Mutagens in human faeces. Are they relevant to cancer of the large bowel?

Evaluation of fecal mutagenicity and colorectal cancer risk

Colorectal cancer is one of the most common internal malignancies in Western society. The cause of this disease appears to be multifactorial and involves genetic as well as environmental aspects. The human colon is continuously exposed to a complex mixture of compounds, which is either of direct dietary origin or the result of digestive, microbial and excretory processes. In order to establish the mutagenic burden of the colorectal mucosa, analysis of specific compounds in feces is usually preferred. Alternatively, the mutagenic potency of fecal extracts has been determined, but the interpretation of these more integrative measurements is hampered by methodological shortcomings. In this review, we focus on exposure of the large bowel to five different classes of fecal mutagens that have previously been related to colorectal cancer risk. These include heterocyclic aromatic amines (HCA) and polycyclic aromatic hydrocarbons (PAH), two exogenous factors that are predominantly ingested as pyrolysis products present in food and (partially) excreted in the feces. Additionally, we discuss N-nitroso-compounds, fecapentaenes and bile acids, all fecal constituents (mainly) of endogenous origin. The mutagenic and carcinogenic potency of the above mentioned compounds as well as their presence in feces, proposed mode of action and potential role in the initiation and promotion of human colorectal cancer are discussed. The combined results from in vitro and in vivo research unequivocally demonstrate that these classes of compounds comprise potent mutagens that induce many different forms of genetic damage and that particularly bile acids and fecapentaenes may also affect the carcinogenic process by epigenetic mechanisms. Large inter-individual differences in levels of exposures have been reported, including those in a range where considerable genetic damage can be expected based on evidence from animal studies. Particularly, however, exposure profiles of PAH and N-nitroso compounds (NOC) have to be more accurately established to come to a risk evaluation. Moreover, lack of human studies and inconsistency between epidemiological data make it impossible to describe colorectal cancer risk as a result of specific exposures in quantitative terms, or even to indicate the relative importance of the mutagens discussed. Particularly, the polymorphisms of genes involved in the metabolism of heterocyclic amines are important determinants of carcinogenic risk. However, the present knowledge of gene-environment interactions with regard to colorectal cancer risk is rather limited. We expect that the introduction of DNA chip technology in colorectal cancer epidemiology will offer new opportunities to identify combinations of exposures and genetic polymorphisms that relate to increased cancer risk. This knowledge will enable us to improve epidemiological study design and statistical power in future research.

Evaluation of the genotoxicity of municipal sewage effluent using the marine worm Platynereis dumerilii (Polychaeta: Nereidae)

Samples of settled (primary) effluent were collected from a municipal sewage treatment works at Newton Abbot, Devon, UK, a site which discharges primary effluent via long sea pipeline into the English Channel (minimum of 200-fold initial dilution). Sewage samples were collected during the period February-April 1995 and were analysed for standard physico-chemical parameters (ammonia, chemical oxygen demand, conductivity, non-purgeable organic carbon and settled solids). Samples were also tested for cytotoxicity, genotoxicity, and for developmental effects in the embryo-larval stages of the marine worm, Platynereis dumerilii. Exposure to sewage concentrations of > or = 10% (v/v) in seawater at 20 +/- 1 degrees C led to a marked reduction in normal embryo-larval development (7 h EC50 values from 10% to 18% v/v, n = 5). There was also evidence of a simultaneous delay in the cell cycle progression (as determined by sister chromatid differential staining) following embryo-larval exposures to sewage concentrations of > or = 10% (v/v). Following the calculation of the Maximum Tolerated Dose (MTD), based on cytotoxic and developmental effects, cells from the same embryo-larvae were analysed for chromosomal aberrations (CAs). Results were consistent for all samples tested, demonstrating the absence of cytogenetic damage following the in vivo exposure of polychaete embryo-larvae to settled sewage.

