Carotenoids, antioxidants and ovarian cancer risk in pre- and postmenopausal women

Consumption of vegetables and fruits and risk of ovarian carcinoma

BACKGROUND

To the authors' knowledge, only a few prospective studies to date have investigated the correlation between vegetable and fruit consumption and the risk of ovarian carcinoma and their results have been inconclusive.

METHODS

Vegetable and fruit intake was assessed in relation to ovarian carcinoma, among 62,573 postmenopausal women participating in The Netherlands Cohort Study on Diet and Cancer. Women reported on dietary habits and on other risk factors for cancer in a self-administered questionnaire in 1986. Follow-up of cancer was implemented by annual record linkage with The Netherlands Cancer Registry and a pathology register. After 11.3 years of follow-up, data regarding 252 incident invasive epithelial ovarian carcinoma cases and of 2216 subcohort members were available for case-cohort analyses.

RESULTS

Multivariable-adjusted rate ratios (RR) of ovarian carcinoma for women in the highest compared with the lowest quintile of intake (RR(Q5 vs. Q1)) were 0.98 (95% confidence interval [95% CI], 0.61-1.58) for total vegetables and 1.11 (95% CI, 0.70-1.78) for total fruit. The RR(Q5 vs. Q1) values of ovarian carcinoma with intake of cooked vegetables, raw vegetables, brassicas, legumes, cooked leafy vegetables, and raw leafy vegetables were 1.35 (95% CI, 0.83-2.21), 0.75 (95% CI, 0.48-1.18), 1.42 (95% CI, 0.88-2.29), 0.93 (95% CI, 0.60-1.44), 1.05 (95% CI, 0.66-1.67), and 1.23 (95% CI, 0.75-2.02), respectively. With the exception of raw endive (multivariable-adjusted RR, 0.24; 95% CI, 0.07-0.78), none of the individual vegetable or fruit items showed a statistically significant association with ovarian carcinoma.

CONCLUSIONS

The results of the current study did not support a significant association between vegetable or fruit consumption and ovarian carcinoma risk in a cohort of postmenopausal women.

A case control study of glycoprotein status in ovarian carcinoma

OBJECTIVES

Ovarian cancer is the leading cause of death due to gynecological malignancies. The aim of our study was to investigate the status of circulating glycoprotein levels in ovarian cancer patients.

DESIGN AND METHODS

Thirty ovarian cancer patients and an equal number of age-matched, apparently healthy subjects as controls were involved in the study. Glycoprotein levels, as indicated by the concentration of plasma total sialic acid, protein-bound hexoses, hexosamine and fucose were estimated in circulation of both the ovarian cancer patients and controls.

RESULTS

Significantly elevated levels of plasma total sialic acid, protein-bound hexoses, hexosamine and fucose were observed in ovarian cancer patients as compared to the apparently healthy controls.

CONCLUSION

Plasma total sialic acid, protein-bound hexoses, hexosamine and fucose in the circulation of ovarian cancer patients are markedly elevated and the increase in these carbohydrate moieties of glycoproteins reflect the stage of cancer and may be an additional tool in the diagnosis and prognosis of ovarian carcinoma.

A case-control study in Shanghai of fruit and vegetable intake and endometrial cancer

In a population-based case–control study of 832 incident endometrial cancer cases and 846 frequency-matched controls among Chinese women in Shanghai, using a validated food-frequency questionnaire, dietary habits were estimated by in-person interviews. Total vegetable consumption was inversely associated with endometrial cancer risk (highest quartile vs lowest: OR=0.69, 95% CI 0.50–0.96). The risk was reduced with increasing intake of dark green/dark yellow vegetables (trend test, P=0.02), fresh legumes (trend test, P<0.01), and allium vegetables (trend test, P=0.04). Fruit consumption was unrelated to risk. These results suggest that high consumption of certain vegetables may reduce the risk of endometrial cancer.

Retinoid receptors in ovarian cancer: expression and prognosis

BACKGROUND

Ovarian cancer is frequently lethal despite aggressive multimodal therapy, and new therapies are therefore needed. Retinoids are potential candidate drugs: they prevent the development of ovarian carcinoma and enhance the efficacy of cytotoxic drugs in ovarian cancer cells. At present, little is known about the retinoid receptor expression in ovarian cancer.

PATIENTS AND METHODS

The retinoid receptors comprise two classes, retinoic acid receptors (RARs) and retinoid X receptors (RXRs), each with three subclasses, alpha, beta and gamma. We investigated the expression of the subtypes RARalpha, RARgamma, RXRalpha and RXRbeta by immunohistochemistry in ovarian cancers of 80 patients, and assessed their prognostic significance. In addition, we quantified the expression of retinoid receptor mRNA using real-time PCR and correlated the results with clinical characteristics.

