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1 Department of Medicine 4, Division of Gastroenterology and Hepatology, Medical University Vienna, Vienna, Austria; 2 Baylor University Medical Center, Dallas, Texas; and 3 Biostatistics, Cancer Center, University of California, San Diego, California
Requests for reprints: Christoph Gasche, AKH Wien, KIM4, Wahringer Gurtel 18, A-1090 Vienna, Austria. Phone: 43-1-404004764; Fax: 43-1-404004735; E-mail: christoph.gasche{at}meduniwien.ac.at.
| Abstract |
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| Introduction |
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B (4). Another possible target for the activity of nonsteroidal anti-inflammatory drugs is the improvement of DNA replication. The fidelity of DNA replication is a product of polymerase accuracy, its proofreading activity, and the proficiency of the postreplicational mismatch repair system (5). Inefficiency of one of these processes can be a key to the development of human cancer, best illustrated by the familial cancer syndrome hereditary nonpolyposis colorectal cancer (also called Lynch syndrome). In hereditary nonpolyposis colorectal cancer, loss-of-function mutations of DNA mismatch repair proteins, such as hMLH1 or hMSH2, reduce the activity of postreplicational DNA mismatch repair and strongly elevate the mutation rate, consistent with the mutator phenotype hypothesis as origin of cancer (6). Aspirin increases mismatch repair protein expression and subsequent apoptosis, suggesting that the up-regulation of the mismatch repair system might be another chemopreventive mechanism of aspirin and related nonsteroidal anti-inflammatory drugs (7). We recently developed a flow cytometrybased assay to study replication fidelity. Frameshift mutations were quantified at a (CA)13 microsatellite that shifted an enhanced green fluorescence protein (EGFP) into a +2 position, thereby leading to expression of a truncated nonfluorescent peptide (8, 9). With this assay, we detected three cell populations according to their fluorescence intensity: nonfluorescent, nonmutant M0 cells; dim fluorescent, intermediate mutant M1 cells; and strong fluorescent, definitive mutant M2 cells (9). We showed that intermediate mutant M1 cells actually carry (CA)13·(GT)12 DNA heteroduplexes that are only present immediately after the polymerase error. Failure of mismatch repair resulted in generation of definitive mutant M2 cells that carry (CA)12·(GT)12 DNA homoduplexes. Herein we applied this assay to test a possible effect of aspirin and mesalazine on replication fidelity in cultured colorectal cells. | Materials and Methods |
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Mesalazine (generously provided by Dr. Falk Pharma, Freiburg, Germany) and aspirin (purchased form Sigma Chemical Co., St. Louis, MO) were dissolved in DMSO and sterile filtered. Twenty-four hours after initial cell sorting, mesalazine or aspirin was added to quadruplicate cultures at a final concentration of 0.0 to 5.0 mmol/L. Corresponding concentrations of DMSO were used as control. All experiments were done at least twice per clone.
A flow cytometrybased assay for mutagenesis. One thousand nonfluorescent cells were sorted into 24-well plates on a FACSVantage SE using CloneCyt Plus sorting technology (Becton Dickinson Immunocytometry Systems, San Jose, CA). After an 8-day growth period at 37°C, 5% CO2, and full humidity, cells were trypsinized, washed in PBS containing 2% fetal bovine serum (FBS), and resuspended in a total volume of 100 µL PBS/2% FBS. Fifty microliters of cell suspension were analyzed on a FACSCalibur with CellQuest acquisition and analysis software (Becton Dickinson) and the cell counts were doubled to quantitate the total cell number per well. The counts of low fluorescent M1 cells (intermediate mutants), and high fluorescent M2 cells (definitive mutants) were expressed as fractions of the total cell number in culture. Mutation rates were calculated as previously described (9, 11).