Chromatographic methods for the determination of toxicants in faeces

Modern chromatographic techniques and their application in the determination of toxic compounds in faeces are reviewed. Faecal analysis may be of importance in toxicokinetic studies of xenobiotics in order to determine factors such as metabolism, body burden and major routes of elimination. Compounds of interest include various food constituents, drugs and occupational or environmental factors. Further, various mutagenic or carcinogenic compounds which are excreted by faeces have been indicated to represent risk factors for colorectal cancer. In this context, the chromatographic determination of the endogenously generated fecapentaenes and bile acids, both postulated etiological factors in colorectal carcinogenesis, is reviewed. For fecapentaene determination, several high-performance liquid chromatographic (HPLC) methods are available; however, the applicability of some of these methods is limited owing to insufficient separation of various isomeric forms or discrimination between fecapentaenes and their precursors. For the determination of bile acids in faeces, many chromatographic procedures have been reported, and the characteristics of the most relevant methods are compared and discussed. It is concluded that separation by gas chromatography (GC) in combination with mass spectrometry provides the highest selectivity and sensitivity. A relatively rapid alternative analysis for the determination of total and aqueous faecal bile acids is proposed. Further, methods for the determination of polycyclic aromatic hydrocarbons (PAHs) are reviewed. Although the use of radiolabelled PAHs in animal studies has many advantages, it cannot be applied for human biological monitoring and HPLC and GC provide sensitive alternatives. An HPLC method for the determination of non-metabolized PAHs in faeces is described.

Influence of dietary fat on fecal mutagenicity in premenopausal women

A dietary intervention study was conducted on 31 premenopausal women (age: 20-40 years) to investigate the relationship between dietary fat and fecal mutagenicity. After a free-living period (baseline) of one menstrual cycle, the subjects were placed on a high-fat diet (40% calories from fat) for 4 menstrual cycles, followed by a low-fat diet (20% calories from fat) for 4 menstrual cycles. One-half of the subjects were randomly assigned throughout the study to a diet with a P:S ratio of 1.0 while the other half was assigned to one with a P:S ratio of 0.3; body weight by group remained constant. Three-day stool samples were collected at the mid-follicular period during the free-living phase and during the 4th menstrual cycle of each of the 2 controlled diet periods. Mutagenicity was assayed by the SOS chromotest. Reduction of dietary fat was accompanied by a significant decrease in fecal mutagenicity in both P:S groups. Combined values, i.e., both P:S groups, were 20.3 units for high-fat diets vs. 8.78 for low-fat diets.

Carcinogenicity tests of fecapentaene-12 in mice and rats

Fecapentaenes, a class of direct-acting bacterial mutagens, have been isolated from the feces and intestinal tract of humans on a Western meat-containing diet. Two bioassays to test pure fecapentaene-12 (FP-12) for carcinogenicity were performed. FP-12 in dimethylsulfoxide (DMSO) solution was injected i.p. into newborn ICR/MA mice on days 1, 3, 7, 10, 14 and 21. The mice killed after 21 months had neoplasms in liver, lung, glandular stomach and subcutaneous fibrosarcoma. Intrarectal (i.r.) infusion of FP-12 in an aqueous vehicle into male F344 rats for 71 weeks, and killing the rats after 21 weeks more, displayed no evidence of neoplasia associated with FP-12 exposure. The positive control, N-nitrosomethylurea (NMU), given i.r. as 4 2-mg doses in 2 weeks, as expected, yielded multiple colonic neoplasms in less than 11 months. Fecapentaene may exert its effect in bacteria and in newborn mice through the generation of hydroxy radicals. However, adult rodent and human colon may have adequate biochemical defense mechanisms against low level, even continuous exposures to chemicals like FP-12, and thus be at low risk of neoplasia, as was found.

Development and application of biomarkers exploitable for human exposure monitoring

The objectives, applications and limitations of laboratory methods for assessing human exposure to carcinogens are concisely discussed. The available technologies include cytological, cytogenetic and molecular analyses, somatic cell mutation, carcinogen-DNA or carcinogen-protein adducts, metabolic markers, and chemical or biological analyses of expired air, body fluids, and excreta.

Effect of dietary fibre on the mutagenicity and distribution of 2-amino-3,4-dimethylimidazo[4,5-f]quinoline (MeIQ)

Female BALB/c mice were fed either a fibre-free diet or one supplemented with 30% wheat-bran for 5 weeks. The ability of these mice to convert MeIQ to a bacterial mutagen in vivo was determined using intrasanguinous host-mediated bacterial mutation assays. Less mutagenic activity was detected in the livers of mice fed the bran-supplemented diet compared with those fed the fibre-free diet. Subsequent experiments demonstrated that the effect of brain was not due to modifications in hepatic metabolism, but to changes in uptake of MeIQ from the gastrointestinal tract.

