The role of endogenous hormones in the etiology and prevention of breast cancer: the epidemiological evidence

Beneficial effects of a medicinal herb, Cirsium japonicum var. maackii, extract and its major component, cirsimaritin on breast cancer metastasis in MDA-MB-231 breast cancer cells

The biological activities of the ethanol extract from Cirsium japonicum var. maackii (ICF-1) and its major component, polyphenol cirsimaritin, were investigated as part of the search for possible alternative drugs for breast cancer. Three in vitro cell-based assays were used: the cell proliferation assay, tube-formation assay, and Western blot analysis. Both the ICF-1 extract and cirsimaritin inhibited the viability of HUVECs in a dose-dependent manner. The inhibition achieved was 36.89% at a level of 200μg/ml by the ICF-1 extract and 62.04% at a level of 100μM by cirsimaritin. The ICF-1 extract and cirsimaritin reduced tube formation by 12.69% at level of 25μg/ml and 32.18% at the levels of 6.25μM, respectively. Cirsimaritin inhibited angiogenesis by downregulation of VEGF, p-Akt and p-ERK in MDA-MB-231 cells, suggesting that cirsimaritin is potentially useful as an anti-metastatic agent. The present study demonstrated that Cirsium japonicum extract and its active component cirsimaritin is an excellent candidate as an alternative anti-breast cancer drug.

A novel use of biomarkers in the modeling of cancer activity based on the theory of endobiogeny

Introduction:

Cancer is a complex disorder whose detection and monitoring remains challenging. A biological modeling system, the biology of functions (BoF), claims to be able to evaluate physiologic elements related to carcinogenic activity. A pilot study was undertaken to evaluate the accuracy of the BoF in detecting differences between cancer cases and matched controls.

Materials and Methods:

A retrospective case control study was performed using the BoF analyses of 46 patients with all types of solid and hematgenous cancers, active and inactive (total cases), and 46 controls from a private practice. The standard BoF panel of 17 biomarkers was evaluated. Sixty-two of 150 BoF indices derived from these biomarkers were pre-selected for analysis based on their relationship to cancer physiology. The data was analyzed with the Wilcoxon Signed Ranks Test using SPSS software.

Results:

Of the 62 indices, 7 were found to be statistically significant in comparing total cancer cases to controls: βMSH/αMSH, Estrogen Fraction #5, Comparative Genital Androgeny, Thyroid, Genito-thyroid, Catabolism/Anabolism and Pro-inflammatory.

Conclusions:

In a small retrospective case control study, statistically significant differences were found between cancer cases and controls in 7 BoF indices. These indices are indicators of physiological conditions consistent with cancer growth. These results warrant further study of this biological modeling system in cancer patients.

Endobiogeny: a global approach to systems biology (part 2 of 2)

ENDOBIOGENY AND THE BIOLOGY OF FUNCTIONS ARE BASED ON FOUR SCIENTIFIC CONCEPTS THAT ARE KNOWN AND GENERALLY ACCEPTED: (1) human physiology is complex and multifactorial and exhibits the properties of a system; (2) the endocrine system manages metabolism, which is the basis of the continuity of life; (3) the metabolic activity managed by the endocrine system results in the output of biomarkers that reflect the functional achievement of specific aspects of metabolism; and (4) when biomarkers are related to each other in ratios, it contextualizes one type of function relative to another to which is it linked anatomically, sequentially, chronologically, biochemically, etc.

Circulating estrogen metabolites and risk of breast cancer in postmenopausal women

BACKGROUND

It has been hypothesized that predominance of the 2-hydroxylation estrogen metabolism pathway over the 16α-hydroxylation pathway may be inversely associated with breast cancer risk.

METHODS

We examined the associations of invasive breast cancer risk with circulating 2-hydroxyestrone (2-OHE1), 16α-hydroxyestrone (16α-OHE1), and the 2-OHE1:16α-OHE1 ratio in a case-control study of postmenopausal women nested within two prospective cohorts: the New York University Women's Health Study (NYUWHS) and the Northern Sweden Mammary Screening Cohort (NSMSC), with adjustment for circulating levels of estrone, and additional analyses by tumor estrogen receptor (ER) status. Levels of 2-OHE1 and 16α-OHE1 were measured using ESTRAMET 2/16 assay in stored serum or plasma samples from 499 incident breast cancer cases and 499 controls, who were matched on cohort, age, and date of blood donation.

RESULTS

Overall, no significant associations were observed between breast cancer risk and circulating levels of 2-OHE1, 16α-OHE1, or their ratio in either cohort and in combined analyses. For 2-OHE1, there was evidence of heterogeneity by ER status in models adjusting for estrone (P ≤ 0.03). We observed a protective association of 2-OHE1 with ER+ breast cancer [multivariate-adjusted OR for a doubling of 2-OHE1, 0.67 (95% confidence interval [CI], 0.48-0.94; P = 0.02)].