Statistics. Means and SEs were calculated for continuous variables (e.g., fluorescence intensity). Cochran-Armitage trend tests were used to compare mutant fractions across different doses of aspirin or mesalazine. The mutation rate is defined as the probability of a cell undergoing a mutation in its lifetime, and is expressed per microsatellite per cell per generation. Mutation rates were estimated using two methods: the method of the mean and the maximum likelihood method (11). A single mutation rate for each dose was estimated by taking a weighted linear combination of the dose-specific mutation rates across clones, with weights chosen to be inversely proportional to the individual variances. All estimated quantities are presented with SEs based on quadruple cultures for each clone.
| Results |
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1.25 mmol/L, mesalazine
5.0 mmol/L). Mesalazine, but not aspirin, reduced the mutant fraction in culture in both HCT116-A1.3 and HCT116-A2.1 clones (Fig. 2). Cochran-Armitage trend tests revealed significant decreases in mutant fractions as the dose of mesalazine increased, with
2 statistics of 141.91 (P < 0.0001) and 106.70 (P < 0.0001) for clones A1.3 and A2.1, respectively. For aspirin the trend test was not significant for either clone (
2 statistic = 1.25, P = 0.26 for A1.3;
2 statistic 1.66, P = 0.20 for A2.1). This reduction in mutant cells by mesalazine was mainly caused by a decrease in intermediate mutant M1 cells (Cochran-Armitage test statistics of 159.45 and 103.88 with associated P values of <0.0001 for the clones A1.3 and A2.1, respectively) and also by a reduction in definitive mutant M2 cells (Cochran-Armitage test statistics of 23.59 and 18.71 with associated P values of <0.0001 for the clones A1.3 and A2.1, respectively; Fig. 3). No change in the mutant fraction was observed when cells were cultured in the solvent alone. The combined (across clones) mutation rate dropped from 6.8 x 104 ± 9.0 x 105 to 5.5 x 104 ± 1.1 x 104 (81% of control; Table 1). No such change or, rather, an increase was estimated for aspirin (8.2 x 104 ± 1.3 x 104; 121% of control; Table 1).
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We previously have shown that M2 cells display a deletion of one CA-dinucleotide within the microsatellite (9). The reduction in M2 cells therefore reflects a reduction in the microsatellite mutation rate by mesalazine. Because HCT116 cells are mismatch repair deficient, this effect can only be explained by mechanisms independent of mismatch repair, such as an improvement of replication fidelity. Indeed, mesalazine significantly lowered the number of intermediate mutant M1 cells, which reflects a population of cells immediate after the polymerase error (Fig. 3B). The mutation-protective effect of mesalazine is therefore caused by improvement of polymerase fidelity rather than by mismatch repair fidelity.
Mesalazine improves replication fidelity in mismatch repairproficient cells. Next, we tested the effect of mesalazine in mismatch repairproficient HCT116+chr3 clones. As previously observed (9), the intermediate mutant M1 cell fraction in HCT116+chr3 clones (0.22 ± 0.05%) was somewhat smaller than in HCT116 clones (0.35 ± 0.05%). HCT116+chr3 cells also did not generate a sizeable number of definitive mutant M2 cells within this short period of time. Therefore, we were unable to measure an effect of mesalazine on generation of M2 cells. Mesalazine decreased the number of M1 cells in a dose-dependent manner (Fig. 3C, P < 0.0001). Aspirin or DMSO had no effect on the generation of M1 cells. The effect of mesalazine was also seen when mesalazine was dissolved in ethanol instead of DMSO, showing that the prevention of mutations is an effect of mesalazine and not of the solvent.
| Discussion |
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Frameshift mutations at microsatellites occur as a time-dependent function of polymerase errors followed by failure of postreplicational mismatch repair. Because the effect of mesalazine was seen in mismatch repairdeficient HCT116 cells and in intermediate mutant M1 cells, mesalazine may act on replication fidelity independent of the postreplicational mismatch repair. Numerous processes determine the fidelity of DNA replication besides mismatch repair. Several of these are responsible for providing undamaged substrates to the replication machinery (e.g., sanitizing deoxynucleotide triphosphate pools, base excision repair, nucleotide excision repair, and single-strand DNA break repair; ref. 13). Next, replication accuracy of undamaged DNA depends on the high nucleotide selectivity and proofreading activity of the various polymerases, which is best illustrated by the emerging relationships between DNA polymerase dysfunction and cancer (14).
