| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Epidemiology and Prevention |
Cancer Chemoprevention Program, Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine and Public Health, The Ohio State University, Columbus, Ohio
Requests for reprints: Gary Stoner, Cancer Chemoprevention and Support Program, Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine and Public Health, The Ohio State University. CHRI Suite 1141, 300 West 10th Avenue, Columbus, OH 43210. Phone: 614-293-6228; Fax: 614-293-4072; E-mail: gary.stoner{at}osumc.edu.
| Abstract |
|---|
|
|
|---|
| Introduction |
|---|
|
|
|---|
Esophageal SCC has a complex etiology. In the Western world, tobacco use and alcohol consumption are the major etiologic factors. In the Far East, in addition to the use of tobacco and alcohol, the disease is associated with the intake of salty food and food contaminated with various mycotoxins, deficiencies in dietary vitamins and minerals, and thermal injuries due to the consumption of hot beverages. Nitrosamine carcinogens also seem to be important causative agents of esophageal SCC (3). Among these is the carcinogen, N-nitrosomethylbenzylamine (NMBA), which is present in the diet in China. NMBA is an asymmetrical nitrosamine that readily induces mutagenic, toxic, and carcinogenic effects in esophageal tissues and is the most potent nitrosamine carcinogen for the rat esophagus (4, 5). In Linxian, China, the region with the highest incidence of esophageal SCC in the world, NMBA was identified in pickled vegetables and its metabolism has been elucidated (6, 7).
The inducible isoform of nitric oxide synthase (iNOS) is an enzyme that catalyzes the conversion of L-arginine to citrulline resulting in the production of nitric oxide (NO; ref. 8). NO is a free radical with an unpaired electron; it can donate or accept an electron to become a nitrosonium cation (NO+) or a nitroxyl anion (NO), which leads to nitrosative stress or oxidative stress, respectively. Nitrosative stress can lead to the formation of nitrosamine carcinogens, deamination of DNA bases, and inactivation of DNA repair proteins, all actions contributing to carcinogenesis. Similarly, oxidative stress can lead to the formation of peroxynitrite (ONOO), which can damage DNA and lead to carcinogenesis. NO is synthesized in mammalian cells by a family of three NO synthases: nNOS, eNOS, and iNOS. nNOS and eNOS are constitutively present in neurons and endothelial cells, respectively. These isoforms are calcium-dependent and produce only a low level of NO. In contrast, iNOS is calcium- and calmodulin-independent, and when induced by cytokines or other factors, generates a high concentration of NO. Up-regulation of iNOS has been reported in several types of cancer including breast, head and neck, lung, colon, melanoma, prostate, as well as esophageal SCC (916).
Prostaglandin endoperoxide synthase, also called cyclooxygenase (COX), catalyzes the formation of prostanoids including prostaglandins A2, D2, E2, F2
, I2, and J2 and thromboxane A2 (17). Two COX isoforms have been cloned: COX-1 and COX-2. COX-1 is constitutively expressed in most mammalian cells and is responsible for homeostasis of normal physiologic functions. COX-2 is expressed in response to certain stimuli such as growth factors, tumor promoters, hormones, and cytokines. COX-2 is important for tumorigenesis because prostaglandins, especially prostaglandin E2 (PGE2), affect cell proliferation, differentiation, apoptosis, angiogenesis, and metastasis (18). Up-regulation of COX-2 has been detected in various cancers including colon, gastric epithelium, breast, skin, pancreas, lung, head and neck, urinary bladder, and esophageal SCC (1927). Clinical cancer chemoprevention studies indicated that COX-2 is a valid target for cancer prevention with the COX-2 inhibitor, celecoxib. Celecoxib significantly reduced the number of colon polyps in patients with familial adenomatous polyposis compared with placebo (28). Other nonsteroidal anti-inflammatory drugs including COX-2-selective and COX-2-nonselective inhibitors, such as aspirin, piroxicam, and sulindac, also exhibit chemopreventive potential in animal and human studies (2931).