CONCLUSIONS

In this study, higher levels of 2-OHE1 were associated with reduced risk of ER+ breast cancer in postmenopausal women after adjustment for circulating estrone.

IMPACT

These results suggest that taking into account the levels of parent estrogens and ER status is important in studies of estrogen metabolites and breast cancer.

Correlation of endogenous hormonal levels, fibroglandular tissue volume and percent density measured using 3D MRI during one menstrual cycle

BACKGROUND

We measured breast density (BD) on MRI and correlated with endogenous hormonal levels.

PATIENTS AND METHODS

Twenty-four premenopausal women received four weekly breast MRI. A blood sample was collected on the same day of MRI. BD was measured using a computer-based algorithm. The generalized estimation equation method was applied to model mean fibroglandular tissue volume (FV) and mean percent density (PD) from predictor variables including estradiol, progesterone, and week during a cycle.

RESULTS

In week 3, a borderline significant correlation between estradiol and PD (r = 0.43, P = 0.04), estradiol and FV (r = 0.40, P = 0.05) and between progesterone and FV (r = 0.42, P = 0.04) was noted. The FV and PD measured in weeks 4 and 1 were higher than in weeks 2 and 3, adjusted for variation in endogenous estradiol and progesterone, indicating that the hormone change could not account for the changes in density. No lag effect of endogenous hormone on the change of FV or PD was noted (all P-values > 0.05).

CONCLUSIONS

Our results showed that BD is not strongly associated with the endogenous hormone. Their association with breast cancer risk was likely coming from different mechanisms, and they should be considered as independent risk factors.

Response of bilateral breasts to the endogenous hormonal fluctuation in a menstrual cycle evaluated using 3D MRI

The normal breast tissue responds to the fluctuation of endogenous hormones during a menstrual cycle (MC) and shows changes in breast density. The changes between left and right breasts of the same women were compared to evaluate the symmetrical response. Twenty-four healthy women were recruited in this study. Four weekly magnetic resonance imaging (MRI) studies were performed during one MC. A computer algorithm was used to segment the breast and the fibroglandular tissue to measure the fibroglandular tissue volume (FV) and three morphological parameters: circularity, convexity and irregularity. The coefficient of variation (CV) for each parameter measured among four MRI studies was calculated; also, the maximal percent change between two MRI studies that show the highest and the lowest FV was calculated. These parameters measured from left and right breasts were compared using Pearson correlation. For the FV, the CV measured between left and right breasts of 24 subjects was highly correlated, with r=0.91; the maximal percent difference was also highly correlated, with r=0.93. Overall, the mean left-to-right difference in the measured FV was small: 1.2%±1.1% for CV and 2.6%±2.3% for the maximal percent difference. For the three morphological parameters, the mean left-to-right percentage difference was similar to the differences seen in FV; however, these morphological parameters do not reveal a high functional symmetry between left and right breasts. The results showed that the measured FV from left and right breasts of the same woman revealed a high functional symmetry. Since endogenous hormone plays an important role in the development of breast cancer, it would be interesting to investigate whether the functional asymmetry of response in some patients is associated with the risk of developing unilateral breast cancer.

Circulating estrogen metabolites and risk for breast cancer in premenopausal women

BACKGROUND

It has been proposed that a shift toward 2-hydroxyestrone from 16alpha-hydroxyestrone metabolic pathway may be inversely associated with breast cancer risk because 2-hydroxyestrone is thought to be less genotoxic and estrogenic than 16alpha-hydroxyestrone.

METHODS

We examined the associations of invasive breast cancer risk with circulating 2-hydroxyestrone, 16alpha-hydroxyestrone, and the 2-hydroxyestrone:16alpha-hydroxyestrone ratio in a case-control study on premenopausal women nested within a prospective cohort the New York University Women's Health Study. The serum levels of 2-hydroxyestrone and 16alpha-hydroxyestrone were measured in 377 incident premenopausal breast cancer cases and 377 premenopausal controls, who were matched on age at enrollment, number and dates of blood donations, and day and phase of menstrual cycle.

RESULTS

Overall, no significant associations were observed between breast cancer risk and serum levels of 2-hydroxyestrone, 16alpha-hydroxyestrone, or their ratio. The 2-hydroxyestrone:16alpha-hydroxyestrone ratio was positively associated with risk for estrogen receptor-positive breast cancer in the analyses controlling for matching factors. However, the association was attenuated and not significant after adjustment for potential confounders (odds ratio for the highest versus the lowest quartile, 2.15; 95% CI, 0.88-5.27; P(trend) = 0.09).

CONCLUSIONS

The results of the current study do not support the hypothesis that a metabolic shift from 16alpha-hydroxyestrone toward 2-hydroxyestrone in premenopausal women is associated with reduced risk for breast cancer. The association between the 2-hydroxy:16alpha-hydroxyestrone ratio and estrogen receptor-positive breast cancer needs to be explored in future studies.