RESULTS

RARalpha and RXRbeta were highly expressed in a majority of ovarian cancers, particularly in advanced stages. High expression of RARalpha was an independent negative prognostic factor of survival in addition to FIGO stage, age and p53 accumulation. The mRNA expression of retinoid receptors did not correlate with clinical properties of the tumors.

CONCLUSIONS

Retinoic acid receptors are frequently and strongly expressed in epithelial ovarian cancer and may be indicators of an adverse prognosis. This study provides the molecular basis for the therapeutic use of retinoids in ovarian cancer.

Association of Dietary Vitamin A, Carotenoids, and Other Antioxidants with the Risk of Ovarian Cancer

Antioxidants may protect the ovaries from oxidative damage and reduce the risk of ovarian cancer. Although a few studies have examined the relation of antioxidant intake to the risk of ovarian cancer, the results have been inconclusive. Questions still remain regarding the effects of confounding factors, such as menopause, tobacco smoking, and alcohol drinking, on the association between antioxidants and ovarian cancer development.

OBJECTIVE

To examine the association of the consumption of micronutrients from foods and supplements with the risk of ovarian cancer.

METHODS

A structured questionnaire was administered to 558 histologically confirmed epithelial ovarian cancer cases and 607 population controls from a multiethnic, population-based case-control study conducted between 1993 and 1999 in Hawaii and Los Angeles.

RESULTS

Overall, vitamin A and carotene intakes were modestly associated with a reduced risk of ovarian cancer. Inverse gradients in ovarian cancer risk with increasing dietary intake of vitamin A and beta-carotene were somewhat stronger among women with mucinous histologic types, smokers, and nondrinkers. A significant positive trend in risk associated with increasing beta-cryptoxanthin intake was observed among postmenopausal women, among women with nonmucinous tumors, and among nonsmokers. The intake of other carotenoids and antioxidants, either from foods or supplements, was unrelated to ovarian cancer risk.

CONCLUSION

Our findings suggest that dietary vitamin A and beta-carotene are modestly protective against ovarian cancer, particularly among smokers. Our data suggest a role for retinoic acid signaling pathways in ovarian carcinogenesis.

Botanical medicine and cancer: a review of the safety and efficacy

It is currently estimated that > 50% of all patients diagnosed with cancer explore complementary and alternative medicine - especially herbal medicine. We conducted a comprehensive review to assess the safety and efficacy of herbal medicines commonly used by patients in an attempt to: prevent cancer; treat cancer; and treat adverse effects associated with conventional cancer treatments. Current evidence suggests that Asian ginseng, garlic, green tea, tomatoes and soy intake as part of the diet may be useful in preventing various cancers; additional research is needed in order to determine the efficacy of essiac, evening primrose oil, mistletoe, reishi, shiitake and turmeric as cancer treatments; and ginger may be effective in treating chemotherapy-induced nausea and vomiting.

Carotenoids, vitamin A and risk of adenomatous polyp recurrence in the polyp prevention trial

One trial reported beta-carotene supplementation was protective of adenomatous polyp recurrence in nonsmokers. We now examine the relation of serum and dietary carotenoids and vitamin A to adenomatous polyp recurrence in a subcohort of 834 participants in a low fat, high fiber, high fruit and vegetable dietary intervention, the Polyp Prevention Trial. Multivariate odds ratio (OR) and 95% confidence intervals (CI) of polyp recurrence were obtained using baseline or the average (first 3 years of the trial) carotenoid and vitamin A values after adjustment for covariates. Compared to the lowest quartile of baseline alpha-carotene concentrations, the OR of multiple polyp recurrence for the highest quartile was 0.55 (95% CI = 0.30-0.99) and the OR of right-sided recurrence was 0.60 (95% CI = 0.37-0.95). Baseline dietary intakes of alpha-carotene and vitamin A from food with/without supplements were inversely associated with any recurrence (p for linear trend = 0.03-alpha-carotene; p = 0.004 and p = 0.007 -intakes of vitamin A). Compared to the lowest quartile of averaged beta-carotene concentrations, the OR of multiple adenomas for the highest quartile was 0.40 (95% CI = 0.22-0.75) with an inverse trend (p = 0.02). The risk was inversely related to averaged: alpha-carotene concentrations and right-sided polyps; alpha-carotene intake and recurrence of any, multiple and right-sided polyps; beta-carotene intake and multiple adenoma recurrence; vitamin A from food (with supplements) and each adverse endpoint. Thus, alpha-carotene and vitamin A may protect against recurrence in nonsmokers and nondrinkers or be indicative of compliance or another healthy lifestyle factor that reduces risk.