Expression of iNOS and COX-2 is controlled by transcription factors including the activator protein (AP-1) complex. AP-1 is composed of the Jun family (c-Jun, Jun-B, and Jun-D) and the Fos family (c-Fos, Fos-B, Fra-1, and Fra-2), which regulate the expression of iNOS and COX-2 by binding to their promoter sequences (32, 33). AP-1 regulates various cellular events including cell proliferation, differentiation, and apoptosis (34). c-Jun is a major component of AP-1, it is up-regulated in transformed cell lines and human cancers and is induced by activated Ras oncogenic proteins (3537). The Ras family of proteins (H-, N-, and K-ras) bind to GTP to form ras-GTP complexes that regulate signal transduction pathways induced by diverse extracellular signals including carcinogens that induce esophageal cancer (38).
Our laboratory reported the overexpression of iNOS and COX-2 mRNAs in preneoplastic lesions and in papillomas induced in the rat esophagus by NMBA. Overexpression of iNOS and COX-2 is associated with increases in the tissue content of nitrite/nitrate and PGE2, respectively (16, 39, 40). We also observed Ha-ras codon 12 G
A transition mutations in all papillomas during esophageal carcinogenesis in rats (41). In view of these results, we conducted the present study to determine whether dietary freeze-dried black raspberries (BRB) inhibit tumor development in the rat esophagus by modulating iNOS, COX-2, and c-Jun.
| Materials and Methods |
|---|
|
|
|---|
Animals, berries, and diets. Male F344 rats, 4 to 5 weeks old, were obtained from Harlan Sprague-Dawley (Indianapolis, IN). The animals were housed three per cage under standard conditions (20 ± 2°C, 50 ± 10% relative humidity, 12-hour light/dark cycles). Food and water were freely available. Hygienic conditions were maintained by twice-weekly cage changes and routine cleaning of the animal rooms. The animals were fed a modified American Institute of Nutrition-76A (AIN-76A) synthetic diet containing 20% casein, 0.3% D,L-methionine, 52% cornstarch, 13% dextrose, 5% cellulose, 5% corn oil, 3.5% AIN salt mixture, 1% AIN vitamin mixture, and 0.2% choline bitartrate (Dyets, Inc., Bethlehem, PA). The diet was stored routinely at 4°C before the preparation of experimental diets.
Ripened black raspberries (Jewel variety) were purchased from the Stokes Raspberry Farm (Wilmington, OH). The berries were picked mechanically, washed, and placed in a 20°C freezer within an hour of picking. They were then shipped frozen to Van Drunen Farms (Momence, IL) for freeze-drying and subsequent grinding into a powder (BRB). BRB was shipped frozen to The Ohio State University and kept at 20°C until used. It was analyzed for content of several vitamins, minerals, carotenoids, and simple polyphenols by Covance Laboratories, Inc. (Madison, WI) and for anthocyanins in the laboratory of Dr. Steven Schwartz, College of Food, Agriculture, and Environmental Sciences, The Ohio State University. In general, the contents of berries varied no more than 20% from those of BRB obtained yearly from the same source during the past 8 years.
AIN-76A diet containing 5% BRB was prepared fresh weekly and stored at 4°C. BRB were mixed into the diet (modified by reducing the concentration of cornstarch by 5% to maintain an isocaloric diet) for 25 minutes with a Hobart mixer (Troy, OH). Fresh experimental and control diets were placed in glass feeding jars weekly and fed to the rats.
Experimental procedures. After a 2-week acclimation period to the animal facility, 150 rats were randomly assigned to four experimental groups (Table 1) and placed on AIN-76A diet. Three days after the final NMBA treatment, rats in group 3 were fed the AIN-76A diet only and rats in group 4 were fed the AIN-76A diet containing 5% BRB for the duration of the bioassay. Food consumption and body weight data were recorded weekly. At 9 and 15 weeks, 5 rats from groups 1 and 2 and 10 rats from groups 3 and 4; and, at 25 weeks, 15 rats from groups 1 and 2 and 30 rats from groups 3 and 4, were euthanized by CO2 asphyxiation and subjected to gross necropsy. The esophagus of each rat was excised and opened longitudinally. Tumors >0.5 mm in a single dimension were counted, mapped, and measured (length, width, and height). Tumor volume was calculated using the formula for a prolate spheroid: length x width x height x
/6. After the tumor data were recorded, tumors were removed from the esophagus and frozen in liquid nitrogen. The epithelium was stripped of the submucosal and muscularis layers and frozen in liquid nitrogen separately. All samples were stored at 80°C until analysis.