Relation between insulin resistance and breast cancer among Chilean women

PURPOSE

In Chile, diabetes and breast cancer are important public health problems. The association between insulin resistance and breast cancer, however, remains largely unexplored.

METHODS

We conducted a case-control study to assess the relationship of insulin resistance (IR) and breast cancer in Chilean premenopausal and postmenopausal women. We compared 170 women, 33 to 86 years old, with incident breast cancer and 170 normal mammography controls, matched by 5-year age interval. Plasmatic insulin and glucose were measured and IR was calculated by the homeostasis model assessment method. Anthropometric measurements and sociodemographic and behavioral data were also collected. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by multivariable conditional logistic regression.

RESULTS

IR was independently associated with breast cancer in postmenopausal women (OR = 2.70, 95%CI = 1.10-6.63), but not in premenopausal women (OR = 0.84, 95%CI = 0.20-3.52). Obesity was not associated with breast cancer at any age (OR = 0.68, 95%CI = 0.39-1.20).

CONCLUSION

In this sample, IR increased the risk of breast cancer among postmenopausal women.

Tamoxifen-associated vasculitis in a breast cancer patient

Background

Estrogen plays a critical role in breast cancer. Thereafter, endocrine therapy is a standard of care in patients with breast carcinoma, expressing ER or PR.

Case presentation

Herein we report the case of a 53-year old patient, who developed cholestasis and vasculitis during the treatment with tamoxifen. This toxicity was reversable after the removal of the drug. Thereafter she continued adjuvant treatment for breast carcinoma with anastrazole. Since tamoxifen has been widely indicated for patients with breast carcinoma, we did a literature review, looking for other cases with this type of toxicity.

Conclusion

This case is the third with vasculitis informed in the literature, but the first one that additionally developed cholestasis and arthritis. Although it is rare, we discuss the indication of this drug in the actual era, where aromatase inhibitors offer a better security profile.

Comparative proteome analysis of breast cancer and adjacent normal breast tissues in human

Two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) and matrix-assisted laser desorption/ionization tandem time-of-flight mass spectrometry (MALDI-TOF/TOF-MS), incorporated with online database searching, were performed to investigate differential proteins of breast cancer and adjacent normal breast tissues. Considering that serum albumin is abundantly presented in normal control samples, 15 differential spots detected in 11 out of 12 (91.7%) breast cancer samples were identified by online SIENA-2DPAGE database searching and MALDI-TOF/TOF-MS analysis. The results indicate that pathological changes of breast cancer are concerned with augmentation of substance metabolism, promotion of proteolytic activity, decline of activity of some inhibitors of enzymes, and so on. Some important proteins involved in the pathological process of breast cancer with changed expression may be useful biomarkers, such as alpha-1-antitrypsin, EF-1-beta, cathepsin D, TCTP, SMT3A, RPS12, and PSMA1, among which SMT3A, RPS12, and PSMA1 were first reported for breast cancer in this study.

Dexamethasone protection from TNF-alpha-induced cell death in MCF-7 cells requires NF-kappaB and is independent from AKT

Background

The biochemical bases for hormone dependence in breast cancer have been recognized as an important element in tumor resistance, proliferation and metastasis. On this respect, dexamethasone (Dex) dependent protection against TNF-alpha-mediated cell death in the MCF-7 cell line has been demonstrated to be a useful model for the study of this type of cancer. Recently, cytoplasmic signaling induced by steroid receptors has been described, such as the activation of the PI3K/Akt and NF-kappaB pathways. We evaluated their possible participation in the Dex-dependent protection against TNF-alpha-mediated cell death.

Results

Cellular cultures of the MCF-7 cell line were exposed to either, TNF-alpha or TNF-alpha and Dex, and cell viability was evaluated. Next, negative dominants of PI3K and IkappaB-alpha, designed to block the PI3K/Akt and NF-kappaB pathways, respectively, were transfected and selection and evaluation of several clones overexpressing the mutants were examined. Also, correlation with inhibitor of apoptosis proteins (IAPs) expression was examined. Independent inhibition of these two pathways allowed us to test their participation in Dex-dependent protection against TNF-alpha-cytotoxicity in MCF-7 cells. Expression of the PI3K dominant negative mutant did not alter the protection conferred by Dex against TNF-alpha mediated cell death. Contrariwise, clones expressing the IkappaB-alpha dominant negative mutant lost the Dex-conferred protection against TNF-alpha. In these clones degradation of c-IAP was accelerated, while that of XIAP was remained unaffected.

Conclusion

NF-kappaB, but not PI3K/Akt activation, is required for the Dex protective effect against TNF-alpha-mediated cell death, and correlates with lack of degradation of the anti-apoptotic protein c-IAP1.