[Nutrition and the etiology of colon cancer: from descriptive epidemiology to dietary prevention]

Colon cancer is one of the most frequent forms of cancer in the Federal Republic of Germany and in most Western countries, but is, however, generally rare in Africa, Asia, and Latin America. Based on epidemiological investigations, differing dietary practices are considered to be main reason for these differences. A high fat and protein consumption was identified as a risk factor, while a high fibre content of the diet was found to be protective. Existing hypotheses of the etiology of colon cancer, which are based on the two-stage initiation-promotion model, regard interactions between initiators, promotors, and inhibitors as decisive for the final outcome of colon cancer. Possible initiators are pyrolysis products of protein-rich food (meat or fish), generated by heating, and products of metabolism of intestinal bacteria (e.g. faecal mutagens, N-nitroso compounds, transformation products of bile acids). Fats probably exert their influence only at the promotional stage. The diet-dependent bacterial formation of deoxycholic and lithocholic acids is a possible mechanism which has been experimentally substantiated. The protective effect of a diet rich in fibre seems to be mediated in particular by dilution and adsorption of harmful compounds. Further protective factors in human diet may be calcium, selenium, vitamin A and beta-carotene. In this paper, evidence, both supporting and refuting the existing hypotheses, is discussed, as well as the possibilities of dietary prevention of colon cancer.

Trapping of chemical carcinogens with magnetic polyethyleneimine microcapsules: III. In vivo trapping of electrophiles from N-methyl-N-nitrosourea and recovery from feces

The use of semipermeable magnetic polyethyleneimine (PEI) microcapsules for trapping carcinogens in vivo is described. After intragastric administration to rodents, up to 40% of the microcapsules were extracted magnetically from fecal suspensions, with most recovered in the first 24 h after administration. The mean diameter of the recovered microcapsule population was in some cases larger than that administered. The changes in size distribution and incomplete recovery could be ascribed to the magnetic extraction technique rather than loss or destruction of microcapsules in vivo. By contrast, magnetic hemoglobin microcapsules were not stable in vivo and were recovered in very low yields. An important factor determining the recovery of administered PEI microcapsules was the amount of encapsulated magnetite. Microcapsules administered intragastrically to rodents trapped up to 0.02% of an intragastric dose of N-[methyl-14C]-N-nitrosourea (1). Binding was dose dependent with the limiting factor being the number of available binding sites; increasing the number of administered microcapsules accordingly increased the total amount of 1 bound by them. After administration of [14C--CH3]-derivatized microcapsules, the recovery from feces of microcapsule-associated radioactivity was 48-74%, up to twice the numerical recovery. Although this indicates that microencapsulated labeled core PEI was recovered, it could not be released upon sonication. This was due in part to an increased resistance of the microcapsules to sonication caused by GI tract transit that was probably due to nonspecific absorption of substances. Subsequent acid treatment released some radiolabeled core PEI, as indicated by precipitation with polyacrylic acid. Excreted microcapsules were found to have material adsorbed both on the outer membrane surface and also throughout the membrane.

Lack of mutagenic activity of bile acids in bacterial fluctuation tests

3 bile acids (cholic acid, chenodeoxycholic acid and deoxycholic acid) were assayed for mutagenicity in Salmonella typhimurium TA98 and TA100 in fluctuation tests in the absence of an external source of metabolic activation. At the doses tested, there were no dose-related statistically significant increases in mutagenicity compared with appropriate controls. These results do not support the claim (Watabe, J., and H. Bernstein (1985) Mutation Res., 158, 45-51) that these bile acids are mutagenic.