|
|
Nitrate/nitrite colorimetric assay. As described previously (39), frozen esophagi were weighed, homogenized in PBS, and centrifuged. iNOS activity in the supernatant was measured using a nitrate/nitrite colorimetric assay kit according to the manufacturer's instructions. Briefly, 80 µL supernatant for each sample was transferred to a 96-well optical plate and incubated with 10 µL nitrate reductase and 10 µL enzyme cofactor for 3 hours. Griess reagent [sulfanilamide and N-(1-naphthyl)ethylenediamine] was added and the absorbance was measured at 550 nm using a SpectraMax M2 multidetection reader (Molecular Devise Corp., Sunnyvale, CA). Standards of sodium nitrate (0-35 µmol/L) were used to create a standard curve. The final nitrite concentration was the sum of the nitrite plus the reduced nitrate in each sample and was taken as an index of iNOS activity as described previously. Each sample was assayed in triplicate.
PGE2 enzyme immunoassay. COX-2 activity in esophageal epithelium and papillomas were assayed by using the Biotrak Enzyme Immunoassay System (Amersham Biosciences) to measure PGE2 concentration. In brief, frozen samples were homogenized in Tris-HCl buffer (pH 7.5) with 0.02 mol/L EDTA and 5 mg/mL indomethacin. Total protein concentration for each tissue homogenate was determined using the DC Protein Assay (Bio-Rad). PGE2 was collected and purified according to the manufacturer's instructions. Absorbance was measured at 450 nm using the SpectraMax M2 multidetection reader (Molecular Devise). PGE2 concentration was normalized against protein concentration in the same sample. Each sample was assayed in triplicate.
Statistical analysis. Body weight, food consumption, tumor multiplicity (mean number of tumors/esophagus), and tumor volume data were collected for all rats fed control or experimental diets. These datathe iNOS, COX-2, and c-Jun expression data; total nitrite and nitrate data; and PGE2 datawere analyzed and compared using one-way ANOVA followed by Dunnet's multiple comparison test to identify individual differences among groups when the ANOVA was significant. Tumor incidence (percentage of animals in each group with tumors) data were analyzed using the
2 test. All statistical analysis was carried out using GraphPad Prism 4.0. Differences were considered statistically significant at P < 0.05. All P values were two-sided.
| Results |
|---|
|
|
|---|
BRB inhibits tumor development. At weeks 9 and 15 of the bioassay, <10% to 20% of the esophagi, respectively, had tumors (papillomas). The tumor responses (incidence, multiplicity, and volume) at these time points were too low to determine if BRB treatment produced any inhibitory effects. At the end of the bioassay (week 25), none of the DMSO-treated rats (group 1) or the rats fed 5% BRB (group 2) developed tumors. In rats treated with NMBA, however, BRB reduced the incidence of esophageal tumors from 96% in NMBA controls (group 3) to 89% in rats treated with NMBA + 5% BRB (group 4). This reduction was not significant (P > 0.05). In contrast, BRB significantly reduced tumor multiplicity, the standard end point in this tumor model, from 3.78 ± 0.41 tumors per esophagus in group 3 to 2.23 ± 0.21 tumors per esophagus in group 4 (P < 0.005; Fig. 1A). The difference in tumor volume between groups 3 and 4 was not significant at 25 weeks (Fig. 1B).
|
|
|
|
| Discussion |
|---|
|
|
|---|
In the NMBA model of rat esophageal tumorigenesis, the principal end point for assessing the inhibitory effects of chemopreventive agents is tumor multiplicity. Reductions in tumor incidence occur only with very potent chemopreventive agents because virtually all NMBA-treated rats develop multiple tumors at 25 weeks. With less active chemopreventive agents, large numbers of animals per group (60-100) are required to show an inhibitory effect on tumor incidence, which makes routine studies cost prohibitive. Similarly, tumor volume data are of limited use in chemoprevention studies because the variability in esophageal tumor volume among individual animals is significant. Thus, as for tumor incidence data, a large number of animals per group (60-100) is required to show the significant inhibitory effect of chemopreventive agents on tumor volume.
