) so as to simulate the types of fat most often consumed in the United States. We have tested this diet for its colon tumor-promoting effect.
The data presented here demonstrate that compared with the LFCO or HFFO diets, administration of a HFML diet significantly augmented the AOM-induced colonic preneoplastic lesions, ACF. Even at early stages of colon carcinogenesis (at week 8) the HFML diet significantly enhanced not only the total number of ACF, but it also affected multicrypt foci containing 4 or more AC/foci in the colon. Recent studies suggest that there is a high degree of correlation between the number of multicrypt ACF formed and the outcome of colonic tumors at the later stages (45
, 52)
. Thus, the present study shows that administration of the HFML diet significantly promotes the formation and growth of preneoplastic lesions in the colon, whereas the HFFO diet, which is rich in
-3 fatty acids, had no such enhancing effect. Also, long-term feeding of the HFML diet for 23 and 38 weeks significantly increased the percentage of multicrypt foci. This indicates that, in addition to the amount and type of dietary fat, the duration of exposure to these fats is important. There were no previous studies enabling any comparison of the present results regarding the modulatory effect of HFML on colonic ACF. However, studies in various laboratories with the role of an HFFO diet in experimental colon tumorigenesis support the results of our present study in that
-3 fatty acid-rich diets inhibited the formation of colonic ACF (18, 19, 20, 21
, 53) . It is not yet clearly understood why only very few colonic ACF will ultimately be transformed into tumors. The data from this study suggest that, unlike the LFCO or HFFO diet, a HFML diet significantly increases the conversion of ACF into tumors. Understanding the exact mechanisms involved in the transformation of colonic ACF into tumors in general, and in the presence of a HFML diet or other tumor-promoting agents, is of great interest.
The present study also demonstrates that the colon tumor-promoting effect of the HFFO diet is nearly the same as that of the LFCO diet. This supports our previous investigations in which we used diets high in fish oil or low in fat (16 , 18 , 21) . The results of the present study also demonstrate for the first time that dietary HFML strongly promotes colon carcinogenesis in a well-established colon carcinogenesis animal model. It is noteworthy that here we observed a 4-fold increase in colon adenocarcinomas in rats fed the HFML diet, compared with those fed the LFCO diet. Equally important, the HFFO diet containing 20% fat (mostly in the form of fish oil) induced fewer colon tumors than the HFML diet containing the same amount of fat mostly from mixed lipids. This reinforces that both the type and the amount of fatty acids in the diet play a critical role in colon carcinogenesis. Another important observation in the present study is that feeding of the HFML diet induced intestinal tumors mainly in the colon (97%) and a negligible number of tumors in the small intestine when compared with the effects of the HFFO and LFCO diets. This observation is very important because it reflects observations on intestinal cancer in humans where the occurrence of colonic tumors is very high in comparison with tumors in the small intestine. The precise reason for a predominance of tumors of the colon in rats fed the HFML diet is uncertain, but it is believed to be the result of promotional factors in the diet.
Several reports indicate that apoptosis has a role in the pathogenesis of colon cancer (38, 39, 40, 41, 42) . We have observed in this investigation that feeding rats a HFML diet significantly suppresses colonic tumor apoptosis compared with feeding the LFCO or HFFO diets. Our previous studies have indicated that administration of a HFCO diet significantly suppresses apoptosis in AOM-induced colon tumors compared with a LFCO diet (44) . Recently, Latham et al. (54) showed that a fish oil diet given to Wister rats significantly enhances colonic crypt apoptosis, and that it reduces carcinogen-induced colonic ACF formation. Several studies also have demonstrated that resistance to apoptosis will lead to the development of colorectal cancer (40 , 53) . Induction of apoptosis by a HFFO diet, as observed in the present study, can lead to diminished tumor incidence in the colon of rats. This suggests that inhibition of apoptosis contributes to increased tumor development. It is not clear how the HFML diet induces the suppression of apoptosis that leads to the high colon-tumor promotion. One speculative hypothesis is that the administration of a HFML diet modulates the levels of the colonic luminal secondary bile acids, which have been shown to promote colon carcinogenesis and suppresses apoptosis. Magnuson et al. (55) have reported that administration of bile acids leads to enhanced of resistance to apoptosis in mice. It is possible that the tumor promoting effect of HFML diets is in part mediated through the bile acid-induced inhibition of apoptosis.
The present study also demonstrates that a HFML diet enhances AOM-induced expression of COX-2 and eicosanoid formation from AA, whereas the
-3 PUFAs in the HFFO diet inhibit the levels of COX-2. Feeding a HFML diet also significantly increases eicosanoid formation from AA via COX enzyme activity. Tsujii and DuBois (36)
, who have implicated COX-2 activity in the regulation of apoptosis of rat intestinal epithelial cells, have shown that overexpression of COX-2 can lead to the suppression of apoptosis. Results of our present study, in which the HFML diet elevated COX-2 expression and inhibited apoptosis and the consequent tumor burden, support this contention. Additional in-depth studies on the mechanism of action of HFML on colon tumor promotion are warranted to gain a clear understanding of the colon tumor-promoting effects of diets high in saturated fats.
In conclusion, the results of this investigation show for the first time that consuming a Western-style mixed-lipid diet (HFML) has a 4-fold higher potential to promote colon tumorigenesis than ingestion of a diet with an equivalent amount of fat containing fish oil (HFFO) or low-fat corn oil (LFCO). This observation makes a strong case for using the mixed-lipid diet (HFML), which reflects the American dietary pattern, in a broad range of preclinical efficacy studies involving chemopreventive agents. In addition, the HFML diet suppresses apoptosis and increases COX-2 activity and expression in colon tumors compared with the LFCO or HFFO diets. The exact mechanism by which the HFML diet promotes colon carcinogenesis has yet to be defined; even so, it would appear that the modulation of AA metabolism through COX activity plays a role in the suppression of apoptosis, leading to the enhancement of colonic ACF and tumors.
| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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1 Supported by USPHS Grants CA-37663, CA-80003, and CA 17613 from the National Cancer Institute. ![]()
2 To whom requests for reprints should be addressed, at the American Health Foundation, One Dana Road, Valhalla, NY 10595. E-mail: anshacvr{at}ix.netcom.com ![]()
3 The abbreviations used are: PUFA, polyunsaturated fatty acids; AA, arachidonic acid; COX, cyclooxygenase; AOM, azoxymethane; ACF, aberrant crypt foci; LFCO, low-fat corn oil diet; HFCO, high-fat corn oil; HFFO, high-fat fish oil diet; HFML, high-fat mixed-lipid diet; Tdt, terminal deoxynucleotidyl transferase. ![]()
Received 8/25/00. Accepted 1/ 4/01.
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