The role of micronutrient deficiency in carcinogenesis

Lessons learned from cancer prevention studies with nutrients and non-nutritive dietary constituents

Epidemiological studies have observed the association between dietary patterns and the risk of certain types of cancer. Extensive studies have been conducted on the cancer preventive activities of constituents from food and beverages. While laboratory research has shown impressive and promising results, such promising cancer preventive activities have not been demonstrated in many human intervention trials. This article analyzes the major differences between these different types of studies and the limitations of these studies. Animal and cell line studies usually use optimal conditions in order to demonstrate the hypothesized effects, sometimes without considering the human relevance. On the other hand, some clinical trials were designed without a good understanding of the biochemical and pharmacological properties of the agents used. Lessons learned from these studies will be illustrated using vitamin E, β-carotene and selenium as examples for nutrients, and green tea polyphenols as an example for non-nutritive dietary constituents. From the lessons learned, we believe that more interdisciplinary collaboration and integration of laboratory and human studies would effectively advance the field of cancer prevention.

Dietary restriction: could it be considered as speed bump on tumor progression road?

Dietary restrictions, including fasting (or long-term starvation), calorie restriction (CR), and short-term starvation (STS), are considered a strong rationale that may protect against various diseases, including age-related diseases and cancer. Among dietary approaches, STS, in which food is not consumed during designed fasting periods but is typically not restricted during designated feeding periods, seems to be more suitable, because other dietary regimens involving prolonged fasting periods could worsen the health conditions of cancer patients, being they already naturally prone to weight loss. Until now, the limited amount of available data does not point to a single gene, pathway, or molecular mechanism underlying the benefits to the different dietary approaches. It is well known that the healthy effect is mediated in part by the reduction of nutrient-related pathways. The calorie restriction and starvation (long- and short-term) also suppress the inflammatory response reducing the expression, for example, of IL-10 and TNF-α, mitigating pro-inflammatory gene expression and increasing anti-inflammatory gene expression. The dietary restriction may regulate both genes involved in cellular proliferation and factors associated to apoptosis in normal and cancer cells. Finally, dietary restriction is an important tool that may influence the response to chemotherapy in preclinical models. However, further data are needed to correlate dietary approaches with chemotherapeutic treatments in human models. The aim of this review is to discuss the effects of various dietary approaches on the cancer progression and therapy response, mainly in preclinical models, describing some signaling pathways involved in these processes.

Colon preneoplasia after carcinogen exposure is enhanced and colonic serotonergic system is suppressed by food deprivation

Calorie restriction regimens usually promote health and extend life-span in mammals. This is partially related to their preventive effects against malignancies. However, certain types of nutritional restriction failed to induce beneficial effects. The American Institute of Nutrition defines calorie restriction as diets which have only 40% fewer calories, but provide normal amounts of necessary food components such as protein, vitamins and minerals; whereas, food restriction means 40% less of all dietary ingredients plus 40% less calories. Our study aimed to test the hypothesis that the latter type of food deprivation (40% less food than consumed by standard fed rats) might increase cancer risk instead of reducing it, as is generally assumed for all dietary restrictive regimens. Since the endogenous modulation of the colon serotonergic system has been observed to play a role during the early steps of carcinogenesis we also investigated whether the serotoninergic system could be involved in the food intake modulation of cancer risk. For this, rats were exposed to a carcinogen and subjected to food deprivation for 56 days. Triglyceride levels and visceral adipose tissue were reduced while hepatic and colonic lipid peroxidation was increased. This dietary restriction also decreased serotonin levels in colon, and gene expression of its intestinal transporter and receptors. Finally, the numbers of preneoplastic lesions in the colon tissue of carcinogen-exposed rats were increased. Our data suggest that food deprivation enhances formation of early tumorigenic lesions by suppressing serotonergic activity in colon tissue.