Trapping of chemical carcinogens with magnetic polyethyleneimine microcapsules: I. Microcapsule preparation and in vitro reactivity of encapsulated nucleophiles

In this paper we describe the synthesis and characterization of magnetic microcapsules, intended for use in vivo, and which contain polyethyleneimine nucleophilic targets capable of trapping electrophilic carcinogens. The microcapsules, 15-50 microns in diameter, consist of a semipermeable cross-linked nylon membrane surrounding core polyethyleneimine and magnetite. These microcapsules can be readily manipulated and extracted from aqueous suspensions by magnetic fields. Core polyethyleneimine was released after membrane rupture by sonication. Magnetic hemoglobin microcapsules were also prepared but were unsuitable due to precipitation of hemoglobin within the core. Treatment by proteolytic enzymes that are present in the gastrointestinal tract caused microcapsule damage resulting in protein release, whereas polyethyleneimine microcapsules remained unaffected. After incubation with N-[methyl-14C]-N-nitrosourea, (1) the microcapsules retained covalently bound radiolabel, both in core polyethyleneimine and the microcapsule membrane. The efficiency of the binding of 1 was investigated by varying the polymer concentration during microcapsule manufacture. These type of microcapsules appear to have the desired properties for investigating carcinogen exposure in the mammalian gastrointestinal tract. They can be prepared easily and reproducibly, contain sufficient magnetite to allow their facile recovery from aqueous suspensions, are easily broken to release soluble core polyethyleneimine, and are stable to hydrolytic enzymes (trypsin) in vitro.

What is the role of histidine in studies of faecal mutagenicity?

Mutagenicity testing can be used to assay faeces for genotoxic substances and the results are reported to correlate with population risk for colorectal cancer (Ehrich et al., 1979). It has been suggested that histidine in faeces may cause false positive results (Venitt and Bosworth, 1983). To determine the relationship between histidine and false positive mutagenicity assays aliquots of non-mutagenic faecal extract and saline were supplemented with histidine and subjected to the Ames Salmonella/mammalian microsome mutagenicity assay (Ames et al., 1975). Using high-pressure liquid chromatography the analytical recovery of histidine from water and faecal extract supplemented with histidine was equivalent (r = 0.998, p less than 0.001). Histidine was measured in faecal extracts (1 in 10 dilutions) from 35 volunteers, 10 patients with inflammatory bowel disease and 4 with rectal cancer. These extracts were also assayed for mutagens using the Salmonella/mammalian microsome mutagenicity assay. None of the faecal extracts gave mutagenicity ratios above 2. Faecal extracts from volunteers were free of detectable histidine. Although 9 of those from inflammatory bowel disease patients contained histidine (mean +/- SEM 255 +/- 34 mumoles l-1) as did 1 extract from a rectal cancer patient (50 mumoles l-1), none contained sufficient histidine to give a false positive Salmonella/mammalian microsome mutagenicity assay result (800 mumoles l-1 in test solution). Our results do not implicate histidine as a cause of error in faecal mutagenicity testing by the Salmonella/mammalian microsome mutagenicity assay.

Population monitoring for genetic damage induced by environmental physical and chemical agents

The short-term tests performed in vitro on different systems, from phage to human cells, or in vivo, on laboratory animals, allow only a qualitative estimate of the action of mutagenic agents, and the extrapolation of such experimental results to man may encounter many difficulties.Direct biomonitoring of populations exposed to chemicals could represent a more realistic approach for an evaluation of the hazards to man. Certain methods are still under development. Nevertheless, other ones can already by used routinely, e.g. the cytogenetic observations on peripheral blood lymphocytes and the Ames test for mutagenic substances in urine, and can provide useful suggestions how to set threshold limits for chemical substances encountered in the working environment.

Fecal mutagenicity arising from ingestion of fried ground beef in the human

Fried ground beef has been shown to contain mutagens, and the major mutagenic component has been identified as 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx). Mutagens in feces of 3 adult volunteers were fractionated by treatment of the feces with blue cotton followed by chromatography on a carboxymethyl cellulose column. The chromatographic fraction, corresponding to MeIQx in terms of the position of elution, was examined for mutagenicity in S. typhimurium TA98 with metabolic activation. When meals containing no heated meat were eaten, this fraction of feces showed little or no mutagenicity. On eating fried ground beef, the feces excreted in the next two days showed greatly increased mutagenicity in this fraction. By eating no-meat meal subsequent to the meat meal, the mutagenicity resumed the original low level on the fourth day after the meat meal. The components in the mutagenic fraction were probably metabolites of the mutagens present in cooked meat, since analysis by high pressure liquid chromatography of the mutagenic fraction showed that the active components in the feces were different from the mutagens in cooked meat.