Black raspberries, a small black berry native to North America, are an abundant source of flavonoid compounds (e.g., ellagic acid, ferulic acid, coumaric acid, quercetin, and the anthocyanins), vitamins (e.g., vitamins A, C, and E and folic acid), minerals (e.g., calcium, potassium, selenium, and zinc), and phytosterols (e.g., ß-sitosterol, campesterol, and stigmasterol). The chemical composition of BRB has not been fully determined. However, recent data suggest that the anthocyanins are most abundant compounds in BRB representing
5% to 6% of their dry weight. Many of the known compounds have antioxidant and anti-inflammatory activities and protect against cancer in animal models. For example, ellagic acid protects against chemically induced cancer in multiple organ sites including the rat esophagus (42). It reduces the metabolic activation of procarcinogens by inhibition of cytochrome P450 enzymes, and it enhances phase II enzyme activities resulting in more efficient detoxification of carcinogens. Cytochrome P450s, 2E1 and 1A1, for example, are major enzymes involved in the bioactivation of procarcinogens such as NMBA and benzo(a)pyrene (43, 44). Ellagic acid decreased the activation of these two enzymes and inhibited carcinogenesis in the rat esophagus and mouse skin (45). Ascorbic acid is another chemopreventive agent in black raspberries. It suppressed the in vivo nitrosation of primary and secondary amines in the stomach from nitrite, thus, inhibiting the formation of nitrosamine carcinogens including NMBA (46). Calcium protects against the development of colon cancer in animals (47), and ß-sitosterol has chemopreventive effects against carcinogen-induced mammary cancer in rodents (48). These are only a few examples of the multiple known chemopreventive agents in black raspberries. By freeze-drying the berries, these components are concentrated
10-fold because black raspberries are
90% water by weight. Ascorbic acid is the only component known to degrade substantially during storage and before freeze-drying the berries. The other components seem to be well preserved even when BRB are stored at 4°C for several months. Biodirected fractionation studies are under way to identify the most active inhibitory components in BRB against NMBA-induced rat esophageal tumorigenesis.
The precise mechanism by which black raspberries inhibit tumor development in the esophagus of rats that have been treated with NMBA is not fully understood. However, in the present study, black raspberry powder was found to inhibit both mRNA expression levels and activities of iNOS and COX-2, two enzymes previously shown in our laboratory to be up-regulated in rat esophageal tumorigenesis (16, 40). Moreover, BRB were found to down-regulate the expression of c-Jun, a component of the transcription factor, AP-1, which controls the expression of multiple genes. Thus, we depict the possible mechanisms for the prevention of tumor development by BRB in Fig. 4.
|
A transition mutation in the H-ras gene, and that the percentage of premalignant dysplastic foci in the esophagus that exhibit mutant ras increases with time after NMBA treatment (41, 49). Because c-Jun is downstream of ras, its expression levels might be related to the percentage of esophagus cells that exhibit mutant ras. Thus, the berries may have been effective at down-regulating c-Jun only in tissues that had a sufficient number of ras-activated cells. Inhibition of the expression of iNOS was observed in the esophagus only at 25 weeks. Again, this was probably related to the higher expression levels of this gene at this time point, which is in agreement with our immunohistochemical studies showing higher levels of iNOS protein in more advanced lesions (16).
The present study is of potential importance to humans because both iNOS and COX-2 are overly expressed in dysplastic lesions of human esophagus and esophageal SCC. In endoscopic surveys of high-risk populations in China, dysplastic lesions exhibited overexpression of iNOS and COX-2 and
70% of patients with esophageal dysplasia are later diagnosed with esophageal SCC (50, 51). Because our results showed that black raspberry powder inhibits iNOS and COX-2 during the progression stage of esophageal carcinogenesis, using black raspberries for chemoprevention of this disease could be an effective strategy for its prevention in high-risk populations.
Interestingly, in the current investigation, we found that BRB significantly inhibit both COX-2 expression and COX-2-derived PGE2 levels in precancerous tissues, but only PGE2 and not COX-2 levels in papillomas. Although the reason(s) for this are unknown, recent studies indicate that an enzyme, 15-hydroxyprostaglandin dehydrogenase (15-PGDH), is a prostaglandin-degrading enzyme that catalyzes the oxidization of the 15(S)-hydroxyl group of PGE2 to produce inactive 15-keto PGE2 (52). The level of PGE2 depends on the rates of COX-2-dependent biosynthesis and 15-PGDH-dependent degradation. In NMBA-induced papillomas, BRB did not inhibit COX-2 expression, but they did reduce PGE2 levels. This could be due to an induction of 15-PGDH by BRB.
