Effect of retinoic acid on bovine papillomavirus (BPV) DNA-induced transformation and number of BPV DNA copies

Retinoic acid metabolism proteins are altered in trichoblastomas induced by mouse papillomavirus 1

Skin cancer burden is significant as treatment costs have skyrocketed to $8.1 million annually and some forms metastasize, such as cutaneous squamous cell carcinoma (cSCC) and melanoma. cSCC is caused by altered growth factor signaling induced by chemical carcinogens, ultraviolet light (UV) exposure, and infections with papillomaviruses (PVs). One of the few options for preventing cSCC in high-risk patients is oral retinoids. While much is understood about retinoid treatments and metabolism in mouse models of chemically and UV exposure induced cSCC, little is known about the role of retinoids in PV-induced cSCC. To better understand how retinoid metabolism is altered in cSCC, we examined the expression of this pathway in the newly discovered mouse papillomavirus (MmuPV1), which produces trichoblastomas in dorsal skin but not cSCC. We found significant increases in a rate-limiting enzyme involved in retinoic acid synthesis and retinoic acid binding proteins, suggestive of increased RA synthesis, in MmuPV1-induced tumors in B6.Cg-Foxn1(nu)/J mice. Similar increases in these proteins were seen after acute UVB exposure in Crl:SKH1-Hr(hr) mice and in regressing pre-cancerous lesions in a chemically-induced mouse model, suggesting a common mechanism in limiting the progression of papillomas to full blown cSCC.

Epidemiological characteristics of women with high grade CIN who do and do not have human papillomavirus

OBJECTIVE

Human papillomavirus infection is an important aetiological agent associated with the development of cervical neoplasia. However, even with the most sensitive methods of detection, human papillomavirus DNA has been detected in only 90% of cases of cervical cancer and between 80%-90% of cases of dysplasia. This study aimed to determine if there are epidemiological differences between women who are positive or negative for human papillomavirus, with high grade cervical intraepithelial neoplasia (CIN).

DESIGN

Four hundred and sixty women with CIN II and III lesions were studied. To ensure optimal detection of human papillomavirus DNA, two specimens (i.e. tampon and cervical biopsy) were collected from each woman and tested by three techniques: L1-polymerase chain reaction, E6-PCR and low stringency Southern blotting. A detailed questionnaire was completed and blood sample collected for determination of serum levels of beta-carotene, vitamin A and E from each patient. Human leucocyte antigen (HLA)-DQB 1 alleles were also compared between the groups of women who were positive or negative for human papillomavirus.

RESULTS

Overall, human papillomavirus DNA analysis was positive in 411 women (89%). Age, number of sexual partners in the last 12 months, past pregnancy and marital status were associated with human papillomavirus detection in the crude analysis. However, in the adjusted analysis no epidemiological features remained significantly different between the human papillomavirus positive and negative patients. Moreover, examination of vitamin A, E and beta-carotene levels did not show a significant difference between the two groups of patients. However, in the HLA-DQB1 allele profile a significantly higher proportion of women who were negative for human papillomavirus had DQB1 *0201, *0603 and *0604 (P = 0.05, 0.001, 0.03, respectively).

CONCLUSION

We did not find a significant difference in epidemiological factors between women with human papillomavirus positive and negative high grade CIN. However differences between the frequency of three HLA DQB1 alleles suggest that women with these allele profiles have a higher chance of clearing human papillomavirus, without affecting their chance of developing dysplasia.

The mutagenic versus protective role of vitamin A on the induction of chromosomal aberration in human lymphocyte cultures

The present study was carried out to evaluate the role of vitamin A (VA) on the induction of chromosomal aberrations (CA) in lymphocyte culture system and to investigate its modulating effect on chromosomal damage induced by gamma irradiation. Lymphocyte cultures from five healthy normal adult males were either treated with VA at a dose level of 2.0, 8.0 or 24.0 microg/ml or exposed to gamma-irradiation of 3.0 Gy, then followed immediately by a treatment with one of the above mentioned doses of VA. Non-treated cultures and cultures exposed to gamma-irradiation served as control for the two sets of experiments. Cultures were set up in duplicates and incubated for 48 h for assessment of CA. Treatment with VA alone increased CA demonstrating a dose-response effect. Addition of VA to gamma-irradiated cultures resulted in an inverse protective effect as the low dose of 2 microg/ml reduced the CA induced by radiation to about 1/3 rd whereas a dose of 8 microg/ml had a protective effect of 40% of the total damage and the large dose of 24 microg/ml had no or little effect. These results suggest that a proportion of the added VA may interfere with the radiation induced free radicals and other reactive metabolites which elevate CA. On the other hand, excessive amounts of VA increased toxicity and reduced effect on repair enzymes.