DNA-damaging activity in ethanol-soluble fractions of feces from New Zealand groups at varying risks of colorectal cancer

Using repair-proficient and repair-deficient strains of E. coli, we investigated the application of a liquid incubation assay to measure the DNA-damaging activity of ethanol-soluble fecal extracts. This method appears to be suitable for the study of a wide range of sample types. It was used to measure the DNA-modifying activity of ethanol-soluble fecal extracts from a group of European colorectal cancer patients. Data were compared with those from Europeans of similar age and sex distribution who did not have bowel cancer. We also studied groups of Maoris, Samoans, and European Seventh-Day Adventists who followed an ovo-lacto vegetarian diet. There are significant levels of DNA-modifying materials in the feces of many Europeans on a mixed diet, regardless of whether or not they have cancer. The number of positive samples was less in the Polynesian groups, and there were no samples that could be unequivocally scored as positive in the Seventh-Day Adventist groups. We conclude that diet can significantly reduce the level of ethanol-soluble mutagens, at least in New Zealand Europeans. The data may provide an explanation for the reduced incidence of bowel cancer in Seventh-Day Adventist groups.

Human fecal fractions can produce nuclear damage in the colonic epithelial cells of mice

Nuclear toxicity of several known carcinogens and fecal fractions obtained from 10 healthy individuals was investigated in the colonic nuclear aberration (NA) assay using an intrarectal administration. Two known colon carcinogens, MNNG and DMAB, and a carcinogen of organs other than the colon, B(a)P, induced NA in a dose-related manner. Chromatographic fractions of feces from 10 donors were tested for their ability to produce NA. The dichloromethane fraction for several was active and yielded a significantly positive response which was dose-related. Our study demonstrated that the feces of some healthy individuals contain compound(s) which damage colonic nuclei in a similar manner to that seen with some known carcinogens.

Faecal mutagens and intestinal tumours in the dimethylhydrazine-injected rat

The relationship between the development of colonic tumours and the presence of faecal mutagens has been investigated in the dimethylhydrazine (DMH) injected rat model. Subcutaneous DMH 20 mg/kg for 6 weeks in 10 rats produced colonic tumours in 8 animals and duodenal tumours in 2. Faeces were collected 6, 10, 14, 20 and 25 weeks after commencing DMH injections and were assayed using the Ames test system with both aqueous and ether extracts. All faeces were initially negative for mutagens, but all became positive at some stage following DMH injections, There was no consistent pattern of mutagen excretion or of the strain of Salmonella typhimurium detecting a positive extract. Early positive extracts tended to be with aqueous extracts, whereas later extracts (20 and 25 weeks) were predominantly with ether extracts. DMH produces a metabolic change in the rat resulting in the production of faecal mutagens. This change precedes the appearance of colonic neoplasms and persists after the withdrawal of DMH injections.

The unique role of rodents in the detection of possible human carcinogens and mutagens

Some of the probable reasons underlying the observation that not all chemicals shown to be genotoxic in vitro are capable of eliciting tumours in rodents or humans are discussed using appropriate examples. It is suggested that a substantial proportion of the resources currently available for conducting rodent carcinogenicity bioassays should be employed in the short-term evaluation in vivo of some of the many hundreds of chemicals recently defined as genotoxic in vitro, rather than in the protracted evaluation of a few chemicals, often of unknown activity in vitro, for carcinogenicity. A decision tree approach to the evaluation of chemicals for human mutagenic/carcinogenic potential is presented which is at variance with the construction and philosophy of many of the current legislative guidelines. The immediate need for the adoption of one of the available short-term in vivo liver assays, and/or the development of a short-term in vivo rodent assay capable of concomitantly monitoring different genetic end-points in a range of organs or tissues is emphasized.

Mutagenicity of different fractions of extracts of human feces

An extraction-fractionation scheme for the isolation of non-volatile fecal mutagens is described. Extraction of feces was with acetone, and a 2-step fractionation scheme employing silica gel SepPak cartridges and normal-phase high-pressure liquid chromatography was used. Assay of mutagens was with the standard plate mutagenicity assay with Salmonella typhimurium tester strains TA98 and TA100, with and without the Aroclor induced S9 microsomal activation system. Single feces samples from 24 donors from a wide socioeconomic spectrum were tested. It was found that most fecal mutagenicity extracted by aqueous acetone could be attributed to a lipid soluble mutagen active on both TA98 and TA100 that has been previously reported.