Fruit and vegetable consumption in relation to ovarian cancer incidence: the Swedish Mammography Cohort

We prospectively examined the incidence of epithelial ovarian cancer and its subtypes in relation to baseline fruit and vegetable consumption in the Swedish Mammography Cohort, a population-based cohort study of 61 084 women aged 38–76 years in 1987–1990. During an average follow-up of 13.5 years, 266 incident cases of invasive epithelial ovarian cancer were diagnosed. After adjustment for potential confounders, we observed a statistically significant inverse association between consumption of vegetables and ovarian cancer risk (P-value for trend=0.01); the multivariate rate ratio (RR) for the comparison of three or more servings of vegetables per day with one or fewer servings per day was 0.61 (95% confidence interval (CI), 0.38–0.97). For fruit consumption a modest, not statistically significant, positive association was found (P-value for trend=0.07); the multivariate RR for the highest compared with the lowest category of consumption being 1.37 (95% CI, 0.90–2.06). The associations with fruit and vegetable consumption did not vary by subtype of ovarian cancer. These findings suggest that high consumption of vegetables, but not of fruits, may reduce the risk of ovarian cancer.

Liquid chromatographic method for the simultaneous determination of different lipid-soluble antioxidants in human plasma and low-density lipoproteins

We describe a reverse phase HPLC method, employing a simple methanol:water gradient as mobile phase, for the determination of several lipophilic antioxidants, such as retinol, gamma-tocopherol, alpha-tocopherol, lycopene, alpha-carotene and beta-carotene among others, using UV detection. Additionally, this method allows the simultaneous separation of probucol, an hypocholesterolemic drug with antioxidant properties. Retinol acetate and alpha-tocopherol acetate were added to samples as internal standards. A NovaPack ODS C18, 150 x 3.9 mm, 0.4 microm column was used and the flow rate was set constant at 1m/min, which allowed the separation of all the desired antioxidants in a total run time of 35 min. A photodiode array detector was used because of its advantages to study the purity of the peaks, however, any programmable multiwavelength UV/VIS detector could be employed given the good resolution of the peaks. The analytical recoveries of the studied compounds were > 96% and the detection limits were: retinol 0.050 microg/ml, gamma-tocopherol 0.137 microg/ml, alpha-tocopherol 0.906 microg/ml, lycopene 0.022 microg/ml, alpha-carotene 0.008 microg/ml, beta-carotene 0.015 microg/ml and probucol 1.503 microg/ml. The intra- and inter-assay coefficients of variation were calculated by using two human plasma samples with different levels of lipophilic antioxidants. The simplicity, rapidity and economy, make this method suitable for the routine measurement of plasma and low-density lipoproteins antioxidants, and may also be used in large scale epidemiological studies. The method has been used to measure antioxidants in samples from patients undergoing treatment with probucol, showing there is a good correlation between the probucol content in LDL and that in total plasma.

Induction of 1,N(2)-etheno-2'-deoxyguanosine in DNA exposed to beta-carotene oxidation products

Epidemiological studies testing the effect of beta-carotene in humans have found a relative risk for lung cancer in smokers supplemented with beta-carotene. We investigated the reactions of retinal and beta-apo-8'-carotenal, two beta-carotene oxidation products, with 2'-deoxyguanosine to evaluate their DNA damaging potential. A known mutagenic adduct, 1,N(2)-etheno-2'-deoxyguanosine, was isolated and characterized on the basis of its spectroscopic features. After treatment of calf thymus DNA with beta-carotene or beta-carotene oxidation products, significantly increased levels of 1,N(2)-etheno-2'-deoxyguanosine and 8-oxo-7,8-dihydro-2'-deoxyguanosine were quantified in DNA. These lesions are believed to be important in the development of human cancers. The results reported here may contribute toward an understanding of the biological effects of beta-carotene oxidation products.

Risk factors and risk reduction of breast and ovarian cancer

PURPOSE OF REVIEW

Breast and ovarian cancer remain a significant burden for women living in the Western world. This paper reviews the risk factors and current strategies to prevent these diseases.