Previously we induced frameshift mutations by H2O2 in a similar model based on transient transfections (8). In clones from stably transfected cells, however, as used herein, H2O2 had no effect on the mutation rate (data not shown). It is likely that this is due to protection of plasmid DNA when integrated into the genome. Because we were unable to induce mutations by H2O2, we did not test any protective effect of mesalazine in cultures with H2O2.
Currently, we do not understand the molecular mechanism of how mesalazine interferes with the generation of frameshift mutations. We also do not know whether this effect is only true for poly-CA tracts or also for other repetitive sequences. The best known model of frameshift mutations at repetitive sequences involves strand misalignment through template-primer slippage (reviewed in ref. 15). Slippage depends on various factors such as the length of the repetitive sequence, the type of nucleotide (pyrimidine runs show higher slippage rates that purine runs), and the type of polymerase. Frameshift fidelity also decreases when proofreading is suppressed or when the composition of the nucleotide pool is changed (16). Because most control mechanisms of replication affect not only frameshift mutations but also base substitution fidelity, we may speculate that mesalazine might also prevent missense mutations (5).
The reduction in cell number by aspirin was mainly caused by cell death (17). Mesalazine also reduced cell numbers at the highest concentration tested but rather by growth inhibition. This is in line with previous studies showing accumulation of cells in the S and G2-M phases of the cell cycle (18). The lower number of mutant cells, however, cannot be explained by simple growth retardation because we measured the mutant cells as fraction of the total cell number at the end of the culture period. However, we cannot exclude that improved replication accuracy takes time and thus may delay cell cycle progression.
The observed effects of mesalazine on replication fidelity were seen at mesalazine concentrations above 1.25 mmol/L (HCT116-A1.3) or 2.5 mmol/L (HCT116-A2.1) and were greatest at the highest dose tested (5.0 mmol/L). Similar or higher mesalazine concentrations were applied in other experimental settings and measured in the colon of patients with ulcerative colitis (19). Mesalazine microgranules reached concentrations above 1 mmol/L in the ileal fluid (20). Because 90% of the oral dose are delivered to the colon, extrapolation of these measurements reveals a colonic mesalazine concentration above 10 mmol/L, which is clearly beyond the highest concentration in our experiments (20).
At the 5.0 mmol/L level, a 19% reduction of the mutation rate was observed in mismatch repairdeficient HCT116. Considering the fact that the tempo of mutations defines the speed of tumor progression (as predicted in the mutator phenotype hypothesis ref. 6), mesalazine therapy could introduce a significantly delay in the clinical manifestation of a tumor. If mesalazine increases the number of years it takes for cells to accumulate the requisite number of mutations required for invasiveness or metastases by 19%, it would significantly reduce the life-threatening manifestations of cancer and diminish cancer deaths even in the absence of reducing cancer incidence. In this respect, mesalazine is potentially useful for prevention of colorectal cancer independent of its anti-inflammatory properties.
| Acknowledgments |
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
We thank Dennis J. Young for assistance with flow cytometry.
Received 10/25/04. Revised 1/ 9/05. Accepted 2/ 9/05.
| References |
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B by sodium salicylate and aspirin. Science 1994;265:9569.This article has been cited by other articles:
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C. Stolfi, D. Fina, R. Caruso, F. Caprioli, M. C. Fantini, A. Rizzo, M. Sarra, F. Pallone, and G. Monteleone Mesalazine negatively regulates CDC25A protein expression and promotes accumulation of colon cancer cells in S phase Carcinogenesis, June 1, 2008; 29(6): 1258 - 1266. [Abstract] [Full Text] [PDF] |
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C. L. Bos, S. H. Diks, J. C.H. Hardwick, K. V. Walburg, M. P. Peppelenbosch, and D. J. Richel Protein phosphatase 2A is required for mesalazine-dependent inhibition of Wnt/{beta}-catenin pathway activity Carcinogenesis, December 1, 2006; 27(12): 2371 - 2382. [Abstract] [Full Text] [PDF] |
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A. Goel, C. Gasche, and C. R. Boland Chemoprevention Goes Gourmet: Different Flavors of NO-Aspirin Mol. Interv., August 1, 2005; 5(4): 207 - 210. [Abstract] [Full Text] [PDF] |
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