Vitamins as antimutagens: advantages and some possible mechanisms of antimutagenic action

Dietary natural inhibitors of mutagenesis and carcinogenesis are of particular importance because they may be useful for human cancer prevention and do not have undesirable xenobiotic effects on living organisms. As was shown in numerous experiments, many endogenous substances, usually obtained in food or synthesized by cells, possess some inhibitory activity towards natural or man-made environmental mutagens which often induce increased frequency of cancer. Among such substances are vitamins, thiol compounds, porphyrin derivatives, polyphenols and others, the antigenotoxicity of which is well established in various genetic tests. Probably a number of these compounds are included in the defense systems of organisms protecting them from harmful exogenous influences continuously affecting genetic material and other components of cells. Some vitamins show protective effects; for example, E, A and C vitamins are active against well-known mutagens both in vitro and in vivo. Genetic properties of other vitamins have been insufficiently explored, but positive results were obtained for a number of them suggesting the desirability of further studies in this field. Synergism of some vitamins activity, both with other vitamins and non-vitamin substances, is of particular interest because clarifying some of their mechanisms of action could be important for understanding the functions of our defense systems.

Human papillomaviruses, cervical cancer and the developing world

Carcinoma of the uterine cervix is the commonest cancer of women in the majority of developing countries; in developed countries it is much less common, as well as being less frequent than some other cancers, such as those of breast, lung and colon. The discovery of human papillomavirus (HPV) as an aetiological agent of cervical cancer (and of other anogenital malignancies) has prompted a great deal of interest in the biology and oncogenicity of this virus, including large-scale epidemiological surveys comparing the prevalence of HPV and other possible causative agents between areas of high and low incidence of cervical carcinoma. These studies have thrown up tantalizing clues concerning the virus' pathogenesis and disease associations. Sexual practices, parity, diet, smoking, other diseases (including sexually transmissible diseases) and immunogenetic characteristics may all play a contributory role in the development of cervical carcinoma. These factors may be independent of each other and of association with HPV infection. Immunization to prevent papillomavirus infection and thus cervical cancer is an attractive prospect. Although the potential in using such an approach has been demonstrated in several animal models, there are several major theoretical problems to solve before HPV vaccination becomes a practicality. Intervention to prevent exposure to other aetiological factors and to improve screening may be a more practicable strategy for reducing the burden of cervical cancer.

Pathogenesis of genital HPV infection

Clinical, subclinical, and latent human papillomavirus (HPV) infections are distinguished from HPV-associated neoplasia. Besides HPV additional cofactors are necessary to transform HPV infected tissue to intraepithelial or invasive neoplasia. Risk factors for the presence of HPV are high number of sexual partners, early cohabitarche, young age at first delivery, suppression and alteration of immune status, young age and hormonal influences. While the fact of a high number of sexual partners exclusively increases the risk of HPV infection, it is not known whether the other factors lead to either an increased risk for HPV infection and/or to HPV-associated neoplasia. Subclinical and latent genital HPV infections are highly prevalent. The prevalence rate depends on the sensitivity of the HPV detection system used, on age and sexual activity of the population screened, and on the number of subsequent examinations performed for each subject. Sexual transmission is the main pathway for genital HPV's, however, vertical, peripartal, and oral transmission are also possible. Seroreactivity against genital HPV may be due to an active infection or the result of contact with HPV earlier in life. Antibodies against the HPV 16 E7 protein indicate an increased risk for cervical cancer. Compared with humoral response cellular immune response is probably more important for regression of genital HPV infection: impaired cellular response is characterized by depletion of T helper/inducer cells and/or Langerhans cells and impaired function of natural killer cells and/or the infected keratinocyte. In condylomata replication and transcription of viral nucleic acids and antigen production coincide with cellular differentiation. However, the interaction between HPV and the keratinocyte on a molecular level in subclinical and latent disease is not well understood. Regression or persistence of subclinical and latent genital HPV infections as observed in longitudinal investigations show a constant come-and-go of HPV presence. Subclinical or latent cervical infections with high-risk HPV types (such as HPV 16 and 18) have an increased risk for the development of HPV-associated neoplasia.

Retinoic acid and interferon combination studies in human cancer

Retinoic acid and interferon-alpha have limited single-agent activity in advanced cancer. Cell culture data indicate that in combination these agents have enhanced activity (modulating growth and differentiation) in a number of malignant cell types. Recent clinical work in advanced squamous cell carcinoma reports major activity with this regimen. This paper reviews the preclinical and clinical data testing retinoic acid in combination with interferons and presents recent work integrating these agents with radiotherapy in locally advanced cervical cancer.

Effects of retinoic acid on NIH3T3 cell transformation by the H-ras oncogene

Exposure of NIH3T3 cells to retinoic acid resulted in a dose-dependent modulation of transformed focus formation after transfection with an activated H-ras oncogene. Inhibition induced by 10 microM retinoic acid was maximal at 21.4% of control values. Maximal inhibition of transformation was found after exposure to 10 microM retinoic acid between days 0 and 3 of the transfection period. This concentration was also inhibitory for colony formation upon transfection of the non-transforming gene aph, suggesting that retinoic acid acts primarily on the process of transfection to inhibit focus or colony formation. Exposure to retinoic acid during the late period of the transfection protocol (days 14-20) resulted in alterations in focus morphology. A transformed cell line containing H-ras underwent reversion of the transformed phenotype after 4 weeks of treatment with retinoic acid, as determined by alterations in cell morphology and anchorage-independent growth. Phenotypic reversion was not associated with changes in the expression of the exogenous H-ras or endogenous c-myc or c-fos oncogenes.