The influence of micronutrients in cell culture: a reflection on viability and genomic stability

Micronutrients, including minerals and vitamins, are indispensable to DNA metabolic pathways and thus are as important for life as macronutrients. Without the proper nutrients, genomic instability compromises homeostasis, leading to chronic diseases and certain types of cancer. Cell-culture media try to mimic the in vivo environment, providing in vitro models used to infer cells' responses to different stimuli. This review summarizes and discusses studies of cell-culture supplementation with micronutrients that can increase cell viability and genomic stability, with a particular focus on previous in vitro experiments. In these studies, the cell-culture media include certain vitamins and minerals at concentrations not equal to the physiological levels. In many common culture media, the sole source of micronutrients is fetal bovine serum (FBS), which contributes to only 5-10% of the media composition. Minimal attention has been dedicated to FBS composition, micronutrients in cell cultures as a whole, or the influence of micronutrients on the viability and genetics of cultured cells. Further studies better evaluating micronutrients' roles at a molecular level and influence on the genomic stability of cells are still needed.

Esophageal and gastric cardia cancers on 4238 Chinese patients residing in municipal and rural regions: a histopathological comparison during 24-year period

BACKGROUND

Nutrition deficiencies or poverty traditionally have been recognized to be related with increased risk for esophageal cancer (EC) in rural regions at junction of Henan, Hebei, and Shanxi provinces in northern China--the highest incidence area for esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinoma (GCA). Since the 1980s, economic and nutrition condition in these areas have been improved greatly. However, the histopathological types, staging pattern, and occurrence of ESCC and GCA, especially for esophageal adenocarcinoma (EAC), which have been rarely examined in the Chinese population during the past decades in these areas have not been well characterized to date.

METHODS

Yearly diagnosed new esophageal cancer (ESCC and EAC) and GCA patients from Beijing Tongren Hospital (in municipal low-risk region) and Cixian People Hospital (in rural high-risk region) during 24-year period (1982-2005) were studied retrospectively. Only local resident patients with surgical resection were included. Age at diagnosis, tumor stage and site, and histopathological pattern were recorded for each patient from the tumor registry database in these hospitals.

RESULTS AND CONCLUSIONS

This study demonstrated that the common ESCC sites were different in municipal (chiefly in lower third of the esophagus) and in rural (chiefly in middle third of the esophagus) regions. The peak age of ESCC, EAC, and GCA patients in rural region was 10 years younger than in municipal region. Eighty-six percent of ESCC and 90% of GCA in municipal region were diagnosed at middle and advanced stage; similarly, more than 95% of ESCC and GCA in rural region were diagnosed at middle and advanced stage during the 24-year study period. An increasing tendency in number of yearly diagnosed new patients with ESCC and GCA was observed in municipal region, but not in rural region. However, an increasing tendency for EAC was observed both in municipal and rural regions during the past 24-year period. The present results demonstrate the difference in municipal and rural regions of ESCC, ECA, and GCA in histopathological types, and suggest that there may be different etiological factors involved in esophageal and gastric cardia carcinogenesis in these different areas.

Chemical carcinogenesis: too many rodent carcinogens

The administration of chemicals at the maximum tolerated dose (MTD) in standard animal cancer tests is postulated to increase cell division (mitogenesis), which in turn increases rates of mutagenesis and thus carcinogenesis. The animal data are consistent with this mechanism, because a high proportion--about half--of all chemicals tested (whether natural or synthetic) are indeed rodent carcinogens. We conclude that at the low doses of most human exposures, where cell killing does not occur, the hazards to humans of rodent carcinogens may be much lower than is commonly assumed.