RECENT FINDINGS

Established factors associated with the risk of breast cancer include family history, reproductive factors and lactation, as well as age at menarche and menopause. Hormone replacement therapy increases the risk, whereas oral contraceptives probably confer no increased risk. Alcohol moderately increases the risk, whereas a diet rich in folate and carotenoids might be protective. The role of other dietary factors, smoking and physical exercise remain unclear. Important risk factors for ovarian cancer are reproductive factors and possibly the long-term use of hormone replacement therapy. The risk is decreased by oral contraceptives. In carriers of a BRCA1 or BRCA2 gene mutation, prophylactic surgery can significantly reduce the risk of breast as well as ovarian cancer. Tamoxifen may be considered as a chemopreventive agent in women with a high risk of breast cancer, including carriers of a BRCA2 mutation, but is probably not effective in BRCA1 carriers.

SUMMARY

During the period of this review, the importance of several known risk factors was confirmed, whereas the effects of other factors became more clear. Chemoprevention and prophylactic surgery have emerged as preventative options that can reduce the risk of breast and ovarian cancer.

Carotenoid bioavailability and bioconversion

The possible role of carotenoids and their metabolites in disease prevention is far from fully understood, because the bioavailabilities of carotenoids are complicated by multiple factors that affect their absorption, breakdown, transport, and storage. Rapid progress in developing sophisticated methodologies, including use of stable-isotope dilution methods, now allows for an accurate determination of the true vitamin A activity of provitamin A carotenoids. The recent identification of specific enzymes, which catalyze the breakdown of beta-carotene as well as nonprovitamin A carotenoids, is providing a better understanding of the functions of carotenoids at the molecular level. The pathways and possible mechanisms of carotenoid breakdown and factors affecting the bioavailability of carotenoids, such as carotenoid type, food matrix, interaction with other carotenoids and other food components, nutritional status, aging, and infection, are discussed in this review.

Antioxidant profile in the circulation of patients with fibroadenoma and adenocarcinoma of the breast

OBJECTIVES

To correlate the extent of lipid peroxidation with the antioxidant status in the circulation of patients with fibroadenoma and adenocarcinoma of the breast.

DESIGN AND METHODS

Ten fibroadenoma and thirty breast cancer patients and an equal number of age- and sex- matched normal subjects were chosen for the study. Lipid peroxidation as evidenced by thiobarbituric acid reactive substances (TBARS) and the status of the antioxidants superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH), glutathione peroxidase (GPx), glutathione S-transferase (GST) ascorbic acid and vitamin E were estimated.

RESULTS

Enhanced lipid peroxidation with concomitant depletion of antioxidants was observed in breast cancer patients as compared to normal subjects and fibroadenoma patients (p < 0.05). A similar pattern of changes was seen in fibroadenoma patients as compared to corresponding normal subjects (p < 0.05).

CONCLUSION

This study has revealed an imbalance in the redox status in patients with fibroadenoma and adenocarcinoma of the breast.

Diet and environmental carcinogenesis in breast/gynaecological cancers

This paper reports on recent advances on the relation between diet, other environmental factors and breast and gynaecological cancers. Despite considerable research the issue remains still unsettled. The protective effect of a diet rich in vegetables and fruit, and thus selected (antioxidant) micronutrients, is not consistently reported in various studies. The possible relationship between fats and breast and female genital tract neoplasms also remains unconfirmed, while the potential benefits of physical activity remains unquantified. Alcohol appears to be related to the risk of breast cancer and overweight is associated with post-menopausal breast cancer and is strongly related to the risk of endometrial cancer.

Impact of water-dispersible beadlets as a vehicle for the delivery of carotenoids to cultured cells

Water-dispersible beadlets of carotenoids were used as supplements for human umbilical vein endothelial cells (HUVECs), human peripheral blood mononuclear cells (PBMCs) and human monocytes. Stability, cellular association and cytotoxicity of the carotenoid beadlets were compared with carotenoids delivered with tetrahydrofuran (THF). Incubations with lycopene, beta-carotene, lutein and astaxanthin dissolved in THF resulted in a lower stability in the medium, lower cellular association, and a higher standard deviation. Beadlets provided 60, 4, 6, and 2 times greater accumulation of lycopene, beta-carotene, lutein and astaxanthin, respectively, by PBMCs than THF. The cellular association of carotenoids delivered by THF seems to be more carotenoid-specific than when carotenoids are delivered by beadlets. After 48 h of incubation under cell culture conditions all of the four carotenoids (1 microM) delivered by beadlets to the medium showed a reduction less than 30%. In addition, no cytotoxic effect of the carotenoid beadlets or the vehicle alone was detected in a concentration range of 0.5-5 microM. The results show that beadlets are a non-toxic vehicle for supplementing and stabilizing carotenoids in culture media offering a reasonable compromise in term of cell accumulation efficiency.