Occurrence of sister-chromatid exchange and chromosomal aberration during vitamin A-induced cell differentiation in vitro

Prompted by the recent growth in interest in the mechanisms of vitamin A (VA) action, we studied the effects of VA on the frequency of sister-chromatid exchange (SCE) and chromosome aberration (CA) in a culture system using a fetal Syrian hamster (female) pulmonary epithelial cell line (M3E3/C3). When manipulated by specific culture conditions, the cells in this system could be rendered competent for activation of polycyclic aromatic hydrocarbons. Cells induced to such a state were exposed to 0, 2, 8 and 24 micrograms/ml of VA for 4 days. The average frequency of SCE per metaphase increased from 1.64 at 0 micrograms/ml to 3.44 at 24 micrograms/ml with a moderate degree of dose dependence. In addition, the q-terminal area of X-chromosomes appears to be one of the most specifically vulnerable sites for SCE due to VA. The frequency of CA encompassing triradial, quadriradial, quinqueradial, ring and dicentric chromosomes also increased in a rather sigmoid fashion from 3.6% at 0 micrograms/ml to 14.8% at 24 micrograms/ml. Apart from the frequently demonstrated protective roles or otherwise less often encountered promotional effects of VA in the development of squamous metaplasia, neoplasia, neoplastic transformation or mutation, an alternative interpretation for the current results implies a possible relationship between SCE and CA caused by VA and cell differentiation and/or drug resistance mechanisms.

The effect of retinoids, carotenoids and phenolics on chromosomal instability of bovine papillomavirus DNA-carrying cells

Antioxidants were found to protect against the genotoxic effects of chemical and physical mutagenic and clastogenic agents. This study focused on the capacity of antioxidants to reduce an intrinsic and persistent chromosome instability. As a model system, strains of C127 cells, which were transformed by bovine papillomavirus (BPV) DNA and which carry BPV DNA varying from 20 to 160 copies, were used. Transformed cells of 10 different strains showed a persistently high incidence of mitotic irregularities detectable at anaphase and telophase (27.3-58.9%), an elevated frequency of cells with micronuclei (6.6-34.7%), and a broad spectrum of nuclear sizes, as measured by image analysis. A 3-day exposure to retinoic acid, retinol, beta-carotene, canthaxanthin, ascorbic acid and ellagic acid greatly reduced the degree of chromosome instability, whereas catechin, eugenol and pyrogallol showed a smaller inhibitory effect, and curcumin had no detectable effect on the frequency of mitotic irregularities. After withdrawal of retinoic acid treatment, the high levels of chromosome instability reappeared. The possibility that the protective effect of the retinoids and carotenoids examined in the model system points to their beneficial administration to human cells with an intrinsic or acquired chromosome instability is discussed.

The involvement of reactive oxygen species in oral cancers of betel quid/tobacco chewers

Most biological reactions, including carcinogenesis, are complex processes involving thousands of compounds, their metabolites and intermediates. The separation of events which form part of a direct chain leading to neoplastic transformation from those which are mere by-products is a herculean task. In this study, we focused on the pros and cons of reactive oxygen species (ROS) being involved in the development of oral cancer among chewers of tobacco and areca nuts. The results revealed that bursts of ROS generation occur at different stages of carcinogenesis, and are caused by different mechanisms. This observation may have considerable practical implications. Different strategies will be required in the administration of chemopreventive agents in order to trap ROS formed in the alkaline (due to the addition of slaked lime) chewing mixture within the saliva of a chewer, to scavenge ROS within mucosal cells exposed to an array of tobacco- or areca nut-related carcinogens or tumour promoters, and to inhibit the action of ROS released from ROS-generating white cells during lymphocytic infiltration of the oral mucosa at a precancerous stage. The remission of oral leukoplakias following the administration of vitamin A (200,000 IU/week) or vitamin A (100,000 IU/week) plus beta-carotene (180 mg/week) for 6 months, the inhibition of new leukoplakias during this trial period, and the reduction of micronucleated oral mucosal cells in chewers treated with beta-carotene or vitamin A are indeed promising results. However, a better understanding of the role of ROS in various stages of carcinogenesis will provide the basis for selection of the proper chemopreventive agents and the design of a treatment regime which may either prevent the formation of precancerous lesions, induce their remission, or inhibit the progression of precancerous lesions into malignant cancers.

The role of vitamins in the etiology of cervical neoplasia: an epidemiological review

Diet may act as a cofactor in the development of cancer of the cervix. A consistent correlation exists between low tissue concentrations, low serum level, and low intake of vitamin A, beta-carotene, vitamin C, or folic acid and an increased prevalence of cervical neoplasia. A moderate effect is seen in clinical trials with vitamin treatment of cervical intraepithelial neoplasias. The studies reviewed here were not consistent especially in the choice of controls and methods for the assessment of dietary and confounding factors. Proper morphologic identification of cervical intraepithelial neoplasia was not always achieved. Longitudinal and prospective cohort studies using more reliable methods for diet monitoring may be valuable for future research in this field.