In conclusion, the present study suggests mechanisms for the chemopreventive action of black raspberries. The outcome of this study is of great interest and has implications for the prevention of human esophageal cancer. Natural food products such as BRB may offer a relatively nontoxic alternative to the prevention of esophageal cancer in humans. In this regard, a phase I clinical trial of freeze-dried BRB recently conducted in our laboratory indicated that black raspberries were well tolerated by humans when administered p.o. at 45 g of powder per day for 7 days (53). In addition, in a trial involving subjects with Barrett's esophagus, black raspberry powder was well tolerated when administered at 32 and 45 g/d for 6 months (54). Thus, black raspberries may be a useful alternative to chemopreventive drugs for the prevention of human esophageal cancer.
| Acknowledgments |
|---|
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.
Received 9/12/05. Revised 12/28/05. Accepted 1/ 4/06.
| References |
|---|
|
|
|---|
A transition mutations in preneoplastic lesions induced by N-nitrosomethylbenzylamine in the rat esophagus. Mol Carcinog 2001;32:18.[CrossRef][Medline]This article has been cited by other articles:
![]() |
J. A. Abrams Review: Chemoprevention of esophageal adenocarcinoma Therapeutic Advances in Gastroenterology, July 1, 2008; 1(1): 7 - 18. [Abstract] [PDF] |
||||
![]() |
S. R. Mallery, J. C. Zwick, P. Pei, M. Tong, P. E. Larsen, B. S. Shumway, B. Lu, H. W. Fields, R. J. Mumper, and G. D. Stoner Topical Application of a Bioadhesive Black Raspberry Gel Modulates Gene Expression and Reduces Cyclooxygenase 2 Protein in Human Premalignant Oral Lesions Cancer Res., June 15, 2008; 68(12): 4945 - 4957. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. S. Shumway, L. A. Kresty, P. E. Larsen, J. C. Zwick, B. Lu, H. W. Fields, R. J. Mumper, G. D. Stoner, and S. R. Mallery Effects of a Topically Applied Bioadhesive Berry Gel on Loss of Heterozygosity Indices in Premalignant Oral Lesions Clin. Cancer Res., April 15, 2008; 14(8): 2421 - 2430. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. Suh, S. Paul, X. Hao, B. Simi, H. Xiao, A. M. Rimando, and B. S. Reddy Pterostilbene, an Active Constituent of Blueberries, Suppresses Aberrant Crypt Foci Formation in the Azoxymethane-Induced Colon Carcinogenesis Model in Rats Clin. Cancer Res., January 1, 2007; 13(1): 350 - 355. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Chen, M. E. Rose, H. Hwang, R. G. Nines, and G. D. Stoner Black raspberries inhibit N-nitrosomethylbenzylamine (NMBA)-induced angiogenesis in rat esophagus parallel to the suppression of COX-2 and iNOS Carcinogenesis, November 1, 2006; 27(11): 2301 - 2307. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. S. Hecht, C. Huang, G. D. Stoner, J. Li, P. M.J. Kenney, S. J. Sturla, and S. G. Carmella Identification of cyanidin glycosides as constituents of freeze-dried black raspberries which inhibit anti-benzo[a]pyrene-7,8-diol-9,10-epoxide induced NF{kappa}B and AP-1 activity Carcinogenesis, August 1, 2006; 27(8): 1617 - 1626. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Ding, R. Feng, S. Y. Wang, L. Bowman, Y. Lu, Y. Qian, V. Castranova, B.-H. Jiang, and X. Shi Cyanidin-3-glucoside, a Natural Product Derived from Blackberry, Exhibits Chemopreventive and Chemotherapeutic Activity J. Biol. Chem., June 23, 2006; 281(25): 17359 - 17368. [Abstract] [Full Text] [PDF] |
||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Cancer Research | Clinical Cancer Research |
| Cancer Epidemiology Biomarkers & Prevention | Molecular Cancer Therapeutics |
| Molecular Cancer Research | Cancer Prevention Research |
| Cancer Prevention Journals Portal | Cancer Reviews Online |
| Annual Meeting Education Book | Meeting Abstracts Online |