Inhibition of the promotional phase of azoxymethane-induced colon carcinogenesis in the F344 rat by calcium lactate: effect of simulating two human nutrient density levels

The effects of 2 levels of dietary calcium and 2 types of dietary fat on the promotional phase phase of azoxymethane-induced colon cancer in the F344 rat were investigated. During the initiation phase of carcinogenesis all animals were fed a 5% corn oil AIN-76A diet containing 0.32% Ca in the form of calcium lactate. Rats were then injected with azoxymethane (AOM) weekly for 8 weeks. Thereafter, the rats were fed 1 of 3 diet formulations: a 5% corn oil diet or a 20% corn oil or 20% American Blend oil fat diet, with the level of Ca set at either 0.32% of the diet, a nutrient density simulating a daily human intake of approximately 1700 mg Ca/day, or at 0.04% of the diet, reflecting a human daily intake of approximately 200-250 mg of Ca/day, thus modeling 2 human nutrient density levels for calcium. Measurements of fecal pH during the experiment indicated an acidic adaptation of the large bowel to the lactate anion. Analysis of collected fecal samples showed more total fatty acids to be present in the colon when higher amounts of calcium were consumed. However, results of the tumorigenesis study indicated that calcium lactate fed at the 0.32% level significantly inhibited the development of colonic adenocarcinoma in all dietary groups. Taken together, this investigation supports the hypothesis that calcium supplementation can inhibit colon neoplasia in rats fed a high fat diet; however, under the conditions of this study, the 20% fat level did not significantly promote colon cancer as compared to a 5% fat level.

Dietary carcinogens, environmental pollution, and cancer: some misconceptions

Various misconceptions about dietary carcinogens, pesticide residues, and cancer causation are discussed. The pesticides in our diet are 99.99% natural, since plants make an enormous variety of toxins against fungi, insects, and animal predators. Although only 50 of these natural pesticides have been tested in animal cancer tests, about half of them are carcinogens. About half of all chemicals tested in animal cancer tests are positive. The proportion of natural pesticides positive in animal tests of clastogenicity is also the same as for synthetic chemicals. It is argued that testing chemicals in animals at the maximum tolerated dose primarily measures chronic cell proliferation, a threshold process. Cell proliferation is mutagenic in several ways, including inducing mitotic recombination, and therefore chronic induction of cell proliferation is a risk factor for cancer.

Immunoregulation of natural and lymphokine-activated killer cells by selenium

The effect of selenium (Se) on natural killer (NK) and lymphokine-activated killer (LAK) cell activities and proliferative responses of human lymphocytes was studied in vitro. Direct addition of Se at 1.0 microgram/ml final concentration to the mixture of target and effector cells during a 4 h cytotoxicity assay significantly suppressed the NK activity of normal lymphocytes. When lymphocytes were preincubated with Se at concentrations as low as 0.2 microgram/ml for a period of 48 h, a significant inhibitory effect on NK activity was observed. In the LAK cell assay, direct addition of Se at concentrations of 0.2-1.0 microgram/ml to a mixture of target and effector cells did not show any effects on LAK cell activity, whereas LAK cells generated in the presence of Se at 0.8 microgram/ml showed significant inhibition of their functions. Lymphocyte proliferative responses to T cell mitogens such as phytohemagglutinin (PHA) and concanavalin A (Con A) were also significantly suppressed by direct addition of Se at 0.5-1.0 microgram/ml. The inhibitory effect of Se was not due to nonspecific toxicity of effector cells as demonstrated by viability nor was the effect directed against target cells. These studies suggest that although Se is an essential micronutrient for various immune mechanisms, an excess of Se may have a deleterious effect on certain immunological functions. As these activities are considered to be important defense mechanisms against tumors and virus infections, a nutritional imbalance of Se could result in an increased risk of these disorders.

Determinants and consequences of colonic luminal pH: implications for colon cancer

Epidemiological data suggest that increased risk of colon cancer is correlated with a higher fecal pH. Although some experimental studies have shown a protective effect against experimentally induced colon cancer by acidifying colonic contents, others have shown that a more acidified colonic content is associated with increased cell proliferation and enhanced tumorigenesis. It is now clear that simply acidifying colonic contents will not consistently result in decreased tumorigenesis. Perhaps the key is how colonic contents are acidified--a decrease in base production or an increase in acid production. Or, more important than luminal pH itself, may be a factor affected by changes in hydrogen ion concentration. This paper reviews the determinants of colonic luminal pH and their dietary sources and discusses important physiological consequences of modifying the pH of